Arterial perfusion for hydrofluoric acid burns.

The perfusion method is briefly summarised: 1 An arteriogram (under brachial plexus block) is carried out, and the radial, ulnar or brachial artery chosen as infusion site, according to the location and extent of the damage. 2 The infusion is administered over 4 h: Radial or ulnar artery 10 ml 20% calcium gluconate in 40 ml normal saline, or brachial artery: 20 ml 20% calcium gluconate in 80 ml normal saline. 3 Heparin 200 u per kg body weight as long as the arterial catheter is in pace.

[Epidemiology of acute drug poisoning in Switzerland]. / Epidemiologie der akuten medikamentösen Vergiftungen in der Schweiz.

In the last five years some 8 in 100 000 people in Switzerland died by poisoning. The majority (74-82%) were suicides, but 14-20% were classified as accidental death. About 40% of all cases involved poisoning by drugs. The most frequent fatal poisons were hypnotics. Among the serious cases reported to the Swiss Toxicological Information Center or admitted to hospital (VESKA statistics), poisonings by combinations of drugs were the most frequent, followed by overdoses of sleeping tablets, analgesics and psychoactive drugs. In children the most frequent causes were analgesics and sleeping tablets. The bromocarbamide poisonings of the early seventies were largely replaced by overdoses of benzodiazepine sleeping preparations and prescription-free barbiturate- and diphenhydramine-containing preparations. In Swiss hospitals the mortality from poisoning by drugs was 1.5%.

[Peroral poisoning with isocyanate and methylenechloride]. / Perorale Intoxikation mit Isocyanant und Methylenchlorid.

Despite worldwide use of organic isocyanates and methylene chloride, little is known of oral intoxication with these substances in human beings. Two suicide attempts and their subsequent clinical course are reported. Coma, shock, relative bradycardia, leukocytosis and metabolic acidosis were ascribed to the effect of methylene chloride. The causes of the necrosis in the gastro-intestinal tract (as demonstrated endoscopically and histologically) of hemolysis and of intravascular clotting are discussed. The prognosis is good after survival of the acute phase. Untoward reactions in cases of pregnancy have not been observed.

[Fatal kidney diseases due to analogesic abuse in Switzerland]. / Tödlich Nierenerkrankungen als Folge des Schmerzmittelmissbrauchs in der Schweiz

As part of an investigation into death by poisoning in Switzerland we were able to examine the register of deaths at the Swiss Federal Bureau of Statistics. All the medical reports which named analgesic nephropathy as being the basic illness and the main cause of death have been taken into consideration in this work. 331 deaths occurred in the five year period 1967-1971, and were studied as closely as the documents allowed. The earliest cases of death arose in the thirties, the maximum number however occurring between the age of 60 and 70. Between the onset of kidney damage and the actual death elapses a period of about 10 years. The ratio from woman to man is almost 2,8:1. The occurrence is particularly frequent among childless housewives. The victims are people of widely different occupations and social classes. The analgesic nephropathy resulting from addiction and leading to death is most frequently encountered among the population of the cities, and the German Swiss Cantons, as well as among people of protestant faith. The shocking number of 331 deaths in five years (in 1973 there were a further 79 cases) bears witness to the need for adequate preventive measures.