[Long-term follow-up after intravenous injection of mercury--two cases report]. / Wieloletnia obserwacja po dozylnym wstrzyknieciu rteci metalicznej--opis dwóch przypadków.

In this paper we present the long-term follow-up of two patients, after injection of metallic mercury. Case 1. In 1997, 29-years-old man injected himself to left elbow about 20 ml of metallic mercury by mistake (he was heroin abuser for short time). Mercury concentration in the blood was 400 microg/L. X-ray of the chest, abdomen and affected elbow area showed radiopaque foreign material (depots of mercury). Depots of mercury were also visible on the tricuspid valve in echocardiography. Mercury from the soft tissue left elbow pit was partially surgically removed. During 15 years follow-up two times chelating therapy was performed with d-penicyllamine and DMPS. In 2012, he was admitted to hospital next time. The blood and urine mercury concentration was still elevated (55.2 microg/L and 197 microg/L), mercury depots in the lung and abdomen were present. The signs and symptoms of CNS damage, like peripheral polyneuropathy and ataxia, were diagnosed. CT of brain did not revealed any changes, despite head trauma before 6 years. However neurological findings are typical for chronic mercury poisoning, it is not possible to determine whether these changes are directly related to mercury, because head trauma history, Case 2. In 2003, 16-years-old woman injected herself one month before, in suicidal attempts to both elbows several millilitres of metallic mercury. Mercury concentration in the blood was 56.2 microg/L, in urine 906 microg/L and in the hair 1.12 microg/g. Chest Xray showed depots of mercury in the lung. Mercury from the soft tissue was two times surgically removed. During 9 years two times chelating therapy was performed with d-penicyllamine and DMPS. After 9 years there is no symptoms of mercury poisoning. Mercury depots in the lung are still present. The blood and urine mercury concentration is low (13.7 microg/L and 2.53 microg/L). In mean time she gave birth two healthy children. Further patients evaluation is necessary.

Green tobacco sickness in Poland.

Green tobacco sickness (GTS) is an illness associated with exposure to nicotine originating directly from the growing tobacco plant. The exposure takes place in the course of activities during tobacco farming. Nausea, vomiting, headache and dizziness are the symptoms typical of GTS. The GTS cases have been most commonly reported in the USA, Japan, India and Italy. The first case of GTS in Poland has been diagnosed in a young man working on a Virginia bright tobacco plantation. The patient had symptoms typical of GTS. The toxicological analysis of urine demonstrated the presence of cotinine at the level of 869 ng/ml. Intravenous fluids, anticholinergic agents and potassium supplementation were used in the treatment. Interestingly, diplopia at the initial stage of tobacco poisoning and horizontal nystagmus, which resolved on the 2nd day of hospital stay were observed. We believe that cases of GTS occur in Poland; however patients do not seek medical care. Given that the majority of activities during tobacco farming in Poland are performed manually, it seems necessary to launch a public awareness campaign on GTS and decontamination methods.

Diplopia in Green Tobacco Sickness.

This paper examines the first reported case of Green Tobacco Sickness (GTS) in Poland. A 25-year-old man who worked in a tobacco field for 14 hours with no protective measures experienced symptoms of GTS, and additionally, diplopia, after leaving the field. Upon hospital admission, diplopia was no longer observed. Diplopia was most probably caused by disturbances to the cholinergic neuromuscular transmission, secondary to nicotine. These neurological disturbances, the first of their kind observed in the course of GTS, deserve special attention. The case shows a potential adverse health effect related to tobacco harvest, as most Polish tobacco plantations are not mechanized. Polish farmers should be obligated to protect their workers with protective clothing, shoes, gloves and masks. Recommendations for tobacco harvester health are put forth in the paper.

Poisoning from aspiration of elemental mercury.

BACKGROUND: Mercury and mercury compounds (inorganic and organic) can cause acute or chronic poisoning. Acute poisonings, especially with inorganic salts, are widely described, but only sparse data are available on intoxication from oral elemental mercury. We report a case of elemental mercury ingestion followed by pulmonary aspiration of the elemental mercury. CASE REPORT: A 49-year-old woman intentionally ingested about 200 mL (2709 g) of elemental mercury and aspirated during gastric lavage. A chest radiograph demonstrated small radiodense droplets in the peripheral parts of both lung fields. Whole blood mercury concentrations were 330 microg/L on day 3, 457 microg/L on day 8, and 174 microg/L on day 17. The mercury concentration in a random urine sample was 231 microg/L on day 17. The patient was treated with oral d-penicillamine on the 25th-32nd day after ingestion. A hair sample taken from near the scalp on day 31 had a mercury concentration of 1.38 microg/g. The patient demonstrated impaired memory and disturbances in verbal-logical thinking. At 6 months, she had improved clinically; her whole blood mercury concentration was 16.4 microg/L and the mercury concentration in a random urine sample was 141 microg/L. CONCLUSIONS: In this case, systemic absorption of elemental mercury, occured after the ingestion of a massive dose of elemental mercury complicated by pulmonary aspiration.

Poisonings resulting from the ingestion of magic mushrooms in Kraków.

Hallucinogenic mushrooms, also called "magic mushrooms", are becoming a more frequent cause of abuse, especially among young people, who use them experimentally for recreational purposes. In the autumn of 2004, several people were admitted to and observed in the Department of Clinical Toxicology in Krakòw after they had used magic mushrooms to experience hallucinatory sensations. Three of them had visual hallucinations, and the fourth experienced both visual and auditory hallucinations followed by the exogenous psychosis after use of Psilocybe semilanceata. One person was hospitalised for several days while the others were observed in the emergency department. The main source of information for patients about hallucinogenic mushrooms was the internet. In the cases discussed the mushroom poisoning caused no organ damage and the symptoms disappeared in about 6 hours.

[Patulin content in Polish apple juices]. / Wystepowanie patuliny w krajowych sokach jablkowych.

Patulin content has been evaluated in 754 samples of apple juices bought on Polish retail markets in the years 1993-2003. The samples were analyzed by means of the HPLC technique with UV detector. Patulin was found above the quantification limit (5 microg/l) in more than 22% of the samples. Most of the positive results did not exceed the permitted level of 30 microg/l. However, the level was exceeded in 8 samples i.e. in 1.1% of the analyzed samples.