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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↗
PubMed1999

Cardiovascular and respiratory changes and convalescence in laparoscopic colonic surgery: comparison between carbon dioxide pneumoperitoneum and gasless laparoscopy.

HYPOTHESIS: Gasless laparoscopy produces smaller cardiopulmonary and systemic changes than carbon dioxide (CO2) laparoscopy during colonic surgery. DESIGN: Prospective randomized trial. SETTING: Department of Surgery in a university hospital. PATIENTS: Twenty-two patients scheduled for laparoscopic colonic resection; 5 patients were excluded because of conversion to open surgery (N = 17). INTERVENTIONS: Patients were randomized to either gasless (n = 9) or conventional CO2 (n = 8) surgery. MAIN OUTCOME MEASURES: Intraoperative assessment of hemodynamic factors and pulmonary function, and postoperative assessment of pain, pulmonary function, convalescence, and various injury factors were done several times until 30 days after surgery. Surgical complications were noted. RESULTS: Descending aorta blood flow after 30 minutes (P=.03) and heart rate after 150 minutes were higher in the CO2 group (P=.009). Central venous pressure, PaCO2 inspiration pressure, and end tidal CO2 level were significantly higher in the CO2 group (P = .05, .03, .04, and .01, respectively). Patients in the CO2 group had less pain during mobilization and coughing (P = .008 and .006, respectively), and were significantly more fatigued (P = .04). No other important differences were observed in intraoperative hemodynamic factors, postoperative convalescence, immunocompetence, or pulmonary function. CONCLUSION: No clinically important differences in cardiovascular and systemic response were observed between patients undergoing CO2 or gasless laparoscopy for colonic disease.

Aged↗
PubMed2025

Impact of High-Titer Convalescent Plasma on Clinical and Virologic Outcomes Among Veterans Hospitalized With SARS-CoV-2 Infection: VA CoronavirUs Research and Efficacy Studies-1 (VA CURES-1).

In the initial absence of proven therapies, empirical COVID-19 convalescent plasma (CCP) was rapidly introduced for individuals hospitalized for COVID-19. Seventy-five participants were randomized from November 2020 to June 2021 in a double-blind, multi-site, placebo-controlled, randomized trial (VA CURES-1) evaluating the impact of CCP vs. saline in Veterans hospitalized with COVID-19 with hypoxemia. The composite primary outcome was acute hypoxemic respiratory failure or all-cause death by Day 29. We analyzed clinical outcomes, nasal viral RNA, plasma cytokines and viral evolution over time. Among 40 participants receiving saline and 35 receiving CCP with high neutralizing titers (median 1:1420), the percent reaching the primary outcome was similar (10%), as were time to clinical recovery and to nasal viral clearance. By whole genome sequencing, viral molecular complexity evolved pre- to posttreatment more frequently in recipients of saline vs. CCP (4 of 7 (57.1%) vs. 1 of 4 (25%), respectively), based on numbers of mixed allele positions. Numbers of amino acid-changing, non-synonymous mutations in the spike protein were greater in saline vs. CCP recipients. Both outcomes suggested purifying selection (reduced overall viral infection complexity) following CCP. In conclusion, convalescent plasma showed no significant clinical impact but may influence SARS-CoV-2 complexity. Trial Registration: ClinicalTrials.gov Identifier: NCT04539275.

Aged↗
PubMed2003

Is laparoscopic colorectal surgery less invasive than classical open surgery? Quantitation of physical activity using an accelerometer to assess postoperative convalescence.

BACKGROUND: With the technical advances of recent years, the number of operative manipulations in the abdominal cavity by laparoscopic surgery is now considered to be the same as that using classical open surgery. The question has been raised whether laparoscopic colorectal surgery with lymphadenectomy improves the recovery compared to open surgery. METHODS: We compared patients' physical activity for 7 days postoperatively as measured with an accelerometer between laparoscopic-assisted colorectal resection (LAC, n = 32) and classical open colorectal surgery (OC, n = 30). RESULTS: Physical activity expressed as cumulative acceleration was significantly higher in the LAC than in the OC group on each postoperative day. The recovery time, defined as the day on which the cumulative acceleration recovered to 90% of the preoperative level, was significantly shorter (p < 0.05) in the LAC (3.4 +/- 1.2 days) than in the OC group (6.8 +/- 1.7 days). CONCLUSION: Our results showed that the duration of convalescence with LAC was significantly shorter than that with the OC procedure. Laparoscopic colorectal surgery appears to allow an earlier recovery after the operation than the classical open procedure, and it is less invasive as assessed by convalescence.

Acceleration↗
PubMed2005

Persistent shedding of viable SARS-CoV in urine and stool of SARS patients during the convalescent phase.

In order to further the present knowledge of the emerging severe acute respiratory syndrome-associated coronavirus (SARS-CoV), 486 different specimens from 54 patients with a clinical diagnosis of SARS were investigated for the presence of viral RNA, and 314 plasma specimens of 73 patients were examined for IgM and IgG antibodies specific against SARS-CoV using an indirect ELISA. Viral RNA was detectable in 28 of the 54 patients tested. Cumulative data showed that 67 of the 73 SARS patients demonstrated seroconversion by week 5 of illness. In contrast, only 1 of 278 healthy subjects enrolled in the study was found to be positive for the IgG antibody. Coexistence of viral RNA in plasma and specific antibodies was simultaneously observed over three consecutive weeks in two critical cases. In three convalescent patients in particular, cultivable SARS-CoV was detected in stool or urine specimens for longer than 4 weeks (29-36 days). These findings suggest that SARS-CoV may remain viable in the excretions of convalescent patients.

Adult↗
PubMed2004

SARS corona virus peptides recognized by antibodies in the sera of convalescent cases.

We synthesized on cellulose membranes 4942 ten-amino-acid peptides which included all of the sequences predicted for the severe acute respiratory syndrome (SARS) corona virus. We probed these membranes with four pairs of acute and convalescent sera from recovered SARS cases. We correlated positively reacting peptides with the in vitro SARS-CoV neutralizing activity of the samples. We found that convalescent sera with high neutralizing activity recognized exclusively only a limited number of peptides on the membranes. This suggests that antibodies against the epitopes represented by these peptides could be responsible for much of the SARS-CoV neutralizing activity. The findings have implications for monitoring humoral responses to SARS-CoV as well as for developing a successful SARS vaccine.

Acute Disease↗
PubMed2002

Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery.

OBJECTIVE: A postoperative regimen using a multimodal approach with enforced mobilization and early oral nutrition has been reported to improve convalescence but has not been compared with other postoperative regimens. METHODS: Forty patients undergoing elective colorectal surgery were randomly allocated to an intervention group receiving comprehensive information on the importance of mobilization, balanced anesthesia, and postoperative analgesia including epidural local anesthetics and enforced postoperative mobilization or a control group receiving anesthesia without epidural local anesthetics, postoperative analgesia with epidural morphine, and mobilization without fixed goals. All patients were offered early oral nutrition. The regimens were compared by means of ambulation time and physical activity, voluntary muscle strength, pulmonary function, and body composition. RESULTS: The ambulation time improved substantially within 22 h in the intervention group versus 3 h in the control group on day 1 (P = 0.0004) and within 8 h versus 2 h on day 4 (P = 0.0003). The voluntary strength of the quadriceps muscle decreased by 3% in the intervention group versus 15% in the control group on day 7 (P = 0.04). Two months postoperatively, the difference between groups was the same (P = 0.02). CONCLUSION: This active per- and postoperative regimen based on a multimodal approach improved ambulation time and muscle function during admission and late convalescence.

Aged↗
PubMed2002

Combined intra-articular glucocorticoid, bupivacaine and morphine reduces pain and convalescence after diagnostic knee arthroscopy.

We studied the effect of intra-articullar saline vs. bupivacaine + morphine or bupivacaine morphine + methylprednisolone after diagnostic knee arthroscopy. In a double-blind randomized study, 60 patients undergoing diagnostic knee arthroscopy without a therapeutic procedure were allocated to groups receiving intra-articular saline, intra-articular bupivacaine 150 mg + morphine 4 mg or the same dose of bupivacaine + morphine + intra-articular methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. All patients were instructed to resume normal activities immediately after the procedure. Pain during movement and walking, leg muscle force and joint effusion, use of crutches and duration of sick leave were assessed. A combination of bupivacaine and morphine reduced pain, duration of immobilization and of convalescence. The addition of methylprednisolone further reduced pain, use of more analgesics, joint swelling and convalescence.

Adult↗
PubMed2004

Putative vaccine antigens from Neisseria meningitidis recognized by serum antibodies of young children convalescing after meningococcal disease.

Serum samples from 31 children < or = 4 years old who were convalescing after meningococcal disease were used in a quantitative hybridization assay to establish antibody reactivity to 94 candidate meningococcal vaccine antigens. Genes encoding 22 of 23 strongly recognized proteins were found in > or = 94% of the patients' meningococcal strains, and most were also widely prevalent in Neisseria lactamica and other commensal Neisseria species. Similar antibody reactivity was found in serum samples from healthy control children, suggesting that these antibodies arose from asymptomatic colonization. The 23rd protein, NadA, elicited strong reactivity solely in convalescent patients previously infected with a nadA+ strain. nadA was not present in any of 29 diverse N. lactamica strains, suggesting that reactivity in these children arose from meningococcal infection. In contrast, serum samples from healthy adults contained anti-NadA immunoglobulin G at high levels. The correlation of NadA antibody level with natural acquisition of protective immunity suggests that NadA may be a valuable component of a childhood antimeningococcal vaccine.

Antibodies, Bacterial↗
PubMed1978

Preparing for the next round: convalescent care after acute infection.

Infections pose a nutritional stress on the growing child. No therapeutic goal is as important as the rapid recovery of preillness weight after acute infections. Successful convalescence, with supernormal growth rates, can be achieved with relatively brief periods of intensive refeeding, offsetting any tendency toward reduced immune defenses or other nutritionally determined susceptibilities to further infection. Since the mother is the only person who can effectively manage convalescent care, she must be given specific tasks with measurable targets in order to reliably oversee the child's rehabilitation. Not generally considered in the realm of preventive medicine, effective home-based convalencent care is the first crucial step in preventing the next round of illness. An approach to the widespread mobilization of mothers to monitor and sustain their children's growth is proposed in this paper. Rather than a passive recipient of health services, the mother becomes the basic health worker, providing diagnostic and therapeutic primary care for her child. Only the mother can break the malnutrition-infection cycle.

Body Weight↗
PubMedDate not supplied

Severe acute respiratory syndrome: thin-section computed tomography features, temporal changes, and clinicoradiologic correlation during the convalescent period.

OBJECTIVE: To evaluate thin-section computed tomography findings of patients with severe acute respiratory syndrome (SARS) in the convalescent period and to correlate the results with clinical parameters and lung function tests. METHODS: Ninety-nine severe acute respiratory syndrome patients with persistent changes on follow-up chest radiography were included. One hundred seventy computed tomography examinations at baseline (n=70), 3 months (n=56), and 6 months (n=44) were retrospectively evaluated to determine the extent of ground-glass opacification, reticulation, and total parenchymal involvement. Patients' demographic information, clinical information during treatment, and results of lung function tests at 3 and 6 months were correlated with computed tomography findings. RESULTS: A significant serial improvement in the extent of overall ground-glass opacification, overall reticulation, and total parenchymal involvement was observed (P <0.01). Advanced age, previous intensive care unit admission, mechanical ventilation, alternative treatment, higher peak lactate dehydrogenase, and peak radiographic involvement during treatment showed a positive correlation with overall reticulation and total parenchymal involvement at 6 months. There was a significant negative correlation between overall reticulation and total parenchymal involvement with diffusion capacity adjusted for hemoglobin at 3 and 6 months (P <0.01). CONCLUSION: Lung changes on thin-section computed tomography of severe acute respiratory syndrome patients improved with time during the convalescent period and showed a significant correlation with advanced age, parameters indicating severe illness, and diffusion capacity adjusted for hemoglobin on follow-up.

Adult↗
PubMed1985

Feelings and attitudes during early convalescence following vascular surgery.

This descriptive study examined patients' attitudes and feelings towards convalescence following vascular surgery. A convenience sample of 25 subjects consisted of patients who had initial (18) and repeat (7) surgery. A self-administered questionnaire and a semi-structured interview guide were utilized to examine patients' perceptions concerning health, uncertainty about the outcome of surgery and course of disease, and their degree of adherence to discharge instructions. The findings suggested that the early convalescent period was difficult for all patients, but particularly for those in the repeat surgery group. Although data analysis revealed no statistically significant differences in perceptions between groups, repeat surgery patients tended to experience less favourable perceptions of health, a higher level of uncertainty, and a lower rate of adherence to discharge instructions.

Aftercare↗
PubMed1996

Oxidative burst response of neutrophils primed with PreS1 antigen of hepatitis B virus in patients with chronic hepatitis B and convalescents.

The pathogenesis of liver damage in the course of hepatitis B virus (HBV) infection depends on the host's specific and non-specific immune response to various viral antigens. The role of polymorphonuclear neutrophils (PMN) in the natural immune reaction and during secondary microbial infections is well documented. Increased free radical production is associated with many pathological conditions such as shock, ischaemia or chronic inflammatory diseases. We studied the oxidative metabolism of neutrophils in patients with chronic HBV and after recovery (convalescents). The effect of the PreS1 fragment of HBV antigen on some neutrophil functions in vitro was also examined. There were significant differences in the values of spontaneous and stimulated oxidative burst of neutrophils, measured using luminol-chemiluminescence, in patients with HBV when compared with the convalescents. PreS1 antigen did not by itself induce the respiratory burst in human neutrophils but it potentiated their response to a second stimulus. Hence we observed a priming of neutrophils, for an enhanced respiratory burst, by PreS1 antigen.

Adult↗
PubMed2006

Convalescence after colonic surgery with fast-track vs conventional care.

OBJECTIVE: To compare convalescence after colonic surgery with a fast-track rehabilitation programme vs conventional care. BACKGROUND: Introduction of a multimodal rehabilitation programme (fast-track) with focus on epidural anaesthesia, minimal invasive surgical techniques, optimal pain control, and early nutrition and mobilization together with detailed patient information have led to a shorter hospital stay after colonic surgery. There are not much data on convalescence after discharge. METHODS: A prospective, controlled, non-randomized interview-based assessment in 160 patients undergoing an elective, uncomplicated, open colonic resection or the Hartmann reversal procedure with a fast-track or a conventional care programme in two university hospitals. A structured interview-based assessment was performed preoperatively, and day 14 and 30 postoperatively. RESULTS: Patients undergoing colonic surgery with a fast-track programme regained functional capabilities earlier with less fatigue and need for sleep compared with patients having conventional care. Despite early discharge of the fast-track patients (mean 3.4 days vs 7.5 days), no differences were found according to the need for home care, social care and visit to general practitioners, although the fast-track group had an increased number of visits at the outpatient clinic for wound care. More patients in the fast-track group were re-admitted, but the overall mean total hospital stay was 4.2 days vs 8.3 days in the conventional group. CONCLUSION: A fast-track rehabillitation programme led to a shorter hospital stay, less fatigue and earlier resumption of normal activities, without the increased need for support after discharge compared with conventionally treated patients after uncomplicated colonic resection.

Aged↗
PubMed2004

Retrospective comparison of convalescent plasma with continuing high-dose methylprednisolone treatment in SARS patients.

Treatment of severe acute respiratory syndrome (SARS) is experimental, and the effectiveness of ribavirin-steroid therapy is unclear. Forty SARS patients with progressive disease after ribavirin treatment and 1.5 g of pulsed methylprednisolone were given either convalescent plasma (n = 19) or further pulsed methylprednisolone (n = 21) in a retrospective non-randomised study. Good clinical outcome was defined as discharge by day 22 following the onset of symptoms. Convalescent plasma was obtained from recovered patients after informed consent. Patients in the plasma group had a shorter hospital stay (p 0.001) and lower mortality (p 0.049) than the comparator group. No immediate adverse effects were observed following plasma infusion.

Adult↗
PubMed2005

Purification of severe acute respiratory syndrome hyperimmune globulins for intravenous injection from convalescent plasma.

BACKGROUND: Severe acute respiratory syndrome (SARS) is a new infectious disease caused by the SARS virus. Current first-line treatments are experimental, and their effectiveness remains open to question. For more effective treatment and prevention of SARS, human SARS hyperimmune globulins for intravenous (IV) injection were purified in this study. STUDY DESIGN AND METHODS: A combination of cold ethanol precipitation and ion-exchange chromatography was used to process pooled SARS convalescent plasma samples. Virus inactivation and removal approaches were taken to ensure safety. RESULTS: The purified hyperimmune globulins were formulated as a 5 percent solution, with an antibody titer specifically against the SARS virus of 1:83, 1:1600, and 1:200, as determined by enzyme-linked immunosorbent assay, immunofluorescence assay, and neutralizing antibody test, respectively. The purity of the SARS hyperimmune globulins was 99.0 percent, and the monomer and dimer content was 100 percent. Other variables analyzed met the Chinese Requirements of Biologics for IV immune globulin. The SARS hyperimmune globulins prepared were subsequently approved for clinical evaluation by the Chinese National Institute for the Control of Pharmaceutical & Biological Products. CONCLUSION: IV-injectable, purified, and concentrated human SARS hyperimmune globulins were prepared from pooled convalescent plasma samples, which are ready to be further evaluated.

Antibodies, Viral↗
PubMed1991

[Serum levels of healthy adult humans and changes of IgG subclass levels between infected and convalescent phase in respiratory infections].

We measured serum levels of IgG subclasses in 100 healthy adult humans and 64 patients with respiratory infections by utilizing the enzyme linked immunosorbent assay (ELISA). The patients were composed of 18 patients with acute bacterial pneumonia and bacterial infection of 9 patients with pulmonary emphysema, 27 patients with chronic bronchitis and 10 patients with bronchiectasis. In healthy adults, serum levels of IgG1 subclass decreased in proportion of age increase. Serum levels of IgG2 rose after 30 years of age. Serum levels of IgG3 and IgG4 showed no remarkable changes by age. In patients with respiratory infectious disease, serum levels of IgG1, IgG2 and IgG4 decreased significantly but IgG3 increased significantly. We also measured serum levels of IgG subclasses in 10 patients with acute bacterial pneumonia and bacterial infection of 5 patients with pulmonary emphysema, 12 patients with chronic bronchitis and 4 patients with bronchiectasis at both infected and convalescent phases. The serum levels of IgG2 in patients with pneumonia and pulmonary emphysema at convalescent phase were significantly lower than those in the patients of infected phase. Other subclasses showed no significant change. We summarized that IgG2 was consumed at the infected phase by protecting against bacterial infections. IgG2 probably has an important role of protecting against bacterial respiratory infections among all IgG subclasses.

Adult↗
PubMed1974

Differences in acute and convalescent-phase antibodies of cats infected with feline picornaviruses.

Complement fixation inhibiting and complement-fixing antibodies were demonstrated in sera from cats during the acute and convalescent stages, respectively, of feline picornavirus infections. Complement-fixing antibody activity was present in 19S and 7S globulins, whereas complement fixation inhibiting antibody activity was confined to the 7S globulins. Sera with complement-fixing antibody and sera with complement fixation inhibiting antibody were also shown to have neutralizing and precipitating antibodies. In a study of antibody responses to homotypic and heterotypic strains of feline picornavirus, less serological cross-reactions were observed between strains of feline picornavirus in sera from cats in the acute phase of feline picornavirus infection than in the convalescent phase. The temporal relationship of complement fixation inhibiting and complement-fixing antibody responses of cats after acute viral respiratory infections is contrasted with previously observed antibody response in cats to feline leukemia virus.

Animals↗