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PubMed1994

Convalescence after inguinal herniorrhaphy.

BACKGROUND: The aim of this investigation was to evaluate factors influencing the length of convalescence after ambulant inguinal hernia repair. METHODS: One hundred and twenty-three patients were followed up to assess when they returned to work, considered that they had regained full working capacity, and resumed leisure time activities. The length of sick leave was recommended on the basis of the load of the occupation. RESULTS: Half of the patients had a longer sick leave than recommended by the surgeon. Active and heavy work showed an independent significant positive correlation to the length of sick leave. Median sick leave among these patients was 42 days, which was the time they considered that they had regained full working capacity and 1 week after they had resumed their leisure time activities. Median sick leave among patients with sedentary or moderately active work was 9 days before regaining full working capacity and 12 days before resuming leisure time activities. CONCLUSIONS: Other factors than load of work and surgeon's advice seem to play a role in the patient's decision about when to resume normal activities on the job.

Adult↗
PubMed2003

A program to reduce fatigue in convalescing elderly adults.

This study is an examination of the influence of a fatigue reduction program on the level of fatigue experienced by elderly individuals convalescing in subacute units after lower extremity injury, surgery, or weakness. Fifty participants with a mean age of 81 were divided into two groups of 25 participants. The experimental group received a fatigue reduction program consisting of planned rest periods after bathing and therapy; high-protein, high-carbohydrate liquid supplement; and a 3-minute back rub at bedtime. Each participant's level of fatigue was tested soon after admission and 1 week later, and data were analyzed using the paired t test. The difference between the change in pre-test and post-test scores of the two groups was significant in all three measures of fatigue. The experimental group exhibited a significantly greater reduction in fatigue. The outcomes reinforced the value of nursing interventions that have been an integral component of nursing care from its beginning: promoting nutrition, alternating periods of activity and rest, and including a back rub in evening care.

Aged↗
PubMed2001

Trajectory, transition and vulnerability in adult medical-surgical patients: a framework for understanding in-hospital convalescence.

Relatively recent changes in health care have seen shorter hospital stays and a considerable increase in day-only admissions, anticipated to involve 60% of all patients admitted for surgery and/or investigations within the next couple of years. Surprisingly little is known about the experiences of the approximately 40% of patients who will begin to convalesce in hospital following illness, trauma or surgery. Findings from a qualitative study, briefly reported here, identified a sense of vulnerability in transition as a significant discomfort. By examining assumptions underlying the care of patients recovering in hospital, the nexus between system-determined care trajectories transition, and patient vulnerability can be identified and problems suitably addressed.

Australia↗
PubMed1991

Failure of ciprofloxacin to eradicate convalescent fecal excretion after acute salmonellosis: experience during an outbreak in health care workers.

OBJECTIVE: To determine the efficacy of ciprofloxacin therapy in eradicating convalescent fecal excretion of salmonellae after acute salmonellosis. DESIGN: Randomized, placebo-controlled, double-blind trial of ciprofloxacin, with prospective follow-up of nonparticipants. SETTING: An acute care community hospital experiencing an outbreak of salmonellosis. PATIENTS: Twenty-eight health care workers developed acute infection with Salmonella java; 15 participated in a placebo-controlled trial of ciprofloxacin, beginning on day 9 after infection. INTERVENTIONS: Eight patients were randomly assigned to receive ciprofloxacin, 750 mg, and 7 patients to receive placebo; both were administered orally twice daily for 14 days. Nonparticipants who received therapy were placed on the same ciprofloxacin regimen. MEASUREMENTS AND MAIN RESULTS: Study participants had follow-up stool cultures every 3 days initially and then weekly for 3 weeks; nonparticipants were followed until three consecutive cultures were negative. All eight ciprofloxacin recipients showed eradication of S. java from stool cultures within 7 days of beginning therapy (compared with 1 of 7 placebo recipients), and their stool cultures remained negative up to 14 days after discontinuing therapy (P less than 0.01). However, 4 of 8 relapsed; their stool cultures became positive between 14 and 21 days after therapy. In addition, 3 of 3 hospitalized patients treated with ciprofloxacin who did not participate in the controlled trial also relapsed. Thus, the total relapse rate was 7 of 11 (64%; 95% CI, 31% to 89%). In 4 of these 7 patients, relapse was associated with a longer duration of fecal excretion of salmonellae than that of the placebo group. Relapse could not be explained on the basis of noncompliance, development of resistance, or presence of biliary disease. CONCLUSIONS: Despite its excellent antimicrobial activity against salmonellae and its favorable pharmacokinetic profile, ciprofloxacin at a dosage of 750 mg orally twice daily had an unacceptably high failure rate in patients with acute salmonellosis and may have prolonged fecal excretion of salmonellae. The late occurrence of relapses indicates the need to obtain stool cultures up to 21 days after therapy to document fecal eradication in acute salmonellosis.

Acute Disease↗
PubMed1997

Clinical and experimental studies on acupuncture treatment of apoplexy at the convalescent stage by consciousness-restoring method.

The consciousness-restoring method and the conventional method of acupuncture were used for treatment of 92 cases of apoplexy at the convalescent stage. They were randomly divided into 2 groups: the consciousness-restoring group (50 cases), and the conventional group (42 cases). The therapeutic results show that the cure rates in the former and latter groups are 43% and 16.67% respectively. The markedly effective and effective rates in the former group are significantly higher than that in the latter group. The experimental results demonstrate that there is remarkable improvement in the majority of criteria of blood rheology, blood lipid, micro-circulation and thrombus formation in vitro, in the former group, and the degree and extent of improvement are markedly better than the latter group.

Acupuncture Therapy↗
PubMed1999

[Hospitalization and convalescence after hysterectomy. Open or laparoscopic surgery?].

Approximately 6,000 hysterectomies are performed per year in Denmark. The major part of these are performed by laparotomy, although the use of laparoscopically assisted techniques is increasing. Laparoscopic surgery seems to lead to a reduction in the need for postoperative hospitalization and convalescence, which is confirmed in the few available randomised and to our knowledge all retrospective studies. The length of stay seems to be reduced from four to two days if the patient is hysterectomised by the laparoscopically assisted or vaginal techniques. The introduction of endoscopic techniques has caused a change in routines and recommendations, but not for women operated by the classical open procedures. In this article we question the relevance of comparing different types of operations given the fact that the routines and recommendations are different.

Convalescence↗
PubMed1999

[Goncharov's novel Oblomow as an example of the story of impeded convalescence].

After the termination of an illness involving a long period of being bedridden and in need of care, not every patients is willing to immediately terminate the state of being ill. Some patients show a more or less concealed resistance to return into their customary social lives, which can hinder the progress of convalescence and rehabilitation. Two of the possible bases for such behaviour were described in depth in medical, but above all in non-medical literature: for one in Goncarov's novel Oblomov, published in 1859, and for another in numerous reports concerning the possible consequences of boredom. To recognize a patient's proneness to such behaviour at an early stage and to be able to implement appropriate countermeasures, extensive knowledge of the person of Oblomov, so called oblomovism, and boredom with its various sequelae is required.

Adult↗
PubMed2000

Evaluation of the antibody specificities of human convalescent-phase sera against the attachment (G) protein of human respiratory syncytial virus: influence of strain variation and carbohydrate side chains.

The C-terminal third of the attachment protein (G) of several human respiratory syncytial virus isolates was obtained as either a glycosylated protease-resistant fragment of the purified protein or a nonglycosylated GST fusion protein expressed in bacteria. The reactivity of human convalescent-phase sera with both forms of the protein segment was evaluated in immunoblots. While all serum samples reacted with the mature intact protein of the different isolates, only certain samples reacted with the nonglycosylated C-terminal segment of some viral isolates. The number of human serum samples reacting with the glycosylated C-terminal fragment was even more limited. These results highlight the heterogeneity of the human antibody response against epitopes located in the C-terminal hypervariable region of the G molecule and the influence of carbohydrate side chains for expression of these epitopes. We also have analysed the specificities of human sera by competitive enzyme-linked immunosorbent assay with murine monoclonal antibodies (MAbs). Most human serum samples inhibited virus binding of MAbs that recognised conserved or group-specific epitopes of the G protein, while only a limited fraction of those samples inhibited binding of MAbs that recognised strain-specific epitopes. These results are discussed in terms of the antibody repertoire induced after human respiratory syncytial virus infection and the relevance of escape mechanisms to preexisting antibodies for the evolution of this virus.

Adolescent↗
PubMed1976

Convalescence following coronary surgery: a group experience.

The patient who has heart surgery and returns home will experience many problems in adjusting to a modified lifestyle. Successful rehabilitation depends on many factors-the knowledge the patient has about his condition, his own motivation and the support he receives from family and friends. If he has received good teaching in the hospital, his task will be much easier. But is in-hospital teaching enough? Current nursing research suggests that patients are more receptive to health teaching after they have returned home and benefit from sharing experiences with a group. The author describes the results of an investigation into the concerns of convalescent coronary patients and their wives and tells how group sessions helped ease their transition from hospital to a productive lifestyle.

Adult↗
PubMed2000

[Renal involvement in convalescents after icterohemorrhagic leptospirosis].

Icterohemorrhagic spirochetosis convalescents develop slowly regressing renal dysfunctions most frequent of which are chronic renal failure, pyelonephritis and tubulointersticial nephritis, arterial hypertension. Renal disorders may be due to immunopathological reactions followed by activation of bacterial microflora. Damage from commissures at the sites of prior hemorrhage is also possible. In bovine leptospirosis renal damage is not so severe but it tends to progression. So, renal affection in leptospirosis is a specific pathology observed in any clinical form of the disease and demands surveillance in the regions of local focuses.

Adolescent↗
PubMed1976

In vitro studies on cell-mediated immune response to tick-borne encephalitis virus: findings in convalescents and human subclinical infections.

Peripheral blood leukocytes from tick-borne encephalitis (TBE) convelescents (manifest and inapparent forms) working with TBE virus-containing material and from individuals without specific serum virus neutralizing antibodies (VNA) were studied in capillary tube leukocyte migration experiments. Partially purified TBE virus preparations were used as antigen. Under standardized conditions a strong inhibitory reaction was observed in convalescents with significantly higher values in persons recovered from an abortive form of infection only. These results differed markedly from values recorded in persons without specific VNA. Significance of correlation between humoral VNA titres and the intensity of the cell-mediated component of the immune response (CM IR), as indicated by leukocyte migration inhibition (LMI) values, was less than P equals 0.25.

Adolescent↗
PubMed2001

[Convalescence recommendations after hysterectomy. A study of opinions among Danish physicians].

INTRODUCTION: The aim of this study was to describe advice and restrictions given by Danish general practitioners (GPs) and gynaecologists to patients after uncomplicated hysterectomy. MATERIALS AND METHODS: Four hundred and ninety-one randomly selected GPs and 433 gynaecologists received a postal questionnaire in 1998/1999. The questions concerned the length of recommended sick leave, lifting restrictions, and time to resumption of seven defined common activities after hysterectomy. In addition, the gynaecologists were asked about the use of vaginal packaging, bladder catheters, and expected length of hospital stay. RESULTS: The total response rate was 72%. GPs and gynaecologists recommended a median of 4 weeks (1-8 weeks) of convalescence after hysterectomy to patients, whose work did not involve heavy lifting, and a median of six weeks (2-12 weeks) to women, whose work did. Responses concerning the resumption of common activities showed considerable variation, for instance patients were advised to postpone sexual intercourse for a median of four weeks postoperatively (0-12 weeks). Lifting restrictions varied from lifting a maximum of 15 kg for two weeks to a maximum of 2 kg for 12 weeks. CONCLUSION: A considerable variation was found in recommendations and regimens for hysterectomised patients. Evidence-based guidelines do not exist, and until these are available, the national and local boards of physicians need to agree on what restrictions should be given to patients.

Attitude of Health Personnel↗
PubMed2000

[Therapeutic hemodynamic effects of external counterpulsation on elderly patients with brain infarction during convalescence].

The therapeutic hemodynamic effects of external counterpulsation(ECP) and medical routine therapy in elderly patients with brain infarction during convalescence were investigated by Transcranial Doppler (TCD). The results showed that hemodynamic parametres(Vp, Vm, DVp, DVm) and asymmetry of MCA in elderly patients with brain infarction who were treated with ECP have improved significantly(P < 0.001), but that of MCA in elderly patients with brain infarction who were treated with medical routine therapy have not significantly improved. Therapeutic hemodynamic effects of ECP on elderly patients with brain infarction were much better than that of medical routine therapy(P < 0.001).

Aged↗
PubMed2003

Treatment of severe acute respiratory syndrome with convalescent plasma.

In March 2003, an outbreak of severe acute respiratory syndrome started in Hong Kong. A 57-year-old woman had a typical presentation, including fever, non-productive cough, malaise, lymphopenia, and raised liver aminotransferases. The clinical course and successful treatment with convalescent plasma, ribavirin, and corticosteroids are discussed.

Convalescence↗
PubMed1962

Viral hepatitis. A study of hyperbilirubinemia with acholuria in convalescence.

In 42 patients convalescing from viral hepatitis, the total and 1-minute serum bilirubin levels were measured on the day bilirubin was first demonstrated to be absent from the urine. The levels of total bilirubin ranged from 0.5 to 6.2 per 100 ml. of blood (mean 2.8 mg.), while the levels of the 1-minute bilirubin ranged from 0.3 to 3.3 mg. per 100 ml. of blood (mean 1.5 mg.). The reason for acholuria in the presence of the elevated 1-minute direct van den Bergh measurements is not clear, but may be due to the failure of the van den Bergh reaction to accurately measure the exact concentrations of free and conjugated bilirubin present in the plasma.

Bile Pigments↗
PubMed2004

[A preliminary report of SARS coronavirus specific RNA in SARS convalescents and medical person].

OBJECTIVE: To observe the method of fluorescent-polymerase chain reaction (F-PCR) and gene-hip technique in detecting coronavirus in severe acute respiratory syndrome (SARS) and its value for clinical application. METHODS: Serum of 60 SARS patients, 20 samples of serum and 20 samples of gargling fluid of medical staff of the "Fever Clinic", and one cDNA specimen obtained from one SARS suspect patient were examined with F-PCR diagnosis kit and gene-chip technique for SARS coronavirus. RESULTS: Three methods, including DR Chip and two F-PCR kit from Zhongshan College Da'an gene stock company and Shanghai Fortune industrial joint-stock Co, Ltd, were used, and the results were all negative for all specimens, except one cDNA specimen, which was obtained from one SARS suspect patient, virus could be amplified by F-PCR. CONCLUSION: Special RNA fragment of SARS virus has not been detected in gargling fluid and serum of SARS convalescents and medical staff.

Adolescent↗
PubMed1992

[Viral hepatitis A and the possible pathogenetic mechanisms of a protracted convalescence].

Metabolites of connective tissue (free serum oxyproline, protein-bound plasma oxyproline, total urine oxyproline, serum glycosaminoglycans), proteolytic enzyme elastase, proteolysis inhibitors (alpha 1-inhibitor, alpha 2-macroglobulin) were investigated in 103 patients with viral hepatitis A. It was established that connective tissue and its metabolites produce a negative effect on hepatocytic repair. Longterm convalescence is attributed to elastase hyperactivity in the presence of relative deficiency of proteolytic inhibitors.

Adolescent↗