The systemic capillary leak syndrome: appearance of interleukin-2-receptor-positive cells during attacks
Article Abstract:
Systemic capillary leak syndrome is a rare condition in which plasma leaks from the capillaries into the surrounding tissues. There is usually no apparent cause for the condition. Recently, a 52-year-old woman was diagnosed with systemic capillary leak syndrome; over a period of two years she was admitted to the hospital 10 times as a result of the syndrome. A typical attack included weakness and malaise, difficulty breathing, thirst, a reduction in urine flow, and edema with a weight gain of up to six kilograms. Numerous laboratory tests were performed during these attacks, and it was observed that an increase in the number of white blood cells expressing the cell-surface receptor for interleukin-2 coincided with the attacks. These cells were not thought to represent a malignancy, since they disappeared when the attack abated. The patient was placed on verapamil, which is a calcium antagonist; since that time she has had only minor episodes which have not required hospitalization. Verapamil blocks calcium-mediated cell contraction, and thus may prevent enlargement of the capillary pores through which the plasma leaks. In addition, verapamil also prevents interleukin-2 production; it is not known if this effect is related to the therapeutic benefit. The appearance of interleukin-2 receptor-bearing cells may be symptomatic of some immunological disturbance which also results in the secretion of cytokines which subsequently affect the capillaries. Systemic capillary leak syndrome is sometimes observed as a complication in cancer patients being treated with experimental interleukin-2 therapy. A further abnormality was noted in the present patient; her karyotype contained only 45 chromosomes rather than the usual 23 pairs. The karyotype, which resulted from a 14-22 translocation, was not observed in the patient's relatives. It is not known if this coincidental finding is related to the syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1990
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Using numerical results from systemic reviews in clinical practice
Article Abstract:
Medical professionals may find more practical use for research studies that present treatment effectiveness data in terms of the number needed to treat (NNT) to obtain the desired effect. NNT calculations can be used to express how effective or harmful a treatment is compared to no or other treatments and may be particularly meaningful in combined studies. An NNT of 4, for example, would indicate that doctors would need to treat four patients to obtain the desired effect in one patient. NNT data are concise and can easily be calculated from risk ratio data.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1997
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Fire Ant Attacks on Residents in Health Care Facilities: A Report of Two Cases
Article Abstract:
Indoor attacks by fire ants means there are colonies nearby, and people in the vicinity should consider themselves at risk, even in their homes. In two separate nursing homes in Mississippi, fire ants attacked an immobile resident, resulting in the death of the person. These followed eight previous indoor attacks in other places and a total of six people dead since 1989. Colonies of ants have been found in Arizona, New Mexico, California, and Virginia, and the occasional non-fatal sting is quite common, although often carrying with it some medical problems.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1999
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