The Western journal of medicine
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The Department of Anesthesiology at the University of Washington has grown steadily throughout its first 25 years. Personal reminiscences of old-fashioned anesthesia induction lead to philosophizing on the role of the larynx in the evolution of the human mind and the limited future of computerized administration of anesthesia. Machines will never substitute for the alliance between science and the humane that characterizes modern anesthesiology.
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Although patient preferences are important in decisions about "do not resuscitate" (DNR) orders, little is known about how physicians discuss these orders with patients. We asked 15 physicians to simulate discussing such orders with a patient. ⋯ Physicians gave conflicting reasons for how they individualized discussions with patients. Awareness of such different behaviors may stimulate physicians to examine what they say to patients about this sensitive and important topic and why they say it.
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Seven patients with methanol poisoning were treated with ethanol, hemodialysis and supportive measures. The interval between ingestion and initiation of ethanol therapy varied from 3 to 67 hours and from ingestion to dialysis from 9 to 93 hours. ⋯ A 10% ethanol solution administered intravenously is a safe and effective antidote for severe methanol poisoning. Ethanol therapy is recommended when plasma methanol concentrations are higher than 20 mg per dl, when ingested doses are greater than 30 ml and when there is evidence of acidosis or visual abnormalities in cases of suspected methanol poisoning.