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PubMed2003

[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↗
PubMed1990

[Role of polymorphonucleocyte-produced leukotriene B4 in Kawasaki disease].

It is postulated that inflammatory cells play an important role in the process of developing vasculitis in Kawasaki Disease. LTB4, a 5-lipoxygenase product of arachidonic acid is one of the most potent chemoattractants to inflammatory cells and is produced in large amounts by PMNs. We investigated the role of PMN-derived LTB4 in Kawasaki Disease. Isolated PMNs were obtained from 19 Kawasaki disease patients in three different phases of the illness, (acute phase: 0-12th day, convalescent phase: 13-29th day, restored phase: greater than 30th day). LTB4 synthesis in the convalescent phase was 26.43 +/- 4.2 ng/5 x 10(6) cells, which was significantly higher than those in the acute and restored phases (11.90 +/- 1.91, 13.87 +/- 1.86 ng) and also higher than that in the control subjects (10.65 +/- 1.26 ng: p less than 0.05). No differences were found between two groups with or without coronary lesions. The results imply that activated PMNs during the convalescent phase of illness produce larger amount of LTB4 which may participate in the development of inflammatory process of the disease and that PMN-derived LTB4 plays no significant roles in the development of coronary lesions.

Aspirin↗
PubMed1991

A comparison of the nutritional status of elderly Chinese living in different types of non-acute care institutions in Hong Kong.

The nutritional status of 191 elderly subjects living in three types of non-acute care institutions was studied by estimating nutrient intake and biochemical status. The dietary intake of women in the long-stay institution was similar to that of free-living elderly subjects. Dietary consumption of subjects living in a private nursing home and a convalescent unit were poorer than for elderly free-living subjects. Elderly women in all institutions had a poorer protein nutritional status, a poorer biochemical status of vitamin B12, folate, ascorbic acid, and vitamin D, and lower plasma potassium levels when compared with free-living elderly women. Those in the private nursing home and the convalescent unit had the poorest protein nutritional status. Among men, institutionalized subjects were observed to have poorer thiamine and riboflavine status, in addition to the above findings. The greater prevalence of chronic diseases and disability in the convalescent unit and the private nursing home may partly account for the poorer nutritional status of residents in these two institutions.

Aged↗
PubMed1991

Acute alterations in the regulation of lipid metabolism after intravascular reexposure to a single bolus of homologous virus during influenza B infection in ferrets: possible model of epiphenomena associated with influenza.

Metabolic responses occurring 24 h following the secondary haematogenous dissemination of influenza B virus during convalescence from infection were examined in the ferret as a possible model for epiphenomena which can occur following infection with influenza. Among the major changes found were a further rise in the mean fasting serum free fatty acid (FFA) level to three times the control mean value and a 50% drop in the mean serum triglyceride (TG) concentration after the intravascular administration of a single bolus of virus compared to levels found in uninfected or convalescent animals. In adipose tissue, hormone-sensitive and lipoprotein lipase activities were increased six and three-fold, respectively, over mean control values, probably accounting for the changes that were observed in serum lipid concentrations. In the liver, total carnitine palmitoyltransferase (CPT) activity was affected only slightly and the total lipid content of the liver remained unchanged. These findings indicate that 24 h after the intravascular dissemination of homologous virus in a single bolus during convalescence from influenza B infection, major distortions in the regulation of lipid metabolism occur in the ferret. Loss of the synchronous regulation of the two adipose tissue lipases is a significant consequence leading to the mobilization of a large amount of FFA during fasting from both adipose tissue and the circulating plasma TG stores.

Adipose Tissue↗
PubMed1976

Virus-like antigen associated with hepatitis A: investigations in children's acute hepatitis.

Stool specimens, collected from 8 children with viral hepatitis [5 of type A, presumably, and 3 of type B (HBsAg-positive)] during the acute phase, were examined in the electron microscope. The presence of 27-nm virus-like particles, aggregated by the convalescent serum of a chimpanzee infected with MS-1 and not by the serum of the same animal drawn before infection, was detected by immune electron microscopy (IEM) in the stools of 3 out of the 5 children with suspected hepatitis A. The virus-like particles (HA-Ag) present in the stools were aggregated by the serum drawn from the corresponding subject during convalescence and not by that obtained in the acute phase of the disease. Employing as antigen a stool particle preparation purified by isopycnic banding in cesium cloride, it was pointed out that, in all 5 children with suspected hepatitis A, antibodies capable to cause the aggregation of HA-Ag particles, appeared. Anti-HA antibodies turned out to be present also in three lots of commercial immunoglobulins. In the three subjects with type B hepatitis (HBsAg-positive) neither virus-like particles with a 27-nm diameter were observed, nor anti-HA antibodies appeared in the convalescent serum.

Acute Disease↗
PubMed1991

[Immunoglobulin levels, number of eosinophils in the peripheral blood and bronchial hypersensitivity in children with Mycoplasma pneumoniae pneumonia].

We studied the immunoglobulin levels and the number of eosinophils in the peripheral blood during the course of Mycoplasma pneumoniae pneumonia in children. Nineteen children with Mycoplasma pneumoniae pneumonia, including eight asthmatic children, were the study subjects. In eight of them, bronchial hypersensitivity was also measured by the Astograph method in both the convalescent phase and the healing (non-symptomatic) phase. The results were as follows. 1) Total serum IgA and IgM increased in the convalescent phase. 2) The levels of total serum IgE were higher in the acute phase and then decreased gradually. 3) The number of eosinophils in the peripheral blood increased over the acute-to-convalescent phase. 4) Bronchial hypersensitivity increased after Mycoplasma pneumoniae pneumonia, and two asthmatic children who exhibited bronchial hypersensitivity had asthmatic attacks. 5) Bronchial hypersensitivity persisted for over one month in two non-asthmatic children.

Adolescent↗
PubMedDate not supplied

[Virological and serological study of rotavirus gastroenteritis].

Cases of acute gastroenteritis with negative bacteriological analyses were examined. Preparations of feces collected from patients in the acute stage of the disease were found by immune electron microscopy to contain typical rotavirus particles forming specific aggregates in the presence of convalescent sera. Examinations of paired acute and convalescent sera of the patients revealed the presence in convalescent sera of specific antibodies neutralizing simian rotavirus SA 11 antigenically related to human rotavirus. The specificity of the antibody was confirmed by their titrations by immune electron microscopy and HI test. Thus, rotavirus etiology of cases of gastroenteritis in various parts of the country was confirmed, and the possibility of specific laboratory diagnosis of such cases using simian rotavirus SA 11 was demonstrated.

Antibodies, Viral↗
PubMed1990

[An outbreak of influenza in hospital personnel].

During the last week of December 1989, an outbreak of respiratory system infection involved 32 hospital personnel and 2 patients was detected in Gazi University Medical Faculty Hospital. White blood cells count of the patients were either normal or there were a slight leucopenia. Throat cultures of the most patients were normal. Serum ASO, CRP, bilirubin, AST and ALT were usually within normal limits. According to symptoms, signs and laboratory data we considered a viral disease, especially influenza. All patients recovered without any sequelae. Of 34 in-patients, 8 paired sera, 2 acute phase sera, and 10 convalescent phase sera were tested for the presence of Hemagglutination Inhibition (HI) antibody to three influenza virus strains recommended by WHO in the 1989-1990 season: Influenza A/Taiwan/1/86 (H1 N1), Influenza A/Shanghai/11/87 (H3 N2), Influenza B/Victoria/2/87. All of the sera were negative for Influenza B/Victoria/2/87. There were no significant rises in HT antibody titer for Influenza A/Taiwan/1/86 (H1 N1). The sera for 4 of 8 patients examined both acute and convalescent phase sera had fourfold or greater rise in HI antibody for Influenza A/Shanghai/11/87 (H3 N2). Four patients examined only convalescent sera had 1/40 or greater rises in HI antibody for this influenza subtype. It was considered that this influenza outbreak was probably caused by Influenza A/Shanghai/11/87 (H3 N2).

Antibodies, Viral↗
PubMedDate not supplied

[Psychological study of adults surgically treated in childhood for hypospadias].

The authors present the study and results in 100 subjects operated of hypospadia. They interviewed patients within 15 and 22 years old, in randomized selection and in permanent percent relations as far as: different types of pathology, the age of surgery effected in Vicenza Hospital - Pediatric Surgery Department (1971-1981). Through a structured questionnaire they tried to analyse psychological lived in operated subjects as far as: surgery, convalescence, psychologic problems before and after surgery, way of life when they became adults. Results explain that exist some psychologic problems in operated patients (8.5 years old) before surgery and during convalescence, while there is no problem after surgery. Moreover when these subjects became adults their kind of life (school, profession, sexuality) is without psychopathological problems. This is because of positive attitudes pre-acquired, brief convalescence and above all the high and positive quality of surgery effected.

Adolescent↗
PubMed1989

[Reducing children's morbidity in departmental preschool institutions].

The study reveals that the work aimed at decreasing morbidity rates and promoting children's health including the organization of the preschool convalescent home for 110 beds, special shifts in convalescent homes for mother and child, summer health-promotion groups results in a significant decrease of disease prevalence in preschool establishments. It is pointed out that rehabilitative treatment of convalescents, children's protection from influenza and acute respiratory virus infections, other organizational measures are of great importance for the process.

Child Health Services↗
PubMed1988

Natural killer cells in dengue hemorrhagic fever/dengue shock syndrome.

Natural killer (NK) cell activity against K-562 target cells and HNK-1+ cell levels were serially determined in peripheral blood of 62 Thai children with dengue hemorrhagic fever/dengue shock syndrome aged 4-12 years and 59 age-matched normal controls. The studies were performed on febrile stage, 1st and 2nd day of subsidence of fever (shock stage), 3rd and 4th day of subsidence of fever (early convalescent stage) and once again on the late convalescent stage (approximately 14-18 days after subsidence of fever). The study revealed that during the course of disease the NK cell activity was not changed significantly from the normal controls. In contrast, the levels of HNK-1+ cells, which exhibited almost all NK and killer cell functional activities, were significantly decreased in the febrile and the shock stages and were normal in the early and late convalescent stages. The NK cell activity, on the per-cell basis, was significantly increased in the early disease stage when compared to that of the later period of the disease and of the normal controls. The study also revealed that patients with grade III of disease severity exhibited significantly more NK cell functional activities per cell than grade II on febrile stage and the first day of shock. These results suggest that natural killer cells were active in defense against dengue viral infection and might play some role in the pathogenesis of dengue hemorrhagic fever/dengue shock syndrome. Their functions might also determine the severity of the disease.

Child↗
PubMed1988

Gastroduodenal hemorrhage and perforation in the postoperative period.

The distinction between stress ulceration and acute exacerbations of chronic peptic ulcer disease is rarely made in the context of postoperative hemorrhage or perforation of the upper part of the gastrointestinal tract. We reviewed our recent experience during a three and one-half year period with 31 emergency operations performed for gastroduodenal hemorrhage or perforation. Seven patients were convalescing from extensive surgical procedures unrelated to gastroduodenal ulcer disease at the time of hemorrhage or perforation. These complications tended to occur about one week after the initial operation. Six of these seven patients had duodenal ulcer disease; prior ulcer disease or current use of ulcerogenic drugs could be documented in all six. Only one of these seven patients had true stress ulceration. There were 143 patients with active peptic ulcer who underwent an extensive surgical procedure unrelated to ulcer disease. Three of these 143 patients required surgical intervention for complications of ulcer disease during the convalescent period. Our experience suggests that a common setting for emergency operations for peptic ulcer hemorrhage or perforation is during convalescence from an unrelated surgical procedure. A history of peptic ulcer disease or use of ulcerogenic agents should alert the surgeon to the possibility of postoperative hemorrhage or perforation. These complications most commonly reflect chronic duodenal ulcer disease or diathesis and not true stress ulceration.

Acute Disease↗
PubMed1986

[Studies on the interaction between cells infected with measles virus and anti-measles antibody. I. Cytotoxic antibody activity of sera obtained from patients with natural measles and subacute sclerosing panencephalitis by use of chronically infected cell lines].

Sera obtained from patients with natural measles and subacute sclerosing panencephalitis (SSPE) showed cytotoxic activity in the presence of complement on cells persistently infected with either measles virus (Schwarz and TYCSA strains) or SSPE virus (Halle and Mantooth strains). The cytotoxic activity was demonstrated in both IgG and IgM fractions of measles convalescent sera, but only in IgG fraction of SSPE sera. Measles convalescent sera completely lost the cytotoxic activity to all carrier cell lines, when absorbed with any one of the cell lines, indicating that the viral surface antigens of these cell lines infected with measles or SSPE virus were identical. On the other hand, the cytotoxic activity of SSPE sera could not be readily absorbed with these cells. Thus, the affinity of SSPE sera for the viral surface antigens might be lower than that of measles convalescent sera.

Adult↗
PubMed1986

Meperidine disposition in burn patients.

Limited information is available describing the pharmacokinetics of hepatically-cleared drugs in burn patients. Based on the hypothesis that after burn injury, plasma meperidine clearance should increase in response to the postburn increase in hepatic blood flow, we examined the kinetics of intravenous meperidine in eleven patients about one week after burn injury (acute study) and in five of these patients about six weeks postburn (convalescent study). The meperidine steady-state distribution volume (about 2 1/kg) during both the acute and the convalescent studies was about half the distribution volume reported in the literature for meperidine in healthy subjects. The meperidine clearance in burn patients (acute, 420 ml/min and convalescent, 600 ml/min) was lower than would be anticipated in the presence of known marked increases in hepatic blood flow in burn patients.

Adolescent↗
PubMed1985

Serial changes in primary hemostasis after massive transfusion.

Primary hemostasis was studied in 22 injured patients in the operating room (OR) after a minimum of 10 transfusions, 6 and 15 hours after surgery, on postoperative days 2 and 4 and during convalescence (mean 25 days after surgery). The platelet count was low in the OR and continued to fall after surgery through the second postoperative day; it began to rise by day 4 and was above normal at convalescence. Most patients had prolonged bleeding time through day 4. Platelet aggregation with adenosine diphosphate and collagen was depressed in the OR and platelet aggregation remained depressed. The platelet-specific proteins, beta-thromboglobulin and platelet factor 4, were elevated in the OR and fell throughout the first 4 postoperative days. A secondary rise in these proteins occurred at convalescence. Despite severe alterations in both the number and function of platelets after massive transfusion for injury, no patient had clinical oozing. Therefore the routine administration of platelets in comparable patients without "medical bleeding" is unwarranted.

Accidents, Traffic↗
PubMed1977

Serum immunoglobulin levels in various forms of meningococcal infection and in meningococcus carriers.

The levels of serum IgG, IgA and IgM were examined in 191 adults including 103 patients with various forms of meningococcal infection, 32 meningitis convalescents and 56 carriers, in order to elucidate the causes of different susceptibility to the meningococcal infection. The IgD level was determined in 54 meningitis patients as well as in convalescents and carriers. The amount of immunoglobulins was determined by radial immunodiffusion. The level of IgG at the beginning of the disease in patients with the generalized forms of meningococcal infection (meningitis, meningitis combined with meningococcaemia, meningococcaemia) was found to be considerably lower than in healthy subjects. The levels of all immunoglobulins, particularly of IgA and IgM, increased in the course of the disease. The levels of IgG, IgA and IgM in meningitis convalescents a year after recovery were found to be the same as in the controls. The levels of IgG, IgA and IgM in patients with meningococcal nasopharyngitis were significantly lower than in healthy subjects. The carriers showed a decreasd level of IgA and a considerably increased level of IgG while the levels of IgM and IgD did not differ from the control.

Carrier State↗
PubMed1983

Immunity to herpes simplex virus type 2. V. Risk of recurrent disease following primary infection: modulation of T-cell subsets and lymphokine (LIF) production.

Phenotypic and functional characteristics of peripheral blood lymphocytes (PBL) from 133 patients (87 female; 46 male) with documented primary or recurrent genital HSV-2 infection were determined by serologic testing and CMI [lymphocyte blastogenesis and lymphokine (LF)] evaluation. Primary infection was followed by the development of virus-specific immune memory as defined in vitro by lymphocyte blastogenesis and the development of neutralizing antibody. Virus-specific LIF production was detected by day 5 following primary infection and continued through convalescence. Unlike blastogenesis. LIF response was no longer detected at greater than or equal to 30 days after onset in patients who subsequently developed recurrent disease. It was also suppressed during recrudescence. During convalescence, LIF production returned to levels similar to those for seropositive controls. Patients who did not develop recurrent disease following primary HSV-2 genital infection were LIF positive at greater than or equal to 30 days. The suppression of LIF production during recrudescence and at prodrome correlated with a significant increase in the proportion of OKT8+ and OKIa+ cells. During convalescence (4-9 days after lesion onset), the proportion of OKT8+ and OKIa+ cells returned to normal, remaining constant during the quiescent period (greater than or equal to 14 days). Similar fluctuations were not observed in seropositive controls. Suppression of the LIF response during recrudescence was abrogated by depletion of glass-adherent OKIa+ and OKT8+ cells or by complement-mediated cytolysis using OKT8, OKM2, or OKIa antibody. PBL obtained from patients during primary genital HSV-2 infection exhibited an increase in the OKT10+ and OKM2+ cells.

Adolescent↗
PubMedDate not supplied

[Lymphocyte subpopulations in the cerebrospinal fluid and peripheral blood in lymphocytic meningitis].

Lymphocyte subpopulations were evaluated in the cerebrospinal fluid and peripheral blood in 22 patients in the initial stage of aseptic meningitis and during convalescence. In the acute stage of the disease the proportion of lymphocytes T, including their active forms, was increased, during convalescence a further significant rise was observed in the subpopulation of lymphocytes T with a fall of the proportion of lymphocytes bearing the high "avid" Fc IgG receptor. In patients with acute meningitis and during convalescence a rise was observed in the proportion of lymphocytes T in the peripheral blood. In the acute stage of the disease the number of lymphocytes with a high binding ability of the Fc receptor was decreased. Changes in lymphocytes subpopulations in aseptic meningitis suggest mobilization of lymphocytes engaged in the cell-mediated immune response.

Adolescent↗