[A case of acute voluntary poisoning with flecainide in a suicide attempt]. / Su un caso di intossicazione acuta volontaria da flecainide a scopo suicida.

A case of acute poisoning caused by an overdose of flecainide (1.5 gr. per os), taken in order to commit suicide, is described here. With a plasmatic concentration of 5000 ng/ml the drug induced a soporose condition, shallow breathing with phases of apnea and intermittent muscular clonuses, a clinical picture of shock with a idioventricular rhythm at a rate of 40/min. and widening of the QRS (400 msec.). The infusion of orciprenaline and 5% glucose solution induced an increase in the ventricular frequency and the normalization of the circulatory condition. Twenty hours after ingestion sinus rhythm was restored. Highest therapeutic level of flecainide was reached 48 hours after ingestion. The stimulation threshold during the acute phase was 1.8 mA and came down 1.3 mA after wash-out. The outcome was favourable.

[Introduction to total parenteral nutrition]. / Introduzione alla nutrizione parenterale totale.

Total parenteral nutrition constitutes a recent resource of intensive therapy that can be applied to a great number of clinical cases. Its realization however requires precise knowledge of metabolic problems and of possible technical complications. As it is not exempt from risks it must be applied with specific competence and in carefully chosen cases.