Methanol poisoning usually comes to the forefront of both professional and general public interest at times, when there is a larger outbreak, outside of these periods these cases appear sporadically. They occur in the whole world, in the developed countries as well as in the developing ones, independently of any restriction on the consumption of alcoholic beverages by the state. In Czech society this topic came to surface especially in 2012, when as a result of methanol intoxication the minimum of 50 people died and many more suffer permanent damage. The trickiness of methanol lies in the fact, that it is not possible to recognize it from ethanol in an alcoholic drink or in any other mixture. Most often it penetrates the organism by way of ingestion; it can also be absorbed through the skin or by inhalation. Methanol itself is not toxic; its metabolites (formaldehyde and formic acid) however present a problem. Typical symptoms include visual disturbances, deepening metabolic acidosis with an increased anion gap and damage to basal ganglia, particularly the putamen. The intoxication is further accompanied by a range of nonspecific symptoms such as stomach pain, nausea, vomiting, impairment of consciousness and cognitive functions. The gravity of the intoxication depends on the amount of ingested methanol and on the mixing ratio with ethanol. Therapy consists of administering specific antidotes ethanol or fomepizole, modifying of the internal environment, continuous or intermittent hemodialysis, if necessary and allowed by the patient's condition and in supportive treatment for maintaining the stability of vital functions. Nursing care has an unreplaceable role in treatment of these patients. Nurses come to contact with these patients in every sector of healthcare, they take part in admission, stabilization and monitoring of vital functions, they tend to the invasions as well as to maximal psychic and physical comfort of the patient. They take part in rehabilitation and also help patients returning into normal life. This thesis deals with the properties of methanol, its production and toxicity, it explores methanol intoxication, its symptoms and sequelae, diagnostics and therapy as well as nursing care in detail. It follows the role of nurses of all the sectors of health care in managing all the stages of the intoxication with emphasis on selected nursing activities in the intensive, standard or aftercare. The thesis concludes with 4 documented case studies. The aim of this thesis was to process the information collected on this topic into a complex and current overview of knowledge on methanol poisoning and the possibilities of dealing with it all of the phases of the poisoning including the aftercare of the patients who were affected. A summary of procedures and variations thereof was acquired on the theoretical basis of Czech and foreign sources such as books, renowned periodicals in paper or electronic form and by means of web sites of professional societies. The sum of knowledge this thesis provides can serve for teaching needsor continuing education of healthcare workers concerning diagnostics, therapy and management of the sequelae of this intoxication with special emphasis on the possibilities of nurse´s intervention in any of the phases of it, or to provide base for further research in this area.

(English) Background: Methanol poisoning is severe medical condition with a need of urgent intensive treatment. Mass poisoning outbreak took place in the Czech Republic in 2012-2013. Costs of hospital treatment of methanol poisoning present significant financial burden to healthcare systems. The effect of treatment modality choice on clinical outcome and healthcare costs is not known, as well as its impact on the quality of life of methanol poisoning survivors after hospital discharge. Aim: To compare different therapeutic methods, choice of antidote (fomepizole versus ethanol) and extracorporeal elimination method (intermittent vs. continuous dialysis) for optimizing clinical outcome, cost-effectiveness, hospital costs, post-discharge costs, and the quality of life in survivors. Methods: For prospective cohort study, all patients hospitalized with acute methanol poisoning were included (n=106); for hospital and one-year healthcare costs study, all survivors of acute methanol poisoning (n=83) were included. For longitudinal quality of life study all survivors with informed consent (n=54) and control group of chronic alcohol abusers, age- and gender-balanced, without history of methanol poisoning (n=23), were included. Results: Comparative data of clinical effectiveness of elimination techniques...

Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2017-07-19T12:01:37Z No. of bitstreams: 1 2012 - Ana Paula de Arag?o Gama.pdf: 10152074 bytes, checksum: cf829662b7139672b123740c06d787f0 (MD5) / Made available in DSpace on 2017-07-19T12:01:37Z (GMT). No. of bitstreams: 1 2012 - Ana Paula de Arag?o Gama.pdf: 10152074 bytes, checksum: cf829662b7139672b123740c06d787f0 (MD5) Previous issue date: 2012-08-31 / Funda??o Carlos Chagas Filho de Amparo ? Pesquisa do Estado do RJ - FAPERJ / Considering the practice of using liquid alcoholic yeast (beer yeast) - a byproduct of the brewery industry - for animal feed on some farms in the southern Fluminense region of Brazil, this study was made to establish the safety margin and the clinic-pathological picture of the intoxication characterized mainly by staggering gait, trips and falls; furthermore, to suggest preventive measures that could avoid or minimize this type of alcoholic intoxication in sheep and pigs. It was seen that the clinic-pathologic picture of the experimental intoxication by beer yeast in sheep, and the natural and experimental intoxication in pigs, is similar to that observed in other animal species poisoned by ethanol, or in cattle by beer yeast. Concentrations of 3.8 and 8.875mL/kg of ethanol contained in the yeast, caused respectively mild to moderate clinical signs and severe ones in sheep. As prophylactic measures are suggested (1) appropriated dilution of beer yeast in water or with beer yeast already stored on the farm (old yeast), (2) beer yeast administration proportionally to animal weight/size, (3) continuous administration without interruption, providing other food is given, as soybean or corn meal, with water ad libitum. It was concluded that despite beer yeast is increasingly used for sheep, pigs and cattle on farms in southern Rio de Janeiro state - since many farmers apply one or more prophylactic measure suggested here - ethanol intoxication through beer yeast is uncommon and death rarely occurs; so, the yeast could be used, providing the prophylactic measures are observed. / Considerando a pr?tica de utilizar ?levedo? l?quido (alco?lico) (LC) - subproduto da ind?stria cervejeira - na alimenta??o de animais, em alguns estabelecimentos da Regi?o Sul Fluminense, esse estudo foi realizado para estabelecer as margens de seguran?a e o quadro cl?nico-patol?gico caracterizado principalmente por andar cambaleante, trope?os e quedas; bem como sugerir medidas profil?ticas que impe?am ou minimizem esse tipo de intoxica??o alco?lica para ovinos e su?nos. Verificou-se que o quadro cl?nico-patol?gico na intoxica??o experimental em ovinos e nas intoxica??es natural e experimental em su?nos, ? semelhante ao observado em outras esp?cies intoxicadas por etanol ou em bovinos pelo LC. Concentra??es de 3,8 e 8,875mL/kg de etanol contido no LC, causaram quadros cl?nicos de leve a moderado e grave em ovinos, respectivamente. Como medidas profil?ticas sugere-se: dilui??o adequada do LC com ?gua, soro de leite ou com o LC j? estocado na propriedade (LC antigo); administra??o do LC proporcional ao peso/tamanho dos animais, administra??o cont?nua, sem interrup??es, disponibilizar outro alimento no cocho, como farelo de soja ou fub? de milho e ?gua ? vontade. Conclui-se que apesar do ?levedo de cerveja? ser cada vez mais utilizado nas propriedades criadoras de ovinos, su?nos e bovinos, no sul do Estado do Rio de Janeiro j? que, muitos propriet?rios aplicam uma ou mais medidas profil?ticas aqui sugeridas, as intoxica??es pelo etanol, contido no LC s?o pouco frequentes e raramente ocorrem mortes, de forma que esse produto deve ser utilizado, desde que as medidas profil?ticas sejam observadas