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M Maizels

Publications and source records attributed to M Maizels.

90 records · Page 5Linked to original sources

Effect of sodium content on sodium efflux from human red cells suspended in sodium-free media containing potassium, rubidium, caesium or lithium chloride.

1. Human red cells treated with lactose solution and loaded with NaCl and BCl subsequently exchange cation with a nutrient BCl medium. B is the same in cells and medium, and is either K, Rb, Cs or Li. In these circumstances Na always moves outwards with the concentration gradient, but the efflux is largely active.2. With suspensions in media containing Ca(2+), the total Na efflux depends on the amount of Na in the cells and on the nature of cation B. Thus for any given value of mean cell Na (Na(m)) in excess of 30 m-equiv/l. cells, the effect of B on the amount of Na efflux is K > Cs > Rb > Li, while with Na(m) between 0.7 and 5 m-equiv/l. cells, the sequence is Cs > Li > K, Rb. With Na(m) between 5 and 30 m-equiv/l. cells, intermediate sequences may be demonstrated for the effects of B on Na efflux. This applies both to the efflux itself and to the flux: concentration ratio, FCR.3. FCR for passive Na efflux in these circumstances is determined by adding strophanthin G to the medium. It varies inversely with the duration of exposure to Ca(2+) in the exchange and nutrient media, but not with the nature of cation B. FCR for passive efflux is probably little affected by the value of Na(m).4. By deducting passive from total Na efflux, active Na efflux is obtained, and variations in the latter with cell Na content, and with B, result in FCR curves similar to those obtained with total Na efflux.5. Total and passive Na efflux have also been measured in Ca-free media. Here the passive efflux is considerable, and with Na + K cells in KCl media FCR increases with Na(m), but in other systems this change is not significant. However, the rate of passive efflux into LiCl media is less than that for KCl or CsCl media. Owing to the magnitude of passive flux in Ca-free systems, the total Na efflux is also increased, but FCR for active Na efflux is quantitatively and qualitatively similar to that occurring in systems containing Ca(2+).6. The effects of B and Na(m) on Na efflux give a series of sequences for B which recall some of those obtainable when chemically modified glass membranes separate solutions of salts, and which are attributable to the charge on the membrane and the hydration of the cations involved. However, certain sequences obtained with red cells do not occur with glass membranes. This difficulty is resolved if it be assumed that throughout the range of Na(m) (0-80 m-equiv/l. cells) active B influx at the external cell face modifies linked Na efflux according to the series K > Rb, Cs > Li, while with Na(m) between 0 and 30 m-equiv/l. cells (and high complementary B), cations escaping passively compete with active efflux of Na inhibiting the latter according to the series K, Rb > Li > Cs. Both these series could theoretically be explained in terms of surface charges and hydration of cations.7. Li-loaded cells in nutrient KCl or other media failed to show active Li efflux.

Biological Transport↗

Diagnosis and treatment for children who cannot control urination.

Primary NE is probably a condition rooted in biologic problems. There is a strong hereditary component. Altered nervous system function may lead to disorganization of how bladder function is controlled and how vasopressin is released. In extreme cases, this disorganization may also be reflected in psychologic issues, such as attention-deficit disorder. Primary NE should not be viewed as laziness of the child, but as an obstacle the child needs professional help to hurdle. The practitioner should collaborate with a pediatrician, urologist, and psychologist in managing children who wet. Routine office evaluation should exclude incontinence as a cause of wetting. When a screening ultrasonogram is normal, this helps the practitioner determine that striking birth defects are unlikely. Follow-up of management by interview with interested staff is necessary. Wetting is reliably correctable and probably best addressed by combination treatment structured as an ETP. Specific treatments vary according to personal preferences. The treatment with strongest scientific research, desmopressin, may be the least effective for cure. The most effective treatment for cure, alarm with behavior reinforcement, is the least often prescribed. A miscellany of adjunctive treatments should be suggested when there are abnormalities in functional bladder capacity, defecation, urethritis, vulvitis, diet sensitivity, upper-airway obstruction, and other areas.

Child↗

Gelfoam and autologous clot embolization: effect on coagulation.

An episode of disseminated intravascular coagulation following therapeutic gelfoam embolization to control bleeding from esophageal varices in a patient with liver disease is presented. We have since followed 13 patients prospectively (six control and seven gelfoam/autologous clot) to determine the effect of this procedure on clotting. We were unable to show significant differences between the two groups as measured by the prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and platelet count. However, fibrin (ogen) degradation products were significantly elevated (p less than .01) in the gelfoam/autologous clot group. We suspect this occurred secondary to clot lysis at the site of embolization. No subsequent bleeding diathesis attributable to this abnormality occurred in any of the patients.

Disseminated Intravascular Coagulation↗

Intranasal lidocaine for treatment of migraine: a randomized, double-blind, controlled trial.

OBJECTIVE: To evaluate the effectiveness of intranasal lidocaine for treatment of acute migraine headache. DESIGN: Prospective, randomized, double-blind, placebo-controlled trial. SETTING: Community urgent care department. PATIENTS: A total of 81 patients (67 women and 14 men; median age, 42 years; range, 19-68 years) with a chief complaint of headache who fulfilled criteria of the International Headache Society for migraine participated. Patients were excluded if headache had lasted more than 3 days or if the frequency of severe headache was more than once per week. INTERVENTION: Patients were randomized in a 2:1 ratio to receive a 4 percent solution of intranasal lidocaine or saline placebo, respectively. MAIN OUTCOME MEASURES: The primary outcome measure was at least 50 percent reduction of headache within 15 minutes after treatment. Secondary measures include reduction in nausea and photophobia, use of rescue medication, relapse of headache, and change in headache disability scores. RESULTS: Of 53 patients who received intranasal lidocaine, 29 (55 percent) had at least a 50 percent reduction of headache compared with 6 (21 percent) of 28 controls (P=.004). Nausea and photophobia were significantly reduced (P=.03 and P=.001, respectively). Rescue medication for headache relief was needed in 15 (28 percent) of 53 patients in the lidocaine group vs 20 (71 percent) of 28 controls (P<.001). Among those with initial relief of headache, relapse of headache occurred in 10 (42 percent) of 24 in the lidocaine group vs 5 (83 percent) of 6 in the control group (P=.17), usually within the first hour after treatment. CONCLUSIONS: Intranasal lidocaine provides rapid relief of headache in approximately 55 percent of ambulatory patients with migraine. Relapse of headache is common and occurs early after treatment.

Acute Disease↗