3.5 out of 5 stars
Toxic Alcohols. Kraut JA, Mullins ME. N Engl J Med 2018 Jan 18;378:270-280.
This is a good general review and update of clinical issues regarding the major toxic alcohols: methanol, ethylene glycol, isopropanol, diethylene glycol, and propylene glycol.
The article is chockablock with information, and would I think be somewhat difficult to follow if one was not already familiar with these agents. For those wishing to learn the subject de novo, a good introductory book chapter in a toxicology or emergency medicine text would be better. But this is a very good refresher for those already comfortable with osmolal and anion gaps, alcohol dehydrogenase inhibitors, and indications for hemodialysis in these poisonings.
80 up-to-date references.
Hemodialysis in acute methanol poisoning: is there really good evidence?
NEJM discussion of ethylene glycol poisoning misses important points
Can hemodialysis be avoided in selected patients with significant serum levels of ethylene glycol?
Use of fomepizole in pediatric poisonings
Tox Tunes #12: Canned Heat Blues (Tommy Johnson)
Central pontine myelinolysis associated with ethylene glycol intoxication
Snow White and ethylene glycol — or was it really diethylene glycol?
Do all patients with significantly elevated ethylene glycol levels need to be dialyzed?
Ethylene glycol, murder, and the media
154 admissions for ethylene glycol poisoning — in the same patient!
Severe ethylene glycol toxicity — did therapeutic* vodka really contribute to a good outcome?
Please join me in welcoming Carl B. Shanholtz, MD, Professor of Medicine and Director of the MICU here at the University of Maryland Medical Center. From humble beginnings as a member of the US Navy, Dr. Shanholtz started his medical career in San Diego before finishing his internal medicine here at ...
Thanks so Sam for presenting an interesting case of a 75M s/p esophagectomy + chemo/rads for esophageal cancer who presented with chest pain and palpitations found to have atrial flutter with RVR.
Here’s one approach to supraventricular tachycardia
There are a variety of cardiac complications of radiation.
Here’s an anatomic approach to these complications as well as recommendations about monitoring patients from a Cleveland Clinic review article.