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PubMed1992

Doppler assessment of left ventricular diastolic filling pattern during the convalescent stage of acute myocardial infarction. Effects of infarct size and coronary thrombolysis.

Pulsed Doppler echocardiography was used to study left ventricular diastolic filling pattern (LVDFP) over the convalescent stage of acute myocardial infarction (AMI) in 25 patients. Twelve normal subjects served as a control group. The patients were divided on the basis of enzymatically estimated infarct size into 2 groups: 7 as the large AMI group, and the other 18 as the small AMI group. Peak early diastolic filling velocity (E) and the ratio of E to peak filling velocity at atrial contraction (E/A ratio) were determined from the Doppler transmitral flow velocity recordings at 1 and 4 weeks after the onset of AMI. At 1 week E and E/A ratio were significantly lower in the small AMI group compared to the control and the large AMI groups, however, there was no significant difference in E and E/A ratio between the control and the large AMI groups. E/A increased with cumulative CK release among the patients (r = 0.54, p < 0.01). In the following 3 weeks E and E/A ratio decreased only in the large AMI group, and E and E/A ratio at 4 weeks weakly correlated with pulmonary capillary wedge pressure (r = 0.63, p < 0.01 and r = 0.65, p < 0.01) and ejection fraction (r = 0.50, p < 0.05 and r = 0.62, p < 0.01) among the patients. There was no significant difference in E or E/A ratio between patients with and without coronary thrombolysis. Thus, LVDFP in the early convalescent stage of AMI was characterized by low E and E/A ratio in patients with small AMI, however, a "pseudonormalized" pattern was observed in patients with large AMI. The effect of the infarct size on LVDFP diminished in the late convalescent stage of AMI. LVDFP in patients with AMI appears to be influenced by the infarct size and by the time of study. The effect of coronary thrombolysis on LVDFP was not evident throughout the convalescent stage of AMI in this study.

Convalescence↗
PubMedDate not supplied

[Use of natural vitamin supplements in children during convalescence and in children with athletic activities].

BACKGROUND AND AIMS: Sporting activities and periods of convalescence call for an added intake of nutrients in children. This study aimed to evaluate the effect of a natural vitamin supplement on diet, food intake, body composition and muscular strength in children during convalescence and in children practising sports. METHODS: A comparative study was performed in two different groups of subjects: 20 children aged between 6 and 12 years old during convalescence following infections of upper airways, and 20 9-year-old children forming part of a football team. All subjects were randomly subdivided into two groups who were respectively given a vitamin supplement (Vitality Roeder 2000 Junior) or a placebo for 4 weeks. Weight, body composition using and muscolar strength using dynamometer measured before and after the study and a food diary was kept for 3 days before each visit. RESULTS: No significant differences in body mass and strength emerged from the data collected in the athletic group, whereas an increase was observed in appetite, calorie intake, weight and muscular strength in the convalescent group (p < 0.05). A significant increase in vitamin B12, B3, B5 and D levels was observed in both groups. CONCLUSIONS: The supplement to provides an adequate intake for those categories at risk of vitamin deficiency or in conditions of increased requirements.

Child↗
PubMed1999

[Cardiovascular function in leptospirosis convalescents].

AIM: To study mechanisms of cardiovascular damage in leprospirosis convalescents. MATERIALS AND METHODS: Cardiovascular system was investigated in 121 leptospirosis convalescents at the age 17-58 years clinically, electrocardiographically and measuring troponin-T in blood serum. RESULTS: 6-12 months after leptospirosis 42.1% of patients who had leptospiral jaundice (88.4%) and bovine leptospirosis (21.6%) myocardial damages were revealed. In spite of disappearance of cardiac pain ECG readings did not return to normal. The myocardial damage has developed in the advanced stage of leptospirosis due to rhandomyolis: high concentration of myoglobin and troponin-T in the blood serum confirms this suggestion. CONCLUSION: Clinical ECG readings as well as the level of troponin-T in the blood serum may be considered as the index of rehabilitation level in leptospirosis convalescents. It should be taken into consideration that 19.8% of the convalescents develop hypertension of renal genesis. This should be accounted for when planning prophylaxis and rehabilitation programs for young patients living in the North Caucasus--natural source of leptospirosis.

Adolescent↗
PubMed2003

[Outcome and tendency of late convalescence in icterohemorrhagic leptospirosis].

To elucidate the time of onset and duration of complications of icterohemorrhagic leptospirosis (IL), a clinical course of early and late convalescence was analysed in 170 patients who were followed up for 1.5-9 years. It was found that affection of hepatobiliary, urinary, cardiovascular and nervous systems persisted for a year after the acute disease in 65.3, 67.6, 31.8 and 13.5% patients, respectively. The organ of vision was affected for 1 year in 7.1% patients. A total of 86% patients retained the above disorders in early convalescence (for a year). In early convalescence the author observed development of such diseases as chronic hepatitis, a latent stage of chronic renal failure, myocardiac myocardiodystrophy. Nervous and ocular complications manifested both in early and late convalescence (4-18 months). The complications combined in 66.0% cases, renal dysfunction + hepatic dysfunction being most frequent. Endogenic infection foci activated within 6 months after IL. In 19.4% patients, the pathological process prolonged up to 1.5 years. In 5.3% patients it can last for several years. It is concluded that IL patients should be followed up for 1.5 years, combined pattern of organ affection typical for IL should be taken into account.

Adolescent↗
PubMed1992

Potential for hepatic and renal dysfunction during influenza B infection, convalescence, and after induction of secondary viremia.

Whether infection with influenza B virus alters hepatic function was examined in the ferret. Also, the possibility that viral-specific antibodies (Ab) could be produced well before their detection in serum was explored. During the febrile period of influenza, reductions in the serum potassium, anion gap, ammonia, albumin and CPK and elevations of the BUN, creatinine and the GGTP levels occurred. With convalescence, the electrolytes, BUN and creatinine normalized, FFA, SGPT and CPK levels rose and the serum GGTP rose even further. Hepatic fatty acid (FA) oxidation, ornithine transcarbamylase (OTC) and carnitine palmitoyltransferase (CPT) activities were minimally altered and liver ATP and total lipid content remained normal. Following experimental secondary viremia, serum FFA continued to rise, TG decreased and CPK remained elevated while SGPT and GGTP levels normalized. In the liver, FA oxidation and OTC rates remained unchanged but CPT activity was inhibited and the liver content of ATP was significantly reduced. Immune complex (IC) protein recovered from postmicrosomal supernatant fractions by polyethylene glycol precipitation was progressively increased in livers from convalescent and viremic animals. While the amount of IC protein recovered in the spleen also increases during convalescence, this is not the case after viremia when the IC formed seem to be processed largely by the liver. By SDS/PAGE, the major proteins identified in the IC were IgM and other viral proteins. However, the viral proteins could not be validated by immunoblot with Ab produced against purified influenza B hemagglutinin (HA) and neuraminidase (NA) most probably due to phagocytic alterations of glycoprotein immunodeterminants. These findings indicate that during influenza, convalescence and post viremia changes in the concentrations of several serum and liver components occur that reflect hepatic involvement. Also, antiviral Ab, largely IgM, appears to be produced early, complexes with Ag and can be found sequestered in both the liver and spleen at a time when Ab is not detectable in the serum.

Adenosine Triphosphate↗
PubMed2004

[Dynamic changes of immunoglobulin G in convalescents who have suffered from severe acute respiratory syndrome patients].

OBJECTIVE: To investigate the dynamic changes of the antibody specific to severe acute respiratory syndrome (SARS) coronavirus in convalescents who have suffered from SARS. METHODS: Samples of peripheral blood were collected twice during the first 2 weeks after discharge and then once every 2 - 4 weeks from 310 convalescents of SARS, 131 males and 179 females, aged 18 - 74, discharged from hospitals in Beijing April 3 to June 20 2003 with the average discharge date of June 10, to detect the level of immunoglobulin G (IgG) by ELISA. A curve of level of IgG was drawn to describe the change by the specific month in the year. RESULTS: Most of the 310 convalescents underwent successive or non-successive testing for 2 - 4 months and 15 were tested for 5 months, 15 for 6 months, and 2 for 7 months. IgG was detected in each sample with the mean of A value of 0.97 +/- 0.37 (0.197 - 1.849). The mean IgG level peaked in July (1.203), about 35 days after discharge, and then gradually declined to 0.857 in December, a decline by 27.3%. CONCLUSION: All SARS patients generate specific antibody against the coronavirus. However, the antibody level gradually decline with the lapse of time during the convalescence. Long-term surveillance of the change of antibody is necessary.

Adolescent↗
PubMed1988

Convalescent phase of bipolar disorder.

The interepisode interval in bipolar disorder has been relatively unstudied, in part because patients are generally considered to be well during that period. The author proposes that a symptomatic convalescent phase follows acute episodes of mania and depression and precedes the return to the entirely well state. A case is presented of a 15-month convalescence that followed a manic episode. The most prominent features of the convalescence were its long duration, its saw-toothed pattern of remitting and recurring symptoms, and the presence of dysphoria. The fluctuation of dysphoric symptoms was at times associated with and at times independent of life events and was independent of lithium levels. Supportive psychotherapy is apparently a critical element in the management of this phase. Questions about the nature and optimal management of the convalescent period are raised.

Bipolar Disorder↗
PubMed1995

Smaller ports result in shorter convalescence after laparoscopic varicocelectomy.

Minimal postoperative pain and a shorter convalescence after laparoscopic surgery are attributable to the small puncture wounds produced to accommodate trocars. We investigated the effects of trocar size on convalescence after 37 laparoscopic varicocelectomies. The initial 21 patients underwent the procedure with 2, 10 mm. ports and 1, 5 mm. port, while the last 16 underwent surgery with 3, 5 mm. ports. Postoperative convalescence was evaluated by a questionnaire. The patients who underwent the 5 mm. port technique achieved complete pain relief, returned to work and could resume work at preoperative levels significantly earlier than those who underwent the 10 mm. port technique (2.4 +/- 1.5 days versus 5.9 +/- 4.8 days, p < 0.03; 8.2 +/- 3.1 days versus 10.0 +/- 2.5 days, p < 0.03, and 10.2 +/- 4.4 days versus 14.3 +/- 6.5 days, p < 0.03, respectively). Our study showed that laparoscopic surgery with smaller ports resulted in less postoperative pain and a shorter convalescence than when larger 10 mm. ports were used.

Adolescent↗
PubMed1993

Drug prescribing for the elderly outpatient and for those confined to convalescent hospitals. How the new OBRA laws will change some established habits.

Families as well as state and federal inspectors have long complained of unnecessary drugs prescribed by physicians, especially antipsychotic drugs, used as chemical restraints in skilled nursing facilities. The US Congress passed the Omnibus Budget Reconciliation Act of 1987 (OBRA), also commonly referred to as the Nursing Home Reform Act, to prevent inappropriate prescribing of medications in long-term care facilities that receive funds from Medicare and Medicaid. The regulations became effective October 1, 1990 and were enforced starting in 1991. Future regulations regarding drug labeling of all prescriptions, including biologics, are being proposed by the Food and Drug Administration for the protection of the elderly from adverse drug reactions in the community. A survey was performed in a 132-bed convalescent hospital in Los Angeles to assess the most frequent types of drugs ordered and the most frequent diseases found in this facility. The study revealed the most frequent diagnosis and drugs ordered on admission to the facility from acute facilities, home, and board and care facilities. The diagnosis differed, and the drugs the patients were taking differed markedly at the time of admission. Attending physicians in the convalescent hospital changed many of the drugs to meet the needs of the convalescent hospitals as well as the new OBRA regulations. Future prescribing habits of physicians will be modified in convalescent hospitals, and the results will need further studies to assess its effect on patient care.

Aged↗
PubMed1998

[Ambulatory laparoscopic cholecystectomy. Feasibility and convalescence].

UNLABELLED: The purpose was to describe feasibility of and convalescence after laparoscopic cholecystectomy in a day case set up in this prospective, open, and descriptive study. Fifty consecutive patients referred for elective cholecystectomy participated. An overnight stay was planned for 13 patients, (12 because they lived alone, one because of pulmonary disease ASA III). The operation was in all cases performed under combined epidural-general anaesthesia. The primary issues were duration of hospital stay, reasons for delayed discharge, frequencies of nausea and vomiting, as well as duration of convalescence and reasons for postponement of return to work or recreational activities. Twenty-six patients (of 37 candidates for day case surgery) were discharged on the day of surgery and 16 on the first postoperative day. Eleven patients had nausea, and three vomited during the first three postoperative hours. Pain was the most common contributory reason for overnight stay (17 patients, eight of these being planned day-case patients who stayed overnight). The patients were recommended to resume work and recreational activities after 48 hours, but 35 patients did not observe this recommendation. The median number of days off work or recreational activity was four days (2-8), including the day of surgery. Pain was the most common contributory reason (19 patients). CONCLUSIONS: Laparoscopic cholecystectomy can be performed as an outpatient operation in more than half of all patients, in approximately 70% of patients not living alone, and with only 15% of the patients requiring more than one over-night stay. Postoperative pain is the primary reason for both delayed discharge and prolonged convalescence. Up to one week's duration of convalescence is recommended.

Adult↗
PubMed2004

Platelet degranulation and monocyte-platelet complex formation are increased in the acute and convalescent phases after ischaemic stroke or transient ischaemic attack.

Flow cytometric studies suggest that platelets are activated in ischaemic stroke or transient ischaemic attack (TIA). However, few studies have measured circulating leucocyte-platelet complexes in this patient population. Whole blood flow cytometry was used to quantify the expression of CD62P-, CD63-, and PAC1-binding, and the percentages of leucocyte-platelet complexes in acute (1-27 d, n = 79) and convalescent (79-725 d, n = 70) ischaemic cerebrovascular disease (CVD) patients compared with controls without CVD (n = 27). We performed a full blood count, and measured plasma levels of soluble P-selectin, soluble E-selectin, and von Willebrand factor antigen (VWF:Ag) as additional markers of platelet and/or endothelial cell activation. The median percentage CD62P expression and the median percentage monocyte-platelet complexes were higher in both acute and convalescent CVD patients than controls (P </= 0.02). The mean white cell count and mean VWF:Ag levels were significantly elevated in the acute and convalescent phases after ischaemic stroke or TIA (P </= 0.02). Otherwise, there was no significant increase in any other marker of platelet or endothelial activation in CVD patients. There was a positive correlation between the percentage expression of CD62P and the percentages of both neutrophil-platelet and monocyte-platelet complexes in the acute phase, and the percentages of all leucocyte-platelet complexes in the convalescent phase after ischaemic CVD. This study provides evidence for ongoing excessive platelet and/or endothelial activation in ischaemic CVD patients despite treatment with antithrombotic therapy.

Acute Disease↗
PubMed2004

[Rehabilitation therapy of convalescents after hemorrhagic fever with renal syndrome in outpatient clinic].

AIM: To assess clinical efficacy of mineral water and perindopril in convalescents after hemorrhagic fever with renal syndrome (HFRS) in outpatient setting. MATERIAL AND METHODS: The study covered 113 HFRS convalescents. HFRS was confirmed serologically. The patients were divided into three groups: group 1 (n = 50) received no rehabilitation care; group 2 (n = 32) drank mineral water "varzi-yatchi"; group 3 (n = 31) drank mineral water and took perindopril (2 mg/day). After-treatment continued for 30-35 days. The effect was assessed by a complex of clinical-laboratory and functional tests for examination of renal functions (Reberg-Tareev, Zimnitsky tests, estimation of uric acid clearance and renal functional reserve, an 18-hour water deprivation test). RESULTS: Mineral water varzi-yatchi and perindopril had a favourable effect on clinical condition and renal functions of HFRS convalescents. Compared to the controls (p < 0.05), they had less severe weakness, lumbar pains, edema of the lower limbs; positive changes in intraglomerular hemodynamics, renal transport of beta 2-microglobulin (MG), uric acid transport. CONCLUSION: It is shown that HFRS convalescents have defective glomerular and tubulointerstitial systems of the kidneys. These disorders demand a differential therapeutic approach. Drinking mineral water improves some tubular functions. The addition of perindopril is necessary in detection of arterial hypertension, impairment of intraglomerular hemodynamics, hyperexcretion of beta 2-MG, osmoregulating renal dysfunction.

Adolescent↗
PubMed2004

[Protective effect of specific antibody in serum of convalescent patient with SARS].

OBJECTIVE: To investigate inhibitory effect of serum severe acute respiratory syndrome (SARS) -specific antibodies from convalescent patients after half an year of onset on SARS-CoV-mediated cytopathic response. METHODS: SARS-CoV immunoglobulin G (IgG) antibody was determined by enzyme linked immunoadsorbent assay (ELISA). Twelve serum samples from convalescent patients, diluted by 1:8 with maintenance medium, were mixed with the three dilution supernatants of SARS-CoV. SARS-CoV were isolated, cultured and identified by the Guangzhou Institute of Respiratory Disease, and cultured with Vero E6 cell suspension. The extent of cytopathic response was observed. RESULTS: The absorbance (A) value of SARS-CoV IgG antibody ranged from 0.81 to 2.06 in patients after half an year of SARS onset, and form 0.79 to 2.01 in patients before half an year of SARS onset. The extent of cytopathic response was decreased by more than 25% in all 12 convalescent patients, as compared with control serum. CONCLUSION: The A value of SARS-CoV IgG antibody in serum of convalescent patients tended to elevate in half an year after SARS onset. SARS-CoV IgG antibody could inhibit SARS-CoV-mediated cytopathic response, indicating it might be one of protective antibodies.

Adult↗
PubMedDate not supplied

Immunologic comparisons of Pneumocystis carinii strains obtained from rats, ferrets, and mice using convalescent sera from the same sources.

Pneumocystis carinii (Pc) infections were developed in animals immunosuppressed by dexamethasone treatment either from activation of latent infection (ferret) or trans-tracheal inoculation of Pc obtained from infected lungs of the homologous species (rat, mouse). Convalescent antisera were obtained by stopping dexamethasone treatment after 2-4 wk and allowing 5-8 wk for recovery. Parasites from infected lungs were purified by differential filtration, solubilized in loading buffer, subjected to sodium dodecyl sulfate- polyacrylamide gel electrophoresis, and blotted to polyvinylidene fluoride sheets for Western analysis. Antisera from each animal species were reacted on Western blots of antigens from rat, ferret, and mouse. Each combination of antigen and antibody from the same species of animal showed reaction with 5 or more bands of Pc antigen. Convalescent mouse antibody did not react with rat or ferret antigens. Convalescent rat antibody reacted with a mouse antigen at about 66 kDa but not with ferret antigen, and convalescent ferret antibody showed minimal, probably non-specific reactions with both rat and mouse antigens. Variations in reactions indicate antigenic differences in Pc strains infecting these animals.

Animals↗
PubMed2026

Widespread Molecular Imprints in the Serum Proteome of COVID-19 Convalescents Uncovering Immune System Sequelae.

Post-COVID-19 sequelae have become an emerging global health issue, but the mechanisms for the sustained susceptibility of convalescents to the sequelae remain poorly understood. Here we report the use of a restricted open-search approach to explore the molecular imprints of SARS-CoV-2 infection left on the proteome of 412 COVID-19 patients and convalescences. A total of 827 non-standard amino acid variations, chemically modified residues as well as post-translational modifications, termed non-coded amino acids (ncAAs), are found spreading over 29,814 sites in patient's serum proteins. Markedly, widespread ncAAs are induced and sustainedly imprinted on the serum proteome predominately perturbing the immunoglobulin-mediated immune response, complement activation and coagulation regulation even 12 months after recovery. Sustained amino acid variations and chemical modifications are found in the complementary&#x2011;determining regions (CDRs) of the variable region of immunoglobulin contributing to the interactions between the emerging antibody and antigens; durable chemical amino acid modifications found in the hyper ncAA-modified regions of the constant region of immunoglobulin important for the interaction with the complement and regulatory receptors. In the complement system, inducible ncAAs are memorized in the components essential for the complement activation, amplification cascades and membrane attack processes. Thus, the workflow described in this study can be used to identify the molecular imprints of viral infection at the proteomic scale, particularly the specific antibodies and the immune targets left in COVID-19 patients and convalescents.

Humans↗
PubMed1999

Occult lifelong persistence of infectious hepadnavirus and residual liver inflammation in woodchucks convalescent from acute viral hepatitis.

Traces of hepatitis B virus (HBV) genome can persist for years following recovery from hepatitis B. To determine overall duration, molecular characteristics, and pathological implications of this serologically undetectable form of hepadnaviral carriage, we have analyzed the expression of transcriptionally active virus genomes, their infectivity, and examined liver alterations during the natural lifespan of woodchucks convalescent from acute infection with HBV- related woodchuck hepatitis virus (WHV). In this study, we document lifelong persistence of scanty amounts of replicating virus both in the liver and lymphatic system after spontaneous resolution of an episode of experimental hepadnaviral hepatitis. Antibodies to virus nucleocapsid (core) were found to be the most reliable immunovirological marker coexisting with occult infection. In the majority of convalescent woodchucks, serial liver biopsies showed protracted minimal to mild necroinflammation with periods of normal morphology; however, hepatocellular carcinoma (HCC) ultimately developed in 2 of 9 animals studied. Inocula derived from lymphoid cells of convalescent animals induced classical acute hepatitis in virus-naive woodchucks that progressed to chronic hepatitis and HCC in 1 of the animals, demonstrating infectivity and pathogenic competence of the carried virus. Our results reveal that low levels of infectious WHV and residual hepatic inflammation usually continue for life after resolution of hepatitis and that this recovery does not avert HCC development. They also demonstrate that, in addition to the liver, the lymphatic system is the site of the occult lifelong maintenance of replicating hepadnavirus.

Acute Disease↗
PubMed2005

Use of convalescent plasma therapy in SARS patients in Hong Kong.

In order to evaluate the efficacy of convalescent plasma therapy in the treatment of patients with severe acute respiratory syndrome (SARS), 80 SARS patients were given convalescent plasma at Prince of Wales Hospital, Hong Kong, between 20 March and 26 May 2003. Good outcome was defined as discharge by day 22 following the onset of SARS symptoms. Poor outcome was defined as death or hospitalization beyond 22 days. A higher day-22 discharge rate was observed among patients who were given convalescent plasma before day 14 of illness (58.3% vs 15.6%; P<0.001) and among those who were PCR positive and seronegative for coronavirus at the time of plasma infusion (66.7% vs 20%; P=0.001).

Blood Component Transfusion↗
PubMed1979

The response to an oral glucose load during convalescence from hypoxia in newborn infants.

The ability to tolerate an oral glucose load during convalescence from hypoxia was studied in four term and 11 premature appropriate-for-gestational-age infants by sequential measurements of the changes occurring in blood pH, bicarbonate, plasma lactic acid, and plasma glucose following an oral glucose load. All infants developed metabolic acidosis and lactic acidemia after the oral glucose load. The maximum fall in blood bicarbonate occurred at 30 minutes, and the maximum rise in plasma lactic acid concentration was attained at 60 minutes. The metabolic changes were found to be more severe in infants given the oral glucose load early in their convalescence and in those infants less than 10 days of age. The absorption of glucose was also decreased in these infants, as shown by a reduced rise in blood sugar. These observations indicate that newborn infants, term or premature, tolerate glucose loads poorly during convalescence from hypoxia.

Acidosis↗