Presse Med
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Sodium concentrations in erythrocytes are lower in women during the luteal phase of the menstrual cycle than in women studied during the follicular phase and in men. Sodium cotransport activity is lower in women during the follicular phase than in men. Women taking oral contraceptives show no monthly variations in erythrocyte sodium concentrations. ⋯ There is no difference between negroes with or without haemoglobin S. There are no changes in erythrocyte potassium concentrations in relation to sex, menstrual phase, race, familial essential hypertension, presence of haemoglobin S or use of oral contraceptives. These physiological variations indicate the factors which must be standardized to study sodium concentrations in cells and sodium transmembrane flux.
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Case Reports
[Fulminant meningococcemia with intracranial hypertension. External lumbar drainage of cerebrospinal fluid].
An 18-year old girl developed acute fulminating meningococcaemia with meningitis, coma, shock, coagulation disorders and extensive purpura. Measurement of intracranial pressure showed severe intracranial hypertension. After medical treatment of shock and intracranial hypertension had failed, external drainage of the cerebrospinal fluid was performed in the lumbar region, using a 16 G silicone catheter. ⋯ The lumbar drainage was maintained for 12 days during which 3180 ml of blood-stained cerebrospinal fluid were evacuated. The fluid was sterilized by antibiotics as early as the 1st day of the disease, but it remained positive for bacterial antigen up to the 9th day. Cure was obtained without neurological sequelae, thanks to the lumber drainage which controlled intracranial hypertension and removed large amounts of microbial toxins.
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Of 3 alcoholic patients with severe lactic acidosis, one had shoshin beriberi; the second--a beer drinker--presented with convulsions associated with hyponatraemia and complicated by rhabdomyolysis and was not thiamine-deficient; the third patient had convulsions associated with Korsakoff's syndrome and was thiamine-deficient. In all three patients treatment with thiamine administered alone corrected the lactic acidosis within less than 4 hours. In patient 1, this result was obtained after symptomatic treatment of shock and lactic acidosis had failed and more than 24 hours before the haemodynamic disorders were corrected. ⋯ In patient 3, the lactic acidosis was also corrected within 2 hours. These results suggest that thiamine should figure among the treatments of lactic acidosis in alcoholic patients. Since thiamine alone is capable of correcting severe lactic acidosis, at least in some of these patients, it deserves to be tried in other types of lactic acidosis.