Since 1981, high frequency jet ventilation (HFJV) has been used in 300 patients undergoing surgery, most commonly during i.v. general anaesthesia for endoscopy and surgery of the airways: laryngoscopy, bronchoscopy, laryngeal microsurgery and laser surgery (more than 230 patients); repair of tracheal stenosis, tracheal sleeve pneumonectomy and tracheal sleeve lobectomy. HFJV was administered through a narrow injection catheter inserted in the airway, with a second rigid catheter positioned distally to the injector in the airway for gas sampling and measurement of airway pressure. In all subjects gas exchange was satisfactory, even during tracheoplasty and bronchoplasty.
1 A woman developed severe mercury intoxication from ingestion of about 2.5 g of mercuric chloride. 2 Antidotal treatment with a dithiol (BAL i.m.) and a monothiol (tiopronin i.v.) was started promptly. 3 Dialysis treatment thereafter markedly increased the elimination of mercury, thus hastening recovery. 4 It is suggested that chelating agents associated with dialysis are an effective treatment for mercury poisoning.
A form for recording acute toxicological cases has been preliminarily applied to a sample of 436 subjects admitted during 1978 into the hospitals of two districts of the Venetian Region. One was predominately manufacture and industry, and the other a mountain-agricultural area. The latter had medical facilities less uniformly distributed. Through epidemiological analysis, the acute poisoning cases from psychoactive drugs (benzodiazepines, barbiturates, antipsychotic agents, and tricyclic antidepressants) prevailed (37.9%). They were followed by acute cases from street heroin or other opiates in addicts (25.7%) that only occurred in the main town of the more industrialized district. The incidence of the other poisoning cases were in the following decreasing order: household poisons (9.8%), nonnarcotic analgesics (5.1%), agricultural poisons (4.1%), cardiovascular drugs (3.7%), miscellaneous drugs (1.4%), food and plants (1.4%), oral contraceptives (1.0%), viper envenomization (0.7%), and insect bites (0.7%). A rate of 8.5% was due to unidentified compounds. Mortality was 0.9% and death occurred after exposure to corrosives, carbon monoxide, or undetermined substances. Between the two districts there were no marked differences in emergency and general measures that mainly consisted in supportive treatment with forced diuresis (13.9%) and gastric lavage (only 21.4%).
A form is presented for recording acute toxicological case histories for statistical purposes. It includes personal data, case history, social and environmental data, characteristics of the poison(s), history of the intoxication, general and prevailing signs and symptoms, criteria of diagnosis, emergency measures, specific and antagonistic treatment before and during hospitalization, clinical laboratory findings, toxicological analysis, and progression of symptoms until full or partial recovery or death. This form was developed in the course of retrospective research, and can be used either for telephone emergency calls or as a part of the clinical file. Through the elaboration of the compiled forms a strict cooperation between the assisting services and the Specialized Toxicology Centre may allow for better preventive and therapeutic measures.
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