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PubMed2003

[Thoracic high resolution CT findings of 100 SARS patients in convalescent period].

OBJECTIVE: To study thoracic high resolution CT findings of severe acute respiratory syndrome (SARS) patients in convalescent period and the relationship between the features with laboratory and pulmonary function results. METHODS: All the 100 SARS patients who had been discharged from hospital for about 2 months underwent thoracic high resolution CT examinations. Among them, 65 also had laboratory results and 91 underwent examinations of pulmonary function. RESULTS: Forty-nine SARS patients (49.0%, 49/100) in convalescent period still had abnormal findings in CT examination. And ground-glass opacification (95.9%, 47/49) and reticular opacification (59.2%, 29/49) were common. There was no significant difference in the level of lymphocytes and CD4 cells among groups divided according to severity of CT findings (P > 0.01). Diffusing capacity for carbon monoxide (DLco%) of level 2 and 3 were statistically lower than that of level 0 (P < 0.01). CONCLUSIONS: The features of CT findings of SARS patients in convalescent period are not the same as those of patients in period of apparent manifestation. The high resolution CT can reflect pulmonary diffusing function to some degree.

Adolescent↗
PubMed2003

[Assessment of pulmonary function in SARS patients during the convalescent period].

OBJECTIVE: To investigate the pulmonary function in severe acute respiratory syndrome (SARS) patients during the convalescent period. METHODS: Followup 89 outpatients of SARS. The follow-up study included interview, physical examination, and pulmonary function test. RESULTS: The interval between hospital discharge and functional assessment was 1.75 +/- 0.53 months (0.5-3.4 months). Mild to moderate abnormalities in pulmonary function were found in 48 patients (53.9%). Diffusion capacity for carbon monoxide (DLco) was impaired in 38 patients (42.7%); in 7 patients (7.9%), lung function was restrictive defect combined DLco impairment; Other patterns of impairment were revealed in 3 patient. Dyspnea during acute phase and CT during the convalescent period were found to have significant influences on DLco and total lung capacity (TLC). CONCLUSIONS: Diffusing capacity impairment as well as restrictive defect persist in convalescence SARS.

Adolescent↗
PubMed2005

[Study on the RNA of severe acute respiratory syndrome (SARS) associated coronavirus in the blood and excretion of convalescent patients with SARS].

OBJECTIVE: To examine the RNA of severe acute respiratory syndrome-associated coronavirus (SARS-CoV) in the blood and excretion of convalescent patient with SARS for prevention and treatment of the disease. METHODS: A total of 276 samples, including plasma, urine, feces and sputum, obtained from 23 convalescent patients with SARS were studied at 3 time-points at least 21 days after the onset of symptoms. RNA was extracted and nested reverse transcription-polymerase chain reaction (RT-PCR) was carried out using SARS-CoV specific primers. RESULTS: Among the 276 samples, SARS-CoV RNA was detected in 6 cases (38.8%) by nested RT-PCR. The positive rates of SARS-CoV RNA was 5.8% in feces and 2.9% in sputum samples but SARS-CoV RNA was not detectable in plasma and urine of all the cases. CONCLUSION: The existence of SARS-CoV RNA in the excretion of some convalescent patients with SARS showed that the excretion from these patients should be carefully treated whilthe re-transmission of SARS by which, should be further studied.

Adolescent↗
PubMed1979

Antigenic glycopolypeptides HA1 and HA2 of influenza virus haemagglutinin. III. Reactivity with human convalescent sera.

The immune reactivity to both haemagglutinin glycopolypeptides HA1 and HA2 [prepared from bromelain-released haemagglutinin of influenza virus A/Dunedin/4/73 (H3N2)], was demonstrated by both gel double immundiffusion and radioimmunoassay in human convalescent sera obtained after natural infection during influenza epidemics in 1974/75 and 1976/77. In gel double immunodiffusion, the precipitin line(s) corresponding to glycopolypeptide HA1 were always more distinct than precipin line(s) corresponding to glycopolypeptide HA2. In radioimmunoassay, human convalescent sera revealed higher titres for binding of 125-I-labelled HA2 than for 125-I-labelled HA1. Characterization of human convalescent sera was completed by haemagglutination-inhibition test.

Antibodies, Viral↗
PubMed1980

Poliomyelitis: immunoglobulin-containing cells in the central nervous system in acute and convalescent phases of the human disease.

The immunoperoxidase method has been used to demonstrate the presence of immunoglobulin-containing cells in the central nervous system in acute and convalescent phases of poliomyelitis. These cells were found in considerable numbers in the areas of damage during the acute phase, and persisted at the same sites, though in smaller numbers, during the convalescent phase for at least 8 months. Most of the positively stained cells were plasma cells. IgA was the commonest heavy chain type demonstrated, with lesser amounts also of IgG and, during the acute phase, IgM. In the acute phase more lambda than kappa light chain was demonstrated but in the convalescent phase this ratio was reversed. More light chain than heavy chain was demonstrable during the acute phase. The significance of these results is briefly discussed.

Acute Disease↗
PubMed1994

Risk of subsequent cardiac events in stable convalescing patients after first non-Q-wave and Q-wave myocardial infarction: the limited role of non-invasive testing.

BACKGROUND: Patients recovering from myocardial infarction are frequently evaluated by non-invasive tests for evidence of myocardial ischemia before returning to work or full activity. The purpose of this study was to evaluate the prognostic significance of clinical and non-invasive ischemic test variables assessed in 549 stable, convalescing patients (median 2 months) after their first Q-wave (n = 363) and non-Q-wave (n = 186) myocardial infarction. METHODS: The ischemic tests performed were resting ECG, exercise ECG, ambulatory ECG, and stress thallium scintigraphy. RESULTS: Cardiac events (unstable angina requiring hospitalization, non-fatal reinfarction, or death from cardiac causes) were observed during a mean 23-month follow-up in 57 patients (15.7%) with Q-wave and in 31 of patients (16.7%) with non-Q-wave infarction. In a step-wise Cox regression model, the only significant independent predictors of subsequent cardiac events (P < 0.001) were post-infarction angina and insulin-dependent diabetes mellitus. The type of infarction did not make a significant contribution to the risk of cardiac events (P = 0.29). However, an interaction between infarct type and post-infarction angina was of borderline significance (P = 0.065), with angina associated with more cardiac events in patients with non-Q-wave than in those with Q-wave infarction. None of the ischemic tests contributed significantly to the Cox model in predicting cardiac events in either infarct type. CONCLUSION: Stable convalescing patients who have recovered from first Q-wave and non-Q-wave myocardial infarction have similar long-term prognoses. The occurrence of post-infarction angina is associated with increased risk of cardiac events in patients with both infarct types, with more marked effect in non-Q-wave than Q-wave infarctions. Ischemia detected by non-invasive tests performed in the convalescing phase after myocardial infarction was not prognostically useful in either infarct type.

Angina Pectoris↗
PubMed1995

[The functional status of the body and work capacity of convalescent patients after typhoid fever].

Convalescents (168 patients) who went through typhoid and 48 sound men (control group) were examined in order to study their clinical and physiological indices, mental and performance capabilities. At the end of inpatient treatment the complete normalization of functional state was marked only in group 1 (convalescents after abortive typhoid). In 96% of patients who went through slight form of disease (group 2) and middle-severe form (group 3) different disorders of functional state of organism were marked. One week after medical rehabilitation the number of convalescents who needed the continuation of rehabilitation treatment has decreased 50% in the 2nd group, after 2 weeks--up to 35%, after 3 weeks there were no changes. In the 3rd group at the end of the 1st week functional disorders were marked in 85% of patients, after 2 weeks--in 35%, after 3 weeks--in 13.8%, after 4 weeks--in 2.5%.

Adult↗
PubMed1977

Left ventricular hemodynamics and function in acute myocardial infarction: studies during the acute phase, convalescence and late recovery.

The left ventricular hemodynamics of 70 patients with acute myocardial infarction were determined from measurements of pulmonary arterial end-diastolic pressure, cardiac index, mean arterial pressure and heart rate during the acute phase(first study, 5 hours after admission), 4 to 6 weeks later (second study, during convalescence) and in 35 percent of all subjects 6 to 12 months after the acute infarction (third study). Serial analysis of serum creatine kinase was carried out during the acute phase. The peak CK value normalized for body surface area was used as a rough index of the extent of the acute myocardial necrosis. The condition of all survivors of the acute stage improved. Patients with only slightly reduced left ventricular performance during the acute stage recovered to nearly normal during convalescence. The condition of patients with greatly reduced left ventricular function also improved but remained impaired during convalescence. In all patients the main changes in left ventricular hemodynamics occurred within the first 4 to 6 weeks; there was almost no further alteration during the following 9 months.

Acute Disease↗
PubMed2004

Detection of causal relationships between factors influencing adverse side-effects from anaesthesia and convalescence following surgery: a path analytical approach.

BACKGROUND AND OBJECTIVE: The anaesthesiologist's preoperative interview with the patient is important in preparing the patient for surgery. Its potential protective influence on adverse side-effects from anaesthesia and convalescence is rarely investigated within the context of other perioperative factors. Structural equation modelling allows detection and quantification of all causal relationships and mediator effects in multivariate models. Therefore, this method is presented as a tool and applied to discover the influence of the preoperative interview within socio-demographic variables and duration of surgery on complaints and recovery after anaesthesia. METHODS: The influence of individual satisfaction with the anaesthesiologist's preoperative interview on postoperative events such as nausea/vomiting, difficulties in recovering from anaesthesia, experience of postoperative pain, physical discomfort and satisfaction with convalescence expressed by the patient was analysed by means of structural equation modelling. The variables gender, age and duration of surgery were also included as predictors in the analyses. The model in the total sample of 710 patients was then analysed for structural differences between groups treated either with propofol (n = 204) or with isoflurane + nitrous oxide (n = 267) for maintenance of anaesthesia. RESULTS: The model revealed that the anaesthesiologist's preoperative interview in combination with associated mediating side-effects explains 45% of the variance of 'feeling physical discomfort' and 18% of the variance of 'satisfaction with convalescence'. The same model could be fitted in the propofol and the isoflurane + nitrous oxide group. Moreover, the structure and the strength of causal relations between variables were identical in the two groups. CONCLUSIONS: The anaesthesiologist's efforts to improve the interview with the patient by more reassuring and proper information will result in less side-effects from anaesthesia and better recovery from surgery. It could be demonstrated that structural equation modelling is a powerful tool for detection of causal relationships and mediator effects in perioperative medicine.

Adolescent↗
PubMed1995

Plasma homocysteine in the acute and convalescent phases after stroke.

BACKGROUND AND PURPOSE: Stroke patients frequently manifest moderate hyperhomocysteinemia. In most published studies, plasma homocysteine was measured at least 1 month after stroke (or the interval was not reported). To determine whether plasma homocysteine concentrations change in the acute phase, we compared acute-phase values with both convalescent-phase and control values. METHODS: Plasma homocysteine concentrations were measured in the acute phase (mean, 2 days after stroke onset) in 162 first-ever stroke patients aged 50 years or more (median, 75 years) and again at a median interval of 583 days (range, 460 to 645 days) after stroke onset in a subgroup of 17 patients, with values for 60 age-matched subjects serving as controls. Twenty of the control subjects were reexamined 2 to 3 years after their initial examination. RESULTS: The median plasma homocysteine concentration was 13.4 mumol/L in the patient group compared with 13.8 mumol/L for control subjects (NS, Mann-Whitney U test) and increased from 11.4 mumol/L in the acute phase to 14.5 mumol/L in the convalescent phase in the subgroup of patients examined twice (P < .01, Wilcoxon signed rank test). In the 20 reexamined control subjects, no significant change over time in plasma homocysteine concentration was found. CONCLUSIONS: The post-acute-phase increase in plasma homocysteine may explain why higher values were obtained for stroke patients than for control subjects in previous studies. Possible reasons for the variation in plasma homocysteine concentrations over time are (1) an acute-phase reduction secondary to a decrease in plasma albumin and (2) an increase in plasma homocysteine during the convalescent phase due to modified vitamin intake and/or lifestyle. The timing of plasma homocysteine measurements relative to stroke onset is a factor to be considered in the interpretation of results.

Aged↗
PubMed1979

Developmental and convalescent changes of the anemia caused by excess methionine in the rat.

An experiment was performed to investigate the progressive changes of the anemia caused by excess methionine in rats, during the developmental and convalescent periods. Hemoglobin concentration, hematocrit value and red blood cell count were elevated in the initial stage of excess methionine feeding, they then gradually decreased. During the convalescent period, after ceasing administration of the excess methionine diet, symptoms of anemia gradually disappeared. The nitrogen efficiency ratio was markedly decreased by excess methionine feeding, however, it rapidly recovered after ceasing administration of the excess methionine diet. Iron deposited in the spleen also disappeared quickly during the convalescent period. Of the symptoms of anemia caused by excess methionine, the activity of delta-aminolevulinic acid synthetase (ALAS) in the bone marrow showed the most acute changes. As mentioned previously (1), although lowered globin biosynthesis due to amino acid imbalance could be considered as one of the important causes of the anemia and also would be one of the causes of the compensative elevation of ALAS activity, the possibility still remain that there are other unknown effects of excess methionine on ALAS activity in the bone marrow in this case.

5-Aminolevulinate Synthetase↗
PubMed2005

[Prospective clinical study on serum immunity in IgG-antibodies positive patients convalescent from severe acute respiratory syndrome].

OBJECTIVE: To investigate the serum immunological characteristics in patients convalescent from severe acute respiratory syndrome (SARS). METHODS: In the 1 st, 3 rd, 6 th month after their discharge, eg. SARS-IgG, T cell subsets, blood routine, and the blood biochemistry were systemically determined in SARS convalescent patients. RESULTS: The SARS-antibodies could be used as the diagnostic evidence. During the 6 months after discharge, the titers of SARS-antibodies were high, but they lowered along with passage of time. At the first recheck, the CD4(+) lymphocyte count was lower than normal level in 55.9% of patients, the CD3(+) lymphocyte count was lower than normal level in 31.2% of patients, and the CD8(+) lymphocyte count was lower than normal level in 14.0% of patients. At the second recheck, the levels of T cell subsets recovered to normal level in the most patients. CONCLUSION: T cell subsets, and the number of leukocyte are abnormal in some patients convalescent from SARS. All the indexes examined recover to normal levels half year after discharge. Therefore, it is necessary to follow up the changes in the levels of SARS-antibodies.

Adolescent↗
PubMed1990

[Changes in various serum protein levels between acute and convalescent phases in patients with respiratory infections].

We determined serum levels of alpha 1-antitrypsin, alpha 1-acid glycoprotein, ceruloplasmin, haptoglobin, alpha 2-HS glycoprotein, C3 and fibronectin in 22 patients with acute pneumonia, 10 patients with mycoplasma pneumonia and 8 patients with exacerbation of chronic bronchitis at both acute and convalescent phases to clarify whether levels of these proteins change with inflammation. Serum levels of alpha 1-antitrypsin, alpha 1-acid glycoprotein, ceruloplasmin, haptoglobin and C3 in the patients in the acute phase were significantly higher than that in the patients in the convalescent phase. The serum level of fibronectin in the patients in the acute phase was significantly lower than that in the patients in convalescent phase. The serum level of alpha 2HS glycoprotein remained unchanged.

Acute-Phase Proteins↗
PubMed1986

[Treatment of Argentine hemorrhagic fever with convalescent's plasma. 4433 cases].

During the 23 consecutive annual epidemics of Argentine haemorrhagic fever observed from 1959 to 1983, a group of 4,433 patients were treated at Junin (Argentina) with convalescent's plasma; the overall mortality rate was 3.29%. In 1958, before convalescent's plasma was used, the mortality rate in 448 patients who received the conventional treatment was 42.85%. The difference between the two groups is highly significant and demonstrates the value of convalescent's plasma in the treatment of the disease.

Adolescent↗
PubMed1988

Lymphocyte subpopulations during acute and convalescence phases of malaria.

Lymphocytes of normal healthy persons were separated from blood by Ficoll-Hypaque gradient centrifugation and iron-magnet application. peripheral blood lymphocytes (PBL) were stained by various dye-labeled monoclonal antibodies. Cells positive for specific surface markers were enumerated by a fluorescence activated cell sorter (FACS) and fluorescence microscope (FM). The results revealed that the percentages of cells positive with one monoclonal antibody counted by these two techniques were similar while the percentages of cells with double staining were higher when counted by FACS than by FM. Lymphocyte subpopulations of 18 patients infected with Plasmodium falciparum during acute and convalescence period were studied. Lymphocytopenia occurred during the acute infection while total white blood cell counts were normal. PBL of the patients were stained with OKT3, OKT4, OKT8, Leu-11 and a combination of Leu-7, Leu-1 monoclonal antibodies. The absolute numbers of all lymphocyte subpopulations were decreased during the acute infection while T8 positive cells were decreased in both percentage and absolute number. Thus T4:T8 ratio (1.7:1) became higher than normal (1.3:1) at this period. During convalescence phase, absolute numbers and percentages of Leu-7+, Leu-1+ and perhaps Leu-7+, Leu-11- cells which had low NK cell activity were significantly higher than during acute illness. The finding might explain why the NK cell activity was low during the convalescence period.

Adolescent↗
PubMed1982

Variable convalescence and therapy after cadaveric renal transplantation under cyclosporin A and steroids.

The postoperative convalescence period was analyzed for 42 consecutive patients who had cadaveric renal transplantation under therapy with cyclosporin A and steroids. Twenty-two of the patients underwent transplantation for the first time, and the other 20 had retransplantation. None of the recipients has died. With follow-up period of two to eight months, the survival rate of grafts is 96 per cent after first transplantation and 85 per cent after retransplantation. Immunosuppression with a standard regimen was used for all patients at the outset. Early convalescence was highly variable, often necessitating adjustments of cyclosporin A and steroid dosage to accommodate the possibilities of rejection or cyclosporin A nephrotoxicity, or both, simultaneously. Management problems were more frequent and complex in patients undergoing retransplantation. From the results, a classification of convalescence patterns was evolved, with recommendations about how standardized initial therapy should be adjusted if the renal graft does not function promptly or deteriorates later.

Adolescent↗
PubMed1993

Association of pneumonia and lung cancer: the value of convalescent chest radiography and follow-up.

A retrospective study of 1011 hospitalized patients with pneumonia was undertaken to assess the value of routine convalescent chest radiography for detection of underlying lung cancer. To investigate the mode of clinical onset of pulmonary carcinoma, 232 inpatients with this diagnosis were also studied. The findings may be summarized as follows: 1) 13/1011 pneumonia patients were found to have previously undiagnosed pulmonary carcinoma; 2) many of these carcinomas (8/13) were disclosed by an acute chest X-ray; 3) pulmonary carcinoma was found by convalescent chest X-ray in 2/88 patients not feeling well and in 2/524 patients feeling well at follow-up, and none of these 4 patients benefitted from the carcinoma diagnosis; 4) ESR was of no value in detecting underlying pulmonary carcinoma at follow-up in patients with pneumonia; 5) of the 232 patients with pulmonary carcinoma, 29 (12.5%) presented with an acute respiratory tract infection; 6) most of these latter patients did not recover as expected and their correct diagnosis was made based on a chest X-ray performed because of persistent symptoms. We suggest that patients with radiologically verified pneumonia undergo clinical examination or are interviewed 4-5 weeks after the onset. If signs or symptoms of respiratory disease persist, chest X-ray should be performed. We consider, however, that routine convalescent chest radiography with the aim of detecting any underlying pulmonary tumour could be omitted if the patient has completely recovered 1 month after the acute onset of illness.

Adolescent↗
PubMedDate not supplied

Susceptibility of convalescent turkeys to pulmonary aspergillosis.

Pulmonary lesions resulting from Aspergillus fumigatus inoculation were assessed in convalescent turkeys and compared with those in previously noninoculated (control) turkeys. In addition, lesions observed in small Beltsville white (SBW) turkeys were compared with those in broad-breasted white (BBW) turkeys challenged with the same inoculum. Turkeys were challenged by unilateral posterior thoracic air sac (PTAS) inoculation, rechallenged via the contralateral air sac after 5 wk, and then necropsied 1 wk later. Pulmonary lesions induced by the initial challenge had resolved in 6 of 10 SBW and 9 of 10 BBW turkeys. However, convalescence did not protect against pulmonary aspergillosis subsequent to rechallenge; 10 of 10 SBW and 9 of 10 BBW developed granulomatous pulmonary lesions on the side of reexposure. A greater proportion of control SBW turkeys developed pneumonia and airsacculitis following challenge as compared with the BBW breed. Lesions were limited to the lower respiratory tract in all turkeys and were confined to the ipsilateral lung and PTAS in the singly inoculated control turkeys. This study demonstrates that convalescence from pulmonary aspergillosis does not confer protection against rechallenge but may, instead, decrease resistance to subsequent infection.

Animals↗