A case report of Clarkson's disease: If you don't know it, you'll miss it

The systemic capillary leak syndrome (SCLS), also known as Clarkson's disease, is a rare disorder characterized by paroxysmal capillary hyperpermeability with a shift of plasma fluid from the intravascular to the interstitial space. A 35-year-old previously healthy woman was admitted with rapidly developing hypovolemic shock syndrome, rhabdomyolysis, and diffuse edema. Laboratory analysis revealed a severe hemoconcentration, renal insufficiency, and paraproteinemia. After exclusion of infection, allergy, burning or drug-induced conditions, the clinical presentation was consistent with the diagnosis of SCLS. Though this is a rare entity, the substantial morbidity and mortality associated with it necessitate the physician's awareness in order to provide timely therapy. This report is meant to enhance awareness of SCLS.

Schiller und das Wiener Burgtheater. Don Karlos-Inszenierungen 1938 und 1955 als Beispiele

Der Beitrag untersucht anhand der Rezeption von zwei exemplarischen Don Karlos-Inszenierungen, die beide in politisch markanten Jahren der österreichischen Geschichte ihre Premiere erlebten, die Funktionalisierung der Institution Burgtheater in Verbindung mit der Funktionalisierung des Dramatikers Friedrich Schiller für eben diese Institution. Eine Neueinstudierung erfolgte 1938, dem Jahr von Österreichs ‚Anschluss’ an Nazi-Deutschland, die andere 1955, dem Jahr der Unterzeichnung des Österreichischen Staatsvertrages. Beide Don Karlos-Inszenierungen fanden als spezifische Festvorstellungen im Rahmen von Feierlichkeiten rund um die Institution Burgtheater statt. Diente 1938 Schillers Don Karlos dazu, als ‚Schlüsselstück’ der ‚nationalsozialistischen Revolution’ einen politisch-gesellschaftlichen Aufbruch zu markieren, so wurde 1955 die Inszenierung des Dramas zum Triumph einer Schauspielerelite, deren Können sich in die konstruierte Tradition eines k.k. ‚Schauspieleradels’ einreihte. Während 1938 der ‚nationale Dichter’ dem ‚heimgekehrten’ Nationaltheater zum ästhetischen ‚Anschluss’ verhalf, diente der ‚überzeitliche’ Klassiker 1955 dazu, eine ästhetische ‚Wiedergeburt’ zu behaupten, die dem restaurativen Kunst- und Kulturbegriff Nachkriegsösterreichs verpflichtet war.

Don't forget asking the others! - The added value of significant other's reports on patient interpersonal style for the prediction of therapy process and outcome

Theory: Interpersonal factors play a major role in causing and maintaining depression. It is unclear, however, to what degree significant others of the patient need to be involved for characterizing the patient's interpersonal style. Therefore, our study sought to investigate how impact messages as perceived by the patients' significant others add to the prediction of psychotherapy process and outcome above and beyond routine assessments, and therapist factors. Method: 143 outpatients with major depressive disorder were treated by 24 therapists with CBT or Exposure-Based Cognitive Therapy. Interpersonal style was measured pre and post therapy with the informant‐based Impact Message Inventory (IMI), in addition to the self‐report Inventory of Interpersonal Problems (IIP‐32). Indicators for the patients' dominance and affiliation as well as interpersonal distress were calculated from these measures. Depressive and general symptomatology was assessed at pre, post, and at three months follow‐up, and by process measures after every session. Results: Whereas significant other's reports did not add significantly to the prediction of the early therapeutic alliance, central mechanisms of change, or post‐therapy outcome including therapist factors, the best predictor of outcome 3 months post therapy was an increase in dominance as perceived by significant others. Conclusions: The patients' significant others seem to provide important additional information about the patients' interpersonal style and therefore should be included in the diagnostic process. Moreover, practitioners should specifically target interpersonal change as a potential mechanism of change in psychotherapy for depression.