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At least 1,423 records · Page 79Linked to original sources
PubMed1995

Virus-associated hemophagocytic syndrome due to measles accompanied by acute respiratory failure.

An 18-year-old male who was admitted to hospital due to fever, skin rashes, cough, and malaise showed laboratory examination findings of leukopenia, thrombocytopenia, mild liver dysfunction, and hypoxia. Bone marrow aspiration revealed 2% histiocytes with hemophagocytosis. Chest X-ray showed bilateral diffuse interstitial pneumonia. The titer of anti-measles virus antibody was < 1:4, and that at convalescence stage was 1:64. He was diagnosed as having hemophagocytic syndrome and acute respiratory failure due to measles, and was treated with methylprednisolone pulse therapy. He promptly recovered from thrombocytopenia and acute respiratory distress. Steroid pulse therapy may be effective in these conditions due to measles.

Acute Disease↗
PubMed1993

Laparoscopic hysterectomy: a series of 100 cases.

OBJECTIVE: To introduce a new method of hysterectomy using the laparoscope and endoscopic stapling equipment. DESIGN: A prospective study of a series of patients. SETTING: Specialist private practice at two private hospitals. PATIENTS: Patients were accepted for laparoscopic hysterectomy except when clinical or ultrasound examination indicated that conventional vaginal or abdominal hysterectomy would be more appropriate or less hazardous. RESULTS: The procedure took longer than conventional surgery but was followed by an accelerated recovery, both in terms of inpatient stay and a short convalescence. CONCLUSIONS: Laparoscopic hysterectomy is an alternative to conventional hysterectomy with apparent advantages. Patient recovery is generally faster. With increasing experience, complications of the procedure are reduced to levels that are comparable with those of conventional surgical hysterectomy.

Adult↗
PubMed1989

[Course of acute hepatitis B in alcoholism].

Clinical course of the acute hepatitis B has been analysed in 29 men chronically abusing alcohol. The most frequent source of the infection was surgery and hospitalizations. Clinical course and biochemical findings were similar in this group and in 30 men not drinking alcohol. A sole difference concerned higher GGTP activity in alcoholics. The persistence of HBs antigen was similar in both groups. Chronic alcohol abuse does not seem to have a significant effect on the course and convalescent phase of the acute hepatitis B.

Acute Disease↗
PubMed1998

[Study of the viral etiology of lower respiratory tract infections in a neonatal unit].

OBJECTIVE: To study the possible viral etiology in 139 infants with lower respiratory tract infection who required hospitalization in the Infant Unit of our hospital, from October 1994 to June 1995. PATIENTS AND METHODS: 139 patients were admitted, aged from 13 days to 14 months, during this period. The etiological agent was detected by direct immunofluorescence from nasopharyngeal secretions. Monoclonal antibodies were used against Respiratory Syncitial Virus, Influenza A Virus, Influenza B Virus, Adenovirus and Parainfluenza 3 Virus. Antibody detection against these viruses by Complement Fixation Test was done on 29 of these patients, with paired sera (acute and convalescent phase). RESULTS: In 82 patients (59%) we found at least one viral agents from the nasopharyngeal specimens, but in 64 of these only one was detected, in the remaining 18, there were more than one. Significant levels of antibodies were detected in only six of the 29 patients tested. Serology was negative in the remaining 23 patients. CONCLUSIONS: Syncitial Respiratory Virus is the first virus responsible for the lower respiratory tract infection in this age group (49%). There was no correlation between serological diagnosis and antigen detection.

Antigens, Viral↗
PubMed1989

[Efficacy of home exercise program in a convalescent phase of acute myocardial infarction evaluated by Borg's indices, expiratory gas analysis and blood lactate].

The Borg's indices, the rate of perceived exertion have been widely accepted to evaluate subjective symptoms semi-quantitatively in exercise tests. We applied the indices to evaluate the efficacy of our home exercise program in patients with acute myocardial infarction. Eighty-five patients were entered in our home exercise program after their discharge from the hospital. This program consisted of everyday 2 km walk-jog exercise for 1 month keeping their heart rate at 100-110/min during the exercise. Before and 1 month after their discharge, they underwent treadmill exercise tests with expiratory gas analysis and a measurement of blood lactate. In the treadmill tests performed before and after the training, VO2 and heart rate increased linearly with Borg's indices, however VE and blood lactate had disproportionate increases after Borg's 13 which is considered to be the anaerobic threshold (AT). In fact, AT measured individually by expiratory gas analysis and blood lactate, appeared at Borg's 13 in 53% of the patients. After 1 month physical training, VO2 and heart rate significantly increased at the same Borg's indices, but there was no significant changes in blood lactate at the same Borg's score before and after the training. These results suggest that, in patients with acute myocardial infarction, exercise performance significantly increased at any score of subjective symptoms and that Borg's indices may reflect the blood lactate levels. It is concluded that Borg's indices, closely related to the dynamics of blood lactate, are not only useful in quantifying subjective symptoms but also to estimate the efficacy of physical training.

Adult↗
PubMed2006

Recovery after coronary artery bypass grafting: patients' and health professionals' views of the hospital experience.

BACKGROUND: Increasing access to revascularisation procedures is a key aspect of a National Service Framework. Coronary artery bypass grafting (CABG) is effective in relieving symptoms and reducing mortality but some patients do not report an improved quality of life or experience a good recovery. AIMS: To describe the recovery trajectory after CABG and identify facilitators and barriers to recovery. METHODS: Semi-structured interviews were conducted with 11 patients who had previously undergone elective, isolated, first-time CABG and with 10 health professionals experienced in caring for these patients. RESULTS: Thematic analysis identified the following themes: definition and timeline of recovery, preparation for surgery including information provision, attitude to surgery and confidence in staff, clinical factors and the in-patient experience. The key finding is the different recovery trajectory between patients with severe versus mild pre-operative symptoms; patients with few pre-CABG symptoms reported a much longer recovery time. CONCLUSIONS: This study has provided insights into the barriers and facilitators to recovery after CABG and the processes involved. Findings have indicated areas where health professionals can intervene to aid patients' long-term recovery and thereby maximise the benefits of CABG.

Aged↗
PubMed2006

[Laboratory diagnoses of the first confirmed human case of avian influenza A (H5N1) in the mainland of China].

BACKGROUND: To determine the etiologic agent of an atypical pneumonia human case admitted to Xiangtan City hospital, Hunan Province in Oct. 2005. METHODS: The patient's respiratory tract samples and serum were collected. Throat swabs were tested by microneutralization and hemagglutination-inhibition assays. RESULTS: The results of nucleic acid detection of all respiratory samples were negative and virus isolation was also negative. The H5-specific antibodies of convalescence showed a 4-fold greater rise than acute phase. CONCLUSION: The atypical pneumonias case was confirmed as the first human case of avian influenza A (H5N1) infection in the mainland of China.

Animals↗
PubMed1984

Ultrasonic destruction of kidney stones.

Kidney stones may be removed without using a surgical incision by a combination of techniques and skills recently developed in the fields of urology and radiology. Percutaneous access to the kidney is established under fluoroscopic control. A guide wire placed into the renal pelvis allows a nephroscope to be inserted and the collecting system visualized. A long hollow metal probe is advanced through the nephroscope and placed in contact with the stone. This probe conducts the ultrasonic energy. The stone absorbs the energy and breaks into fine granules, which are evacuated by suction.Twenty-three consecutively seen patients presenting with 27 upper urinary tract calculi for which removal was indicated underwent successful percutaneous ultrasonic lithotripsy. Fifteen stones were located in the renal pelvis, eight in a calix, three at the ureteropelvic junction and one in the upper ureter. One infected staghorn calculus was removed. Two complications resulted in extended hospital stays, but in no patients were surgical incisions required. Of the 23 patients, 9 had previously had a surgical lithotomy. The authors believe that most renal and upper ureteral calculi for which removal is indicated may be extracted percutaneously with the aid of the ultrasonic lithotriptor. The patients may expect a rapid convalescence with diminished pain.

Adult↗
PubMed1997

Anterior flap extraperitoneal cystoplasty.

PURPOSE: We report on our initial experience with the anterior flap extraperitoneal cystoplasty for refractory voiding symptoms secondary to detrusor hyperactivity. MATERIALS AND METHODS: A total of 27 patients underwent anterior flap extraperitoneal cystoplasty, the principles of which include a Pfannenstiel skin incision, a small peritoneotomy with minimal manipulation of the bowel, extraperitoneal bowel resection with ileovesical anastomosis and creation of an anterior bladder wall flap. RESULTS: Convalescence was uneventful in 25 patients (92%). Oral intake resumed on postoperative day 3 or 4, and the patient was discharged home on postoperative day 5 or 6. Voiding symptoms resolved or improved significantly in 92% of patients, who were dry or used 1 or no pads a day. Two complications required prolonged hospitalization. CONCLUSIONS: Anterior flap extraperitoneal cystoplasty is a safe and effective treatment that has the potential to decrease postoperative complications and recovery time.

Adult↗
PubMed1997

Puumala and Dobrava viruses cause hemorrhagic fever with renal syndrome in Bosnia-Herzegovina: evidence of highly cross-neutralizing antibody responses in early patient sera.

Hantavirus infection was diagnosed serologically by mu-capture IgM and IgG ELISAs in hemorrhagic fever with renal syndrome (HFRS) patients admitted to Tuzla Hospital, Bosnia-Herzegovina. The results indicated that more than one hantavirus caused the outbreak. To address the question of which hantavirus serotypes were involved, sequentially drawn sera were analyzed by focus reduction neutralization test (FRNT) for antibodies against Puumala, Hantaan, Dobrava, and Seoul hantaviruses. The data revealed that acute- or early convalescent-phase sera, even when drawn as late as 3 weeks after the onset of disease, could not be used for typing of the causative hantavirus; a significant number of these samples showed similar reactivity of neutralizing antibodies to several different hantavirus serotypes. Moreover, although several acute-phase sera showed the highest FRNT titer to Hantaan virus, convalescent sera from these patients in all cases showed high specificity for Puumala or Dobrava viruses. This phenomenon, interpreted as a cross-neutralizing primary antibody response, makes several earlier reports concerning causative agents of HFRS questionable. Serological examination of small rodents trapped in the endemic area identified Puumala- and Dobrava-like virus infections. RT-PCR and sequencing of rodent lung samples identified Dobrava virus in one yellow-necked field mouse (Apodemus flavicollis). Cross-FRNT data, using polyclonal rabbit antibodies, clearly confirmed Dobrava virus as a unique hantavirus serotype. In conclusion, the results revealed that both Puumala- and Dobrava-like viruses caused HFRS in Bosnia-Herzegovina, whereas no signs of Hantaan or Seoul virus involvement were found.

Animals↗
PubMed1989

Determination of a glucose-containing tetrasaccharide in urine of patients with acute pancreatitis.

The oligosaccharide Glc alpha 1-6Glc alpha 1-4Glc alpha 1-4Glc (Glc4), formed by amylolytic degradation of starch and glycogen, is excreted at extremely high levels in the urine of patients with acute pancreatitis. To determine if Glc4 is a useful indicator for this disease, we studied 55 patients admitted to the hospital because of acute abdominal pain (possibly acute pancreatitis). The highest values of Glc4 excretion in urine was found in a group of 11 patients with acute pancreatitis. The Glc4 values, but not serum and urine amylase values obtained at admission, correlated significantly with the severity of the disease. In two patients, followed through convalescence, the Glc4 excretion remained elevated for 7 and 2 wk in contrast to serum and urine amylase that returned to normal levels within a few days. It seems probable that glycogen, released from the liver and subsequently degraded by amylase originating from the pancreas, can be measured as Glc4 in the urine. This might be valuable for diagnosing acute pancreatitis and gives indications of the prognosis.

Acute Disease↗
PubMed1987

Blood donor selection can prevent cytomegalovirus infection after open heart surgery.

Thirty-four patients without IgG antibodies against cytomegalovirus (CMV) prior to open heart surgery were studied. The patients were randomized to receive blood either from unselected donors, or from donors without detectable CMV antibodies. Fresh whole blood was mainly used. Eleven patients received CMV seronegative blood only. All had an uneventful convalescence period and remained seronegative. Ten of the 23 patients who received blood from unselected donors had typical CMV disease with the onset of symptoms in the third or fourth postoperative week, and fever lasting for two to three weeks. They all had liver enzyme release and later seroconversion against CMV. Four patients were hospitalized during this period. The incidence of symptomatic CMV infection after open heart surgery was higher than usually reported among the CMV seronegative patients. Selection of blood donors who lack antibodies against CMV may be an adequate protective measure. Avoidance of fresh blood and reduced use of blood products are presumably also of importance.

Antibodies, Viral↗
PubMed1994

[Epidemiological study on respiratory syncytial virus lower respiratory tract infections in northern Hokkaido, Japan].

We carried out an epidemiological study on lower respiratory tract infections, concerning the respiratory syncytial virus (RSV) infection, in northern Hokkaido, Japan, during the 2-year-study period from April 1991 to March 1993. There were 467 hospitalized patients with lower respiratory tract infections. We examined the presence of RSV antigen in their nasopharyngeal specimens of 456 out of 467 patients (97.6%) by enzyme immunoassay. The diagnosis of Mycoplasma pneumoniae infection was done by the rise of antibody titer, performed with complement fixation method, in the sera of the acute and convalescent phases. There were 133 patients with RSV infection (28.9%), 45 patients with Mycoplasma pneumoniae infection (9.8%) and 7 patients with measles virus infection (1.5%). RSV played an important role in the lower respiratory tract infections in northern Hokkaido, Japan. The epidemic of RSV infection was observed in spring and early winter in 1991 and only in early winter in 1992. The number of patients with RSV infection from April 1991 to March 1992 was greater than that from April 1992 to March 1993. In contrast with RSV infection, the epidemic of Mycoplasma pneumoniae infection was observed in 1992. We speculated that the RSV and Mycoplasma pneumoniae infections might interfere with each other.

Adolescent↗
PubMed1988

Enterotoxigenic Escherichia coli diarrhea in an endemic area prepares the intestine for an anamnestic immunoglobulin A antitoxin response to oral cholera B subunit vaccination.

We examined whether infection with enterotoxigenic Escherichia coli (ETEC) producing the heat-labile enterotoxin (LT) can prime the gut immune system to respond more efficiently to the immunologically related cholera B subunit component of a recently developed oral B subunit-whole-cell cholera vaccine (B-WCV). Nine Bangladeshi adults who had been hospitalized for watery diarrhea caused by LT-producing ETEC were given a single oral immunization with B-WCV on day 28 after hospital admission. The vaccine preparation used was adjusted to contain a lower-than-usual dose of B subunit, which had been found in previous studies to elicit a significant gut mucosal immunoglobulin A antitoxin response mainly in individuals with previous toxin-specific priming of their gut immune system. For comparison, nine patients convalescing from severe cholera disease and eight healthy subjects with no recent history of either cholera or ETEC infection were given the same oral vaccination with B-WCV. Vaccination in the ETEC convalescents induced an immunoglobulin A antitoxin response in intestinal lavage fluid which was comparable with that in the vaccinated cholera convalescents and superior to that in the vaccinated, previously uninfected controls. By contrast, only the cholera patients responded with anamnestic-type anti-cholera lipopolysaccharide antibody titer rises in the intestine after vaccination. These data support the specificity of the anamnestic anti-cholera toxin response in the ETEC patients after vaccination with cholera B-WCV.

Bacterial Toxins↗
PubMed1999

Elevated high molecular weight fibrinogen in plasma is predictive of coronary ischemic events after acute myocardial infarction.

This study investigates the association between the concentration and function of plasma fibrinogen molecules measured at the time of hospital admission in patients with acute myocardial infarction (AMI), with reference to the risk of new coronary ischemic events during a three-day follow-up period of. Before starting fibrinolytic and anticoagulant treatment plasma fibrinogen, high molecular weight fibrinogen (HMW-fibrinogen), fibrin formation rate (FbFR) and phosphorous content in fibrinogen were determined in 90 AMI patients. During a three-day follow-up period 12 patients suffered new ischemic events. The 12 patients with coronary ischemia had higher concentrations of plasma fibrinogen (312+/-23 vs. 270+/-73 mg/dl, p<0.05) and HMW-fibrinogen (246+/-35 vs. 189+/-23 mg/dl, p<0.001) and a higher FbFR (65+/-30 vs. 40+/-25, p<0.001) than patients without these events. No association was found between the phosphorous content in fibrinogen and new coronary ischemic events. We conclude that after myocardial infarction an elevated plasma level of HMW-fibrinogen and a high FbFR value at the time of hospital admission are associated with new coronary ischemic events during a three-day follow-up period.

Aged↗
PubMed2002

[Course of postoperative pain in laparoscopic cholecystectomy under multimodal anesthesia-analgesia in ambulatory care].

OBJECTIVE: To evaluate the evolution of postoperative pain and convalescence in a group of patients undergoing elective laparoscopic cholecystectomy under a multimodal anesthesia-analgesia treatment protocol. MATERIAL AND METHOD: Eighty-four consecutive patients undergoing elective laparoscopic cholecystectomy were given intramuscular ketoprofen during induction, anesthesia, with minimal use of opioids, and intraperitoneal irrigation with bupivacaine. We assessed the rate of conversion to hospitalization, hospital stay in hours, duration of the pain-free interval, oral analgesics per day at home, and intensity of postoperative pain and physical activity daily on a visual analog scale. RESULTS: The procedures were carried out on an outpatient basis in 90.5% of the cases, and the mean postoperative hospital stay was 7.2 +/- 0.9 hours. Eight patients required an overnight stay. No postoperative analgesics were required by 27.3% of the patients. Patients requiring analgesics had pain-free intervals lasting 17.3 +/- 11.8 hours after discharge. On the third day after surgery 80% had used no analgesics and over 75% had no pain or only minor pain. On the fourth postoperative day 50% were able to perform activities of daily living without help, and 50% returned to work on the eleventh day after surgery. CONCLUSIONS: The multimodal analgesia-anesthesia treatment proposed allows a high percentage of laparoscopic cholecystectomies to be performed on an outpatients basis. The protocol provides good control of postoperative pain and nausea and rapid return to habitual activity.

Ambulatory Surgical Procedures↗
PubMed1982

[Non typhoidal Salmonella infections: a clinical study of 491 cases (author's transl)].

491 cases of non typhoidal salmonella infections were studied in the Rouen Hospital University Centre. Affected patients are mainly children who usually present mild febrile gastroenteritis. Severe forms with septicemia, enteric fever, or focal manifestations, usually occur in adults. In nearly half the cases an underlying disease or another predisposing condition was found. In these cases, the mortality rate was increased. Antibiotic therapy prolonged post-convalescent excretion of salmonellae. Adequate diet and hygiene are sufficient in mild forms. Antibiotics should be used only in acute salmonella infections.

Adult↗