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PubMed1984

A comparison of the combination pivmecillinam/pivampicillin and co-trimoxazole in the treatment of convalescent carriers of Salmonella and Shigella.

52 convalescent carriers of Salmonellae (n = 25) and Shigellae (n = 27) were treated with a 4-week course of either co-trimoxazole or the combination pivmecillinam/pivampicillin. 84% of the salmonella isolates and 89% of the shigella were resistant to one or more antibiotics. Sulphonamide resistance was observed in 52 and 58% of the strains, respectively. 12 and 44% of the isolates, respectively, were resistant to ampicillin. All were sensitive to mecillinam and all except 2 were sensitive to co-trimoxazole. In salmonella carriers, co-trimoxazole was successful in 54% of the subjects and pivmecillinam/pivampicillin in 58%. Co-trimoxazole cured 83% of the shigella carriers and pivmecillinam/pivampicillin 87%. Shigella carriers responded to therapy promptly. Concurrent biliary disease or diverticulosis adversely affected the prognosis in salmonella carriers.

Adult↗
PubMed2000

[Changes of femur minerals and serum BGP in hindlimb unloaded rats during convalescence].

Objective. To observe bone mass changes during convalescence after simulated weightlessness. Method. 7-week-old rats were tail-suspended for 21 d then reloaded for 7 d and 21 d to recover, and measured serum BGP. Result. Tail suspension of rats for 21 d caused significant decrease of serum BGP and phosphorus as well as femur minerals. Serum BGP and femur minerals were still lower than control levels, but serum contents of calcium, phosphorus and magnesium increased significantly after reloading for 7 d. Femur minerals and serum BGP, calcium, phosphorus and magnesium returned to control levels after reloading for 21 d. Conclusion. The deficit in femur mineral induced by hindlimb unloading in rats can be restored by return to normal weight bearing, BGP can be used to monitor the case of its recovery.

Animals↗
PubMedDate not supplied

Preliminary evaluation of a convalescence cardiac unit for older patients as a model of "transitional facility" from hospital to home.

OBJECTIVES: The increasing number of older cardiac patients combined with the tendency to reduce hospital stays created the need for a Convalescence Cardiac Unit (Con.CU). It functions as a transitional facility for elderly patients discharged from hospitals after cardiac events, and was established within a geriatric medical center using existing infrastructure and staff. METHODS: Patients from 5 neighboring general hospitals (including 23 internal medicine wards and 3 departments of cardiac surgery) were offered the option of one week stay in the Con.CU after discharge. During the stay in the unit they received medical supervision as well as counsel on matters of nutrition and physical activity. RESULTS: 78 patients were admitted during the first 14 months. Forty patients were after coronary artery bypass grafts (CABG) (51%)30 after acute myocardial infarction (MI) (38%). The average age was 75 +/- 2.5 (SD). Medical complications developed in 57%. Most of these patients were treated by the local staff. Five cases had to be readmitted to the hospital they came from. Elderly cardiac patients that chose the option of Con.CU and their families expressed high appreciation regarding this experience and its contribution in facilitating return home. CONCLUSION: This innovative model is aimed to improve continuity of care for elderly cardiac patients and provide them with a new service in this era of "early discharge" from hospitalization. Geriatric settings striving to diversify their services, and medical directors required to contribute to policy development may learn from this experience.

Journal Article↗
PubMed2003

[Changes in bone strength during convalescence after immobilization induces bone loss--experiment with adult rats].

The aim of the present study was to evaluate the impact of a hindlimb immobilization on mechanical properties of mature bone, both cancellous and cortical tissue. The effectiveness of bone recovery during free activity after remobilization was also studied. The right hindlimb of mature 24 weeks old male rats was immobilized for three weeks. Femora and proximal tibiae methaphyses as well as the straight muscle of thigh were investigated post mortem just after immobilization period or four weeks after remobilization. Mass of the muscle, mass, density and mineralization of bones as well as mechanical properties in axial compression (tibiae metaphyses) or in three-point bending (femora) were measured. After immobilization all parameters were significantly lower in immobilized tibia than in the left, loaded and in respect to the right tibia in the control group. In femur a decrease of dry mass was observed, without any change of breaking force and work to fracture. After four weeks of convalescence, a significant worsening of mechanical competence of femur, and no recovery in tibia was stated. The results obtained indicate that a restoration of mobility without any additional rehabilitation is not enough to stop the processes of bone deterioration induced by unloading in mature bone.

Animals↗
PubMed1992

[The use of plasma from donor convalescent patients in the combined treatment of peritonitis].

The article analyses the treatment of 12 patients with diffuse purulent peritonitis in whom the titers of specific antibodies against microflora causing peritonitis were corrected in the period of secondary immunodeficiency. The authors suggest a new method for the treatment of peritonitis which is based on inclusion of convalescents' plasma after peritonitis in the therapeutic complex. This plasma contains specific antibodies against the cultured microflora in high titers and is a polyvalent hyperimmune medium which makes it possible to cause an effect on the level of humoral immunity. This improved the results of treatment: the titres of specific antibodies against the cultured microflora grew, such complications of diffuse peritonitis as the formation of circumscribed abscesses in the abdominal cavity and suppuration of the postoperative wound were encountered less frequently, mortality reduced by 16.6% as compared to the control group. The efficacy of the suggested methods was also proved in experiments on 164 animals.

Animals↗
PubMed2005

Prevalence of malnutrition and risk factors in geriatric patients of a convalescent and rehabilitation hospital.

OBJECTIVES: To investigate the prevalence and risk factors of malnutrition in geriatric patients admitted to a convalescent and rehabilitation hospital. DESIGN: Cross-sectional study. SETTING: Regional hospital, Hong Kong. PATIENTS: A total of 120 patients (aged 60 years or older) referred to Tung Wah Eastern Hospital. MAIN OUTCOME MEASURES: Anthropometric, biochemical, and haematological parameters were measured for nutritional assessment. Malnutrition was defined as a body mass index of lower than 18.5 kg/m(2) and serum albumin level of lower than 35 g/L. The clinical outcomes of patients were also recorded. The predictive value of the Chinese Mini Nutritional Assessment as a nutritional screening tool was assessed. Potential risk factors associated with malnutrition were evaluated according to established protocols. RESULTS: The mean age of patients was 80.3 years (standard deviation, 7.4 years), and the mean body mass index was 21.9 kg/m(2) (standard deviation, 4.4 kg/m(2)). The prevalence of malnutrition was 16.7%. The age distribution of malnourished patients (mean, 86.2 years; standard deviation, 7.0 years; n=20) was significantly different to those nourished (mean, 79.1 years; standard deviation, 6.9 years; n=100) [P=0.0001]. Mortality was also higher in malnourished patients (25%) than nourished patients (4%) [P=0.001]. Based on the Chinese Mini Nutritional Assessment, 16.9% of patients were classified as malnourished (cut-off value, 18.5). The Chinese Mini Nutritional Assessment was useful as a screening tool to exclude patients who were not malnourished, ie it had a high negative predictive value (95%). Being totally dependent for the performance of activities of daily living, living in a home for the elderly, and being chair- or bed-bound posed a significantly increased risk of malnutrition. The presence of mental depression (geriatric depression scale score of 8 or higher), moderately or severely impaired cognitive function (abbreviated mental test score of lower than 7), or polypharmacy (five medications or more) did not significantly affect risk of malnutrition. CONCLUSIONS: Malnutrition was common in the geriatric patients studied and was associated with an increased mortality. The Chinese Mini Nutritional Assessment was a useful screening tool to exclude malnutrition. Significant risk factors of malnutrition were total dependence, living in a home for the elderly, and being chair- or bed-bound.

Age Factors↗
PubMed1989

[Blood gas changes during treadmill exercise in convalescents from pulmonary tuberculosis. 1. Method of measurement].

With advances in treatment for tuberculosis, pulmonary tuberculosis has become curable. However, chronic respiratory failure has been more often observed in those who have ever had thoracic operation, and were cured with anti-tuberculous chemotherapy in spite of initially severe pulmonary tuberculosis with wide spread lesions in both lungs, particularly in the aged. Therefore it is now necessary to understand accurately the real physio-dynamic situation of respiro-circulatory impairment in these patients. For this purpose, an exercise test was newly designed, and changing curves of blood gas (O2- and CO2-partial pressure, measured transcutaneously) were drawn in 4 healthy persons and 23 recovered patients from pulmonary tuberculosis. The newly designed method was carried out by using Treadmill walk apparatus (Nihon-Denki Sanei Co., Japan), transcutaneous blood gas measurement apparatus (Radio-Meter Co., Copenhagen) and automatic blood pressure measurement apparatus (Kyorin Co., Japan). Treadmill walk exercise test was done through Bruce-Sheffield converted method. The details of this exercise test are written and illustrated in this paper. The results of the test were classified into 4 types by the changes of transcutaneously measured O2 partial pressure curve during the test: 1. unchanged, 2. slightly decreased, 3. moderately decreased, 4. markedly decreased. The significance of these 4 types will be discussed in the next report after examining more convalescents from pulmonary tuberculosis. The reproducibility of this test was examined in 6 patients, and it was almost good. In addition, in 3 out of 27 patients, odd curves contrary to our expectation, that is increase of the value of trans-cutaneously measured O2 partial pressure and/or decrease of the value of trans-cutaneously measured CO2 partial pressure immediately after the initiation of the first test were observed. But in the second test, carried out in the other day, the curve fell into one of the 4 types mentioned above. The odd curve might be due to psychological hyperventilation.

Adult↗
PubMed1987

Antigenic variation of the viruses belonging to the tick-borne encephalitis complex as revealed by human convalescent serum and monoclonal antibodies.

Solid-phase enzyme-linked immunoassay (ELISA) was used for the detection of antigenic relationships and/or differences among the viruses belonging to the tick-borne encephalitis (TBE) complex. Monoclonal antibodies of IgM class with haemagglutination-inhibiting activity to the Skalica strain of TBE virus were used to compare the TBE complex viruses. Antigenic analysis of 9 viruses of the TBE complex, isolated from Eurasia and America showed close relationships among them. Nevertheless, it was possible to differentiate the Skalica strain from Langat, louping-ill and Omsk haemorrhagic fever (OHF) viruses by ELISA when monoclonal antibodies and antigens were diluted 1:10,000. Monoclonal antibodies to the Russian spring-summer encephalitis virus did not react with the Skalica strain in immunofluorescence test. By the use of convalescent serum no reaction was found with louping-ill, Russian spring-summer encephalitis, Powassan and OHF viruses in haemagglutination-inhibition (HI) test.

Animals↗
PubMed1988

Adjustment problems of spouses of patients undergoing coronary artery bypass graft surgery during early convalescence.

Our purpose was to assess the social adjustment of spouses of patients who had undergone coronary artery bypass surgery during the patients' early convalescence. Specifically the study focused on social support and social activities, affective responses, and financial, marital, and sexual difficulties. Following an exploratory descriptive design, we conducted a semistructured interview using Benson's (1984) Social Adjustment Scale. A sample of 26 spouses were interviewed in a cardiology clinic 4 to 10 weeks after their mate's bypass surgery. Associations between demographic characteristics and the level of adjustment were determined by chi-square (adjusted for continuity) analysis. Nineteen spouses reported a high level of vigilance, with 13 reporting that this was a change since their mate's surgery. Ten spouses reported their economic level to be highly inadequate, and all of those stated that their economic situation had changed since surgery. A small number of subjects rated their mate as being dependent on them, and they had feelings of anxiety, fear, and depression. All of those subjects described this as a change since surgery. The majority of subjects had a low level of marital friction and a high level of communication with their spouse. Those married 30 years or longer were generally those satisfied with their level of social support.

Adult↗
PubMed1987

Fatigue and muscle amino acids during surgical convalescence.

Muscle and plasma amino acids, subjective fatigue and body weight were studied in 16 patients before and 20 days after uncomplicated elective abdominal surgery. Fatigue increased from a mean (+/- SEM) preoperative level of 2.4 +/- 0.4 arbitrary units to 4.4 +/- 0.5 on postoperative day 20, while body weight fell from 67.3 +/- 2.5 to 64.7 +/- 2.9 kg (both differences p less than 0.001). Correlation was found between increase in fatigue and fall in body weight (r = 0.56, p less than 0.05). Plasma amino acids showed little change after surgery. In muscle, the nonessential amino group taurine, asparagine, glutamate and glycine increased and histidine and arginine decreased (both p less than 0.05) postoperatively. No correlation was found between postoperative fatigue and weight loss versus changes in muscle amino acids. Some of the well-defined immediate postoperative changes in muscle amino acids thus persisted into late, otherwise uncomplicated convalescence, but postoperative fatigue was related only to weight loss--not to changes in muscle or plasma amino acids.

Adolescent↗
PubMed1987

Persistence of a positive test for IgM antibodies to hepatitis A virus in late convalescent sera.

We had the opportunity to carry out a long-term follow up of 15 patients with viral hepatitis Type A. The serum IgM response to hepatitis A virus (HAV) was investigated with a commercially available kit (HAVAB-M). IgM antibodies were detected in all specimens collected during the acute phase of the disease and during early convalescence (first 3 months). However, there was a clear decrease in the "sample-to-cutoff" ratio (s/co ratio) after the first 2 months. Serum samples were available from six patients 30 to 32 months after onset of illness. Two of these were positive for IgM anti-HAV, but the s/co ratios were low. These results point to the need for careful evaluation of the diagnosis of acute or recent viral hepatitis Type A when low s/co ratios are obtained.

Acute Disease↗
PubMed1976

[Preventive and therapeutic effect convalescent zona and varicella sera in high risk children (659 cases)].

Study of 659 cases treated with serum from patients convalescent after herpes zoster and chickenpox over a period of two and a half years in French hospital departments, showed the obvious effectiveness of this type of therapy which seems to be better than that of zoster specific gamma globulin used by other workers since we obtained protection against chickenpox in 90 p. cent of cases, and attenuation of chickenpox in 82 p. cent. It would seem that these results could be improved by increasing the doses used.

Chickenpox↗
PubMed1984

[Bioelectric activity of the brain in the acute and convalescent periods of tick-borne encephalitis in children].

The bioelectrical activity of the brain was studied in 86 children in the acute period of tick-borne encephalitis and during convalescence. A total of 183 electroencephalograms were analyzed, predominantly in the subclinical form of the disease (153). The acute stage was characterized by impairments in the bioelectrical activity of the brain in children of all age groups. The severity of the disorders and the form of the disease were closely correlated both according to the data of the baseline EEG and the findings of the functional tests. The changes were mostly manifest in a lowered threshold of cerebral excitability and, consequently, in increased convulsive readiness. In the course of the follow-up (2-3 years) these changes leveled off.

Acute Disease↗
PubMed1978

Spirometry in convalescent hemiplegic patients.

The forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) were determined in 20 patients with convalescent hemiplegia. The FVC and FEV1 were reduced and the PEFR was within normal range. These results indicate a restrictive ventilatory defect with an FEV% that approached the vital capacity. The physical ability of each patient was assessed on the basis of the time it took to walk a distance of 18.5 meters as quickly as possible. Although it appears from the results that physical ability did not bear any relationship to the degree of restrictive ventilatory defect, other parameters of spirometry may be needed to confirm this. The results suggest that the restrictive ventilatory defect will be of more clinical importance in exercise tolerance for strenuous exercise than in ordinary daily activities.

Adult↗
PubMed1994

Intake from an energy-dense porridge liquefied by amylase of germinated wheat: a controlled trial in severely malnourished children during convalescence from diarrhoea.

OBJECTIVE: To evaluate the role of an energy-dense diet liquefied with amylase-rich flour from germinated wheat (ARF) in increasing the energy intake in severely malnourished infants and young children and its acceptability to mothers. DESIGN: A randomized controlled clinical trial with two sets of controls. SETTING: Nutrition rehabilitation unit of a large diarrhoea treatment centre where mothers stay with their very severely malnourished children. SUBJECTS: 78 severely malnourished children aged 5-18 months just recovered from diarrhoea. INTERVENTION: Children were randomly assigned to receive either an energy-dense porridge made liquid by adding ARF (test diet) or an unaltered thick porridge of similar energy density (control 1 diet), or the porridge made liquid with addition of water to have the same viscosity as the test diet but of lower energy (control 2 diet), in four major meals a day for 5 days and intake was measured; breast-milk was measured by test weighing. Children also received an additional three milk-cereal meals a day. RESULTS: The mean energy intake (95% CI, P value for difference between test and control) was 385 (339-431), 289 (251-327, P < 0.005), and 255 (222-289, P < 0.001) kJ/kg.d respectively. Feeding test diet was not associated with significant adverse effects e.g. on diarrhoea, vomiting, breast-milk intake, and was well accepted by mothers. CONCLUSION: The results suggest that use of an energy-dense ARF-treated liquefied porridge increases calorie intake by very severely malnourished children during convalescence from diarrhoea, and that it does not produce any adverse effect.

Amylases↗
PubMed1996

Post surgical convalescence of dairy cows with left abomasal displacement in relation to fatty liver.

Blood parameters, feed intake and milk yield were determined in 53 cows with a left displacement of the abomasum (LDA) on the day of surgery (ds; laparotomy and omentopexy) and during the following four days (d1-d4). Using histological methods severe (group SF), moderate (group MF) or no/mild (group NF) fatty liver was found in 32%, 40% and 28% of the patients, respectively. Moderate and severe fatty liver were found almost exclusively in cows in the first three weeks post partum. Post surgery, feed intake and daily milk yield increased steadily in cows of the NF- and MF-group; in cows suffering from severe fatty liver feed intake remained low (p < 0.05). On ds, mean serum levels of nonesterified fatty acids (NEFA), beta-hydroxybutyrate (BHB), total bilirubin, aspartate aminotransferase (ASAT), gammaglutamyl transpeptidase (GGT) and glutamic dehydrogenase (GLDH) in SF-cows were significantly (p < 0.05) higher and values of cholesterol significantly lower (p < 0.05) as compared to the NF- and MF-group; no significant differences were found between the groups in mean serum glucose concentrations. In the four day period following surgery, in all groups mean serum levels of ASAT, GGT, GLDH and cholesterol remained nearly unchanged, whereas total bilirubin, NEFA, BHB and glucose decreased significantly (p < 0.05). Apart from LDA, 55% of the patients were suffering from mastitis, endometritis or lameness. Within three weeks post surgery, 3 cows of the SF-group and 1 cow of the MF-group developed recumbency and liver coma, and were culled for that reason. In conclusion, post surgical convalescence of cows with LDA is clearly related to disturbances of energy metabolism and fatty liver. Therefore, successful treatment of cows suffering from LDA requires the effective treatment of excessive lipomobilization, ketosis and fatty liver along with the immediate surgical correction of LDA.

Abomasum↗
PubMedDate not supplied

[The use of synthetic peptides for detection of antibodies against foot-and-mouth disease virus in the blood from convalescent animals].

Peptides were synthesized, which, according to theoretical analysis of the antigenic structure of protein VP1 of foot-and-mouth disease (FMD) virus types A, 0, and Asia 1, corresponded to potential immunodominant protein sites. Activities of the peptides were studied by solid-phase indirect radioimmunoassay on polyethylene film with purified immunoglobulins against intact FMD virus. Virtually no cross reactions were observed. Blood sera of cattle convalescent after FMD were tested with the FMD virus and peptides containing VP1 fragments 141-160 (A22 No. 550), 140-160 (O1 No. 194), and 140-153 (Asia 1 No. 48). The specificity of interactions between the sera and peptides and the virus was uniform, this permitting the identification of the virus type which caused the disease.

Amino Acid Sequence↗