Intravenous immunoglobulin therapy for women with RRF and NK or NKT-like cell expansion was a safe and beneficial therapeutic strategy that associated with high clinical pregnancy and live birth rates.
Purpose. To assess complement factors and T lymphocyte activation subset abnormalities in patients with thrombotic antiphospholipid syndrome (APS) as potential biomarkers for development of clinical complications. Methods. We assessed C3, C4, factor B concentrations (nephelometry), complement haemolytic functional activity (CH100, radial immune diffusion), and the activation status of CD4+ and CD8+ T-cells (three-colour flow cytometry) in patients with thrombotic APS. Antiphospholipid (aPL) positive patients without APS-related clinical criteria, systemic lupus erythematosus (SLE) patients, and healthy individuals were evaluated as controls. A clinical followup was performed to assess the potential relationship between the immunological parameters and development of APS-related complications. Results. Lower concentrations of C3 and higher levels of CD8+DR+ cells were risk factors for development of APS-related complications during followup, including rethrombosis and neuropsychiatric symptoms. Patients with diagnosed thrombotic APS had significantly lower levels of C3, C4, and CH100 as well as higher percentages of activated CD4+DR+ and of CD8+DR+ T-cells than healthy controls but similar to that observed in autoimmune disease controls. Conclusion. Lower C3 and C4 complement levels and higher percentages of CD8+DR+ T-cells were observed in thrombotic APS patients. The potential role of these abnormalities as biomarkers of clinical outcome warrants further evaluation in a multicenter study.
found the case in other (homoeopathic) hands. I afterward learned that it was removed, with forceps, after about ten days' delay.Case XIV. A child one year old swallowed a pin one and a fourth inches long, upon which were strung two porcelain buttons one half inch in diameter. I was called to see the patient about eight weeks after the accident, and found it apparently in the last stage of croup ; respiration was rapid and noisy, voice lost, cough croupy, skin cyanotic, and the strength nearly exhausted. On passing my forefinger down into the pharynx I became painfully aware that the pin was present, with its point directed upward ; it was firmly imbedded, was removed with some difficulty with forceps, but the breathing was not improved thereby. Search was then made for the buttons, but they could not be found. The symptoms being urgent, tracheotomy was performed and the air-passages explored, with a negative result. A tracheotomy tube was inserted, but respiration was not improved by the operation. The child lived about four days longer, when it died of inflammation of the laryngeal mucous membrane.Case XV. I was called up at two o'clock in the morning by a middle-aged lady, who had come four miles to consult me. She stated that she had a full set of false upper teeth ; that she had them in her mouth when she retired the night before ; that she awoke at one o'clock, choking ; that she felt the teeth go down into the stomach, and that she had suffered from severe pain in the stomach since. I doubted whether she could swallow so large an object so easily, but she stated that when she went to bed the teeth were certainly in her mouth ; that the bedding had been carefully examined and the whole house ransacked to find the teeth, but they were nowhere to be found ; and that she was sure she had swallowed them. I passed a probang into the stomach, but felt nothing. I then gave her a dose of sulphate of zinc, which operated in two minutes, but no sign of the teeth. I then advised her to go home and fill the stomach with soft food, and await events. I saw nothing more of her for a month, when I called on her to ascertain what followed. She looked somewhat mortified when she told me that after her return home that night another search was made, when the teeth were found under the bed. THE TREATMENT OF TYPHOID FEVER.1
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