Laparoscopic versus open restorative proctocolectomy for familial adenomatous polyposis

sem informaçãoThis study compared outcomes after laparoscopic (LAP) or conventional (open) total proctocolectomy with outcomes after ileal J-pouch anal anastomosis (IPAA) at a single institution. Methods: Charts from 133 familial adenomatous polyposis patients (1997-202814752sem informaçãosem informaçãosem informaçã

Suicide Attempt Using Pure Methanol With Hospitalization Of The Patient Soon After Ingestion: Case Report

Context: Most patients with methanol poisoning typically show up one to several days after ingestion, presenting severe acidosis, visual disorders, or both. Reports of hospitalization less than 6 h after exposure are unusual. We describe a case of attempted suicide using methanol admitted 3 h after ingestion. Case report: A 52-year-old male was hospitalized 3 h after intentional ingestion of 150 ml of 99.9% methanol with no co-ingestion of ethanol. He was alert and cooperative, presenting nausea and vertigo, and reporting six episodes of vomiting. Physical examination showed no remarkable features. A blood sample for methanol and ethanol determination was obtained 4 h after ingestion. The result (available 10 h after ingestion) showed 70 mg/dl of methanol, without detectable ethanol. He was treated with a loading dose of 10% ethanol solution (7 ml/kg, intravenously), followed by a maintenance dose of 0.9-1.0 ml/kg/h intravenously (10 to 51 h); hemodialysis (19 to 27 h, together with 2.1 ml/kg/h of 10% ethanol intravenously); and folinic acid intravenously (50 mg every 6 h, from 4 to 51 h). He developed mild/moderate metabolic acidosis without acidemia and was discharged on day four after ophthalmological evaluation and cerebral computed tomography scan, without abnormalities. Follow-up revealed no sequelae. Conclusion: This could be classified as a potentially severe case of methanol poisoning, according to the amount and concentration of methanol ingested, and blood methanol concentration at 4 h. The good outcome was attributable to early hospitalization and early antidotal therapy with hemodialysis, starting at 10 and 19 h, respectively.1272108110Barceloux, D.G., Bond, G.R., Krenzelok, E.P., Cooper, H., Vale, J.A., American Academy of Clinical Toxicology Ad Hoc Committee on the Treatment Guidelines for Methanol Poisoning. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning (2002) J Toxicol Clin Toxicol, 40 (4), pp. 415-446Paasma, R., Hovda, K.E., Tikkerberi, A., Jacobsen, D., Methanol mass poisoning in Estonia: Outbreak in 154 patients (2007) Clin Toxicol (Phila), 45 (2), pp. 152-157Kostic, M.A., Dart, R.C., Rethinking the toxic methanol level (2003) J Toxicol Clin Toxicol, 41 (6), pp. 793-800Brent, J., McMartin, K., Phillips, S., Aaron, C., Kulig, K., Methylpyrazole for Toxic Alcohols Study Group. Fomepizole for the treatment of methanol poisoning (2001) N Engl J Med, 344 (6), pp. 424-429Liu, J.J., Daya, M.R., Mann, N.C., Methanol-related deaths in Ontario (1999) J Toxicol Clin Toxicol, 37 (1), pp. 69-7