132 research outputs found

    New aspects in the pathogenesis, prevention, and treatment of hyponatremic encephalopathy in children

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    Hyponatremia is the most common electrolyte abnormality encountered in children. In the past decade, new advances have been made in understanding the pathogenesis of hyponatremic encephalopathy and in its prevention and treatment. Recent data have determined that hyponatremia is a more serious condition than previously believed. It is a major comorbidity factor for a variety of illnesses, and subtle neurological findings are common. It has now become apparent that the majority of hospital-acquired hyponatremia in children is iatrogenic and due in large part to the administration of hypotonic fluids to patients with elevated arginine vasopressin levels. Recent prospective studies have demonstrated that administration of 0.9% sodium chloride in maintenance fluids can prevent the development of hyponatremia. Risk factors, such as hypoxia and central nervous system (CNS) involvement, have been identified for the development of hyponatremic encephalopathy, which can lead to neurologic injury at mildly hyponatremic values. It has also become apparent that both children and adult patients are dying from symptomatic hyponatremia due to inadequate therapy. We have proposed the use of intermittent intravenous bolus therapy with 3% sodium chloride, 2Β cc/kg with a maximum of 100Β cc, to rapidly reverse CNS symptoms and at the same time avoid the possibility of overcorrection of hyponatremia. In this review, we discuss how to recognize patients at risk for inadvertent overcorrection of hyponatremia and what measures should taken to prevent this, including the judicious use of 1-desamino-8d-arginine vasopressin (dDAVP)

    Complexation and distribution of counterions in a grafted polyelectrolyte layer

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    The complexation and the distribution of various cations, bound to a poly(styrene sulfonate) brush, have been investigated using infra-red spectroscopy and neutron reflectivity. Small counterions (like tetremethylammonium) are distributed throughout the brush in such a way that a local electroneutrality is ensured. They also exchange readily with other bulk small cations. On the other hand, model polycations are irreversibly trapped to the brush despite a relative small number of ionic bonds involved in the complexation. These complexed polycations are localized at the outer border of the brush, forming a macromolecular barrier. However, this spatial segregation does not allow the buildup of polyelectrolyte multilayers. Cationic surfactants are associated stoichiometrically with the brush sulfonates but unlike small counterions, this complexation is "irreversible"and induces a restructuring of the polymer interface

    Synthesis of Poly(styrene sulfonate) Brushes

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