Education and the hospital: developing patients' knowledge of health.
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Attitude to Health↗
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Results for “HOSPITALS, CONVALESCENT”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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Hospitalization and personality change: recognition vital to nursing care.
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Adaptation, Psychological↗
Renal transplantation: laparoscopic live donor nephrectomy.
Laparoscopic nephrectomy is now performed at many centers worldwide. This technique for organ harvesting offers less postoperative pain, quicker convalescence, and an optimal cosmetic result when compared with the traditional open approach. With experience, the laparoscopic technique is accomplished without compromise to donor safety or allograft function, and complications are comparable with the rates in open historic series. Longer operative times and the need for disposable equipment result in greater hospital costs; however, the quicker convalescence permits patients to resume activity sooner, allowing marked cost savings for patients and employers. The laparoscopic technique is associated with a steep learning curve. Launching a successful laparoscopic living donor program requires a dedicated coordinated effort involving physicians, nurses, and hospital administration. The ultimate impact of this technique on the willingness of individuals to donate has not yet been determined.
Humans↗
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↗
Feeding convalescent patients; nutritional needs and present cost.
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Convalescence↗
Seduction and the hospitalized person.
Seductive behavior seen in the convalescent individual is generally a signal that the patient is in the process of assessment. It is not a social invitation to sexual activity. The patient is merely trying to reassess his situation after having experienced an illness, injury or surgery. Nurses have an obligation to be informed regarding the effects of illness on sexuality, and an obligation to recognize the patient's seductive signals. Nurses need to recognize the mechanics of seductive behavior and be able to qualify the behavior in order to help the patient express his/her concerns during convalescence. Finally, nurses have an obligation to discover or create referral sources in their local area where patients may seek help with their altered sexual function, should that be warranted.
Female↗
Anaesthesia, surgery, and challenges in postoperative recovery.
Surgical injury can be followed by pain, nausea, vomiting and ileus, stress-induced catabolism, impaired pulmonary function, increased cardiac demands, and risk of thromboembolism. These problems can lead to complications, need for treatment in hospital, postoperative fatigue, and delayed convalescence. Development of safe and short-acting anaesthetics, improved pain relief by early intervention with multimodal analgesia, and stress reduction by regional anaesthetic techniques, beta-blockade, or glucocorticoids have provided important possibilities for enhanced recovery. When these techniques are combined with a change in perioperative care a pronounced enhancement of recovery and decrease in hospital stay can be achieved, even in major operations. The anaesthetist has an important role in facilitating early postoperative recovery by provision of minimally-invasive anaesthesia and pain relief, and by collaborating with surgeons, surgical nurses, and physiotherapists to reduce risk and pain.
Anesthesia↗
[Reduction of surgical access trauma: reliable advantages].
Minimizing the trauma of surgical access is becoming an essential task in modern surgery. The treatment has to become more comfortable for the patient and financial resources have to be considered. Minimally invasive surgery is one of the attempts to achieve this goal. A comparison of surgical procedures, such as cholecystectomy, fundoplication and sigmoid resection in diverticulitis, which are already routinely performed laparoscopically, should be suitable for evaluating whether minor access surgery is really advantageous. The value of minor access may be quantified by different parameters such as influence upon the immunologic function, lung function, postoperative pain, time of hospitalization, return to work and duration of convalescence, as well as a comparison of the effects upon the quality of life index. The data concerning the effects upon immunology are not unequivocal. All in all, the degree of postoperative inflammation seems to be lower after laparoscopic surgery. There is no doubt that there is far less impairment on lung function, the results are better as far as postoperative pain is concerned, and hospitalization and duration of convalescence are shorter. It is also evident that immediately after the operation the quality of life index is superior, which, however, levels out in the course of time. The advantage of minimally invasive surgery is really apparent only after the mastering of the so-called "learning curve" and in cases of benign malignancies. The role of the minor access approach in oncological surgery is, however, not yet defined.
Humans↗
Body weight and body water in chronic cor pulmonale.
1. Body weight was measured through forty consecutive illnesses in seventeen patients with oedema in association with chronic bronchitis and hypoxia. All patients were taking diuretic drugs at the time. 2. Body weight increased little as peripheral oedema and a raised jugular venous pressure appeared. The subsequent weight-loss during treatment was usually greater than the pre-treatment weight-gain. Body weight increased slowly in convalescence to equal or exceed hospital admission weight without a deterioration of general health or reappearance of oedema. 3. Total body water, exchangeable sodium and exchangeable potassium were measured in patients after treatment of the acute illness and clearance of oedema and again in six patients of the group 2-3 months later in convalescence. Total exchangeable sodium was normal or slightly reduced after treatment of oedema and in convalescence between recurrent acute illnesses. Even when gross oedema was present exchangeable sodium was substantially increased in only one of three patients studied at this stage. Total exchangeable potassium was invariably severely depressed. 4. Large changes of body tissue weight without comparable change in exchangeable sodium support previous evidence that oedema in hypoxic bronchitis is not simply a further form of congestive cardiac failure. 5. It is suggested that at least some of the tissue loss in acute exacerbations is a direct result of hypoxaemia and similar to that observed at high altitude. Part of the oedema fluid is thought to be derived from intracellular water released during dissolution of tissue matrix.
Aged↗
Organization and work of medical service during 1992 military operations in north Bosnia (Bosanska Posavina).
During military operations in Bosanska Posavina in 1992, 6,105 soldiers of the army of the Croatian Defence Council (Bosnian Croats and Muslims) were treated at various health care levels: 920 soldiers were killed, 3,258 were heavily wounded, and 1,927 lightly wounded. The treatment was provided in medical units organized on the front line, in the combat area, and in the communication area. On the front line, medical service was organized as battalion units, whereas the area in general was medically covered by the Slavonski Brod Medical Center in Croatia. Slavonski Brod played a key role with surgical treatment of 5,418 wounded, and definitive care was offered to most subjects seeking medical aid. Scarcity of medical personnel on the front lines and long lines of transportation resulted in a 6.5% death rate (354 patients) during transportation from Bosnian battlefields to Slavonski Brod. In contrast, the mortality rate in the Slavonski Brod Hospital was 3.0% (161 patients). Convalescence homes were established in the Slavonski Brod surroundings, whereas specialized health institutions and rehabilitation centers throughout Croatia accommodated those needing advanced treatment.
Bosnia and Herzegovina↗
The effect of balanced analgesia on early convalescence after major orthopaedic surgery.
Forty-two patients scheduled for total knee arthroplasty (n = 20) or hip arthroplasty (n = 22) were randomly allocated to receive either continuous epidural bupivacaine/morphine for 48 h postoperatively plus oral piroxicam, or general anaesthesia followed by a conventional intramuscular opioid and acetaminophen regimen. Patients undergoing knee- or hip arthroplasty treated with epidural analgesia had significantly lower pain scores during mobilization under the 48 h epidural infusion compared with patients receiving conventional treatment, while no important differences were observed after cessation of the epidural regimen. However, the achieved pain relief had no impact on postoperative convalescence parameters, such as ambulation, patient activity including need for nursing care, fatigue or hospital stay. Late postoperative pain, fatigue and conservative attitudes and routines in the postoperative care, were the most important reasons limiting mobilization and activity. We conclude that effective early (48 h) postoperative pain relief with balanced analgesia does not per se lead to important improvements in convalescence and hospital stay.
Acetaminophen↗
[Laparoscopic cholecystectomy. The first 400 cases at Akureyri Central Hospital.].
OBJECTIVE: To assess the outcome of the first 400 laparoscopic cholecystectomies (LC) in Akureyri Central Hospital (FSA), Iceland. METHODS: We carried out a prospective study of LCs performed between July 1992 and February 2001. Primary endpoints were complication- and conversion rate, hospital stay and duration of convalescence. RESULTS: A total of 426 operations were performed in the period. In 26 cases it was decided beforehand to perform an open cholecystectomy (OC). A LC was begun on 400 patients. Indication for operation was acute cholecystitis in 41 cases (10,3%) and an elective LC was performed in 359 (89,7%) cases. Conversion to OC was required in sixteen (4%) cases with a conversion rate in acutely performed LCs of 12,2% versus 3,1% in elective LCs. Mean hospital stay after LC was 3,6 days (1-45) versus 12,3 days (4-31) after OC. Mean operation time was 89 minutes (45-270) in the first 100 LCs versus 75 minutes (30-180) in the last 100 LCs. Duration of convalescence of patients undergoing LC was 13,5 days (4-70). Complication rate in LCs was 10% (40/400). Four patients required a reoperation. CONCLUSIONS: Our results show that LC is a safe procedure in FSA. Conversion rate to OC, complication rate and duration of convalescence stands good comparison to other studies.
English Abstract↗
[The second chart. A retrospective critical analysis of hospital stays of long duration in a public plastic surgery department].
A nine-month retrospective survey related to the long-duration hospital stays was carried out in our plastic surgery department. Twenty five patients were concerned by a more than 21 days hospitalization, the sum of which reached 1,098 days. These figures corresponded to 1.4% of the patients and 14.5% of the hospitalization days. A critical analysis was based on four principles: 1--a plastic surgery department is exclusively devoted to plastic surgery, 2--nursing cares required by the healing of a soft tissues defect don't usually need hospitalization, 3--even if it has a wide surface and/or if it is located on the lower limbs, a skin graft doesn't usually require more than ten days of hospitalization, 4--without complications, a free tissue transfer doesn't usually require more than 15 days of hospitalization. Application of these principles showed that 633 days (58%) could have been theoretically spared. Consequently, it could have permitted to treat a greater number of patients. The cause of delaying patient exit was related to the surgeon in all but one cases. It was associated in 16% of cases with a bed shortage in the convalescent or nursing homes. As hospitalization durations longer than 25 days seemed unwarranted to the authors even in the most complex cases, they suggest a simple way to alert surgeons of their department to the long-duration stays. As the department patient's chart represents 13 days of hospitalization, they ask surgeons make a decision upon planning the exiting of patients before adding a second chart.
Adult↗
Neonatal back transport: clinical outcomes.
The convalescent course of 55 infants transported from a Level III hospital back to the community hospitals from which they were originally transported was compared with the course of 58 infants who convalesced in the tertiary center nurseries. The events in their prenatal course and acute neonatal course were similar, thus making comparisons of their convalescent course possible. Weight gain was greater among the transported infants for infants with birth weights greater than or equal to 2,000 g and comparable if birth weight was less than 2,000 g. Transported infants received fewer transfusions than their nontransported counterparts. Tolerance of feedings, the occurrence of apnea and bradycardia, and use and discontinuance of supplemental oxygen were similar in both groups. Major new health problems occurred in 27% of all subjects, 20% of transported infants and 32% of nontransported infants. Readmission to the tertiary center or a change in status to more intensive care in the tertiary center occurred in 10% of all infants, 7% of transported and 14% of nontransported infants. It was concluded that convalescing infants often presented new clinical problems, in similar numbers and severity whether convalescing in the tertiary center or after back transport to community hospitals. Community hospital care givers were considered alert to these new problems and to have provided appropriate care, including retransfer to the tertiary center when necessary.
Body Weight↗
Percutaneous lithotripsy of staghorn calculi.
Eleven cases of staghorn calculi managed by percutaneous lithotripsy were reviewed. Ten of 11 cases were successful, and 70% of the successfully treated patients were discharged free of any renal stones. The percentage of patients discharged with residual stone fragments was higher than those with either percutaneously managed nondendritic calculi or surgically treated staghorn calculi. The complication rate was higher than for nonbranched stones managed percutaneously and was comparable to that for surgically removed dendritic calculi. Hospital stay averaged 18 days, equal to that for staghorn calculi treated by conventional surgical approach, but considerably longer than for nonbranched stones. Overall results more closely approximated those for surgical removal of staghorn calculi than those for percutaneous removal of nonbranched calculi. However, the principal advantage of percutaneous lithotripsy of staghorn calculi over surgical management is the significant reduction in convalescence after discharge from the hospital.
Adult↗
The Auckland experience with laparoscopic donor nephrectomy.
AIMS: To examine the initial experience of laparoscopic donor nephrectomy (LDN) in New Zealand and compare it with open donor nephrectomy (ODN). METHODS: All LDNs performed between June 2000 and June 2002 were reviewed. An equal number of ODNs were reviewed. Data were also collected on the recipients of the grafts. Key clinical data were prospectively collected; remaining data were collected by retrospectively reviewing patient charts. Auckland Hospital databases were accessed for costing analysis. RESULTS: Thirty five cases of each procedure had been performed. There has been 100% LDN graft survival. There was no significant difference in graft function (serum creatinine) at one and 12 months (p = 0.25 and 0.35) between the two groups. There was no significant difference in donor morbidity (26% vs 31%, p = 0.59). LDN resulted in a shorter hospital stay (3 vs 6.5 days, p <0.0001) and convalescence period (3 vs 6 weeks, p <0.0001). LDN was significantly more expensive (13 357 dollars vs 6713 dollars, p <0.0001). CONCLUSIONS: LDN in the New Zealand setting provides effective grafts for renal transplant recipients and is safe for the donor. Advantages for the donor are a shorter hospital stay and convalescence period. The major disadvantage of LDN is its higher cost compared with ODN.
Adult↗
[Dynamics of changes in magnesium (Mg) serum levels in patients suffering from infectious mononucleosis].
The aim of the study was to assess the dynamics of changes in magnesium (Mg) serum levels in the acute, symptomatic period of infectious mononucleosis and during the convalescence period, when clinical symptoms were no longer present. 50 subjects were included, among them 26 patients (14 women and 12 men) at the age of 16 to 27 years in the acute, symptomatic stage of the disease. The diagnosis of infectious mononucleosis was based on the clinical, hematological, biochemical and serologic criteria. Mg concentration was measured 3 times: on the 1st day and in the 2nd week of hospitalization, and also in the convalescence period--3 weeks after the regression of clinical symptoms. The control group consisted of 24 healthy individuals (5 men and 5 women) at the age of 17 to 26 years. Mg concentration was measured once in this group. All measurements of Mg serum concentration were performed using the method of atomic absorption spectrophotometry (AAS) at the wavelength of 285.2 nm. We observed significantly higher Mg serum concentrations in patients with acute, symptomatic infectious mononucleosis than in healthy individuals. During the convalescence period Mg serum concentrations were lower but still statistically higher than in the control group.
Acute Disease↗
Safety of combining abdominoplasty and total abdominal hysterectomy: fifteen cases and review of the literature.
Combined surgeries eliminate the need for 2 anesthetics and 2 hospitalizations, the postoperative period of convalescence is no longer than for either procedure alone, and the total cost is reduced significantly. However, the safety of combining procedures is an unanswered question. We present 15 patients that underwent combined abdominoplasty with total abdominal hysterectomy from January 1992 to July 2002. A retrospective chart review was performed; surgical reports were analyzed, along with subsequent clinical follow-up notes. One patient had a wound infection that required hospitalization, drainage, and intravenous antibiotics. Four patients had minor complications. Patients' satisfaction with the esthetic and functional results of combined procedures has been impressive. Our experience confirms the basic safety of the combined surgery when done on appropriately selected patients. These results are discussed in respect to the current literature.
Abdomen↗