Patients In Convalescent Phase Research Articles

Abstract WP326: Randomized-Controlled Study on the Effects of Hand Bathing on Stroke Patients in Convalescence - Subjective Improvements in Hand Movement and Increased Positiveness in Talking

Background and Purpose: Depressed stroke patients are more likely to drop out of rehabilitation. Hand bathing is a term used to describe a uniquely Japanese hygiene care in which a nurse washes and stimulates the patient’s hands in warm water while talking to each other. The purpose of this study was to verify, by a randomized-controlled study, the hypothesis indicated in the author’s preliminary studies that hand bathing makes stroke patients more conscious of their hand movement on the affected side and talk more positively. Methods: Stroke patients in convalescent phase in the Brunnstrom stages I to V were randomly allocated to the hand-bathed group (23 patients) or the control (21 patients). Both groups received a 15-minute intervention four times within a week. Before and after each intervention, the visual analogue scale (VAS) was assessed for hand movement, edema, and numbness/pain, the tip palm distance was measured, and the QOL was assessed using the QUIK-R. The t-test and repeated measures ANOVA were used to analyze the data. A verbatim record of all conversation was subjected to morphological analysis, TF-IDF, and TF analysis of nouns and adjectives. Results: The hand-bathed group felt improved hand movement significantly more after the first and fourth interventions (F=4.41,p=.013). No significant difference was detected between the two groups in the VAS for edema, numbness/pain, and heavy feeling in hands. Positive adjectives were used more often by the hand-bathed group after the second, third and fourth interventions (F=3.58, p=.016). In the hand-bathed group, the average score of QOL questions on socializing and sense of contentment/well-being improved significantly after interventions (p=.003) Conclusions: The finding supported the said hypothesis in that hand bathing leads to subjective improvement in hand movement of stroke patients in convalescent phase and makes them talk more positively. It has additionally been indicated that hand bathing also helps them become more sociable and have a better sense of contentment and well-being.

Lsa63, a newly identified surface protein of Leptospira interrogans binds laminin and collagen IV

Leptospira interrogans is the etiological agent of leptospirosis, a zoonotic disease that affects populations worldwide. We have identified in proteomic studies a protein that is encoded by the gene LIC10314 and expressed in virulent strain of L. interrogans serovar Pomona. This protein was predicted to be surface exposed by PSORT program and contains a p83/100 domain identified by BLAST analysis that is conserved in protein antigens of several strains of Borrelia and Treponema spp. The proteins containing this domain have been claimed antigen candidates for serodiagnosis of Lyme borreliosis. Thus, we have cloned the LIC10314 and expressed the protein in Escherichia coli BL21-SI strain by using the expression vector pAE. The recombinant protein tagged with N-terminal hexahistidine was purified by metal-charged chromatography and characterized by circular dichroism spectroscopy. This protein is conserved among several species of pathogenic Leptospira and absent in the saprophytic strain L. biflexa. We confirm by liquid-phase immunofluorescence assays with living organisms that this protein is most likely a new surface leptospiral protein. The ability of the protein to mediate attachment to ECM components was evaluated by binding assays. The leptospiral protein encoded by LIC10314, named Lsa63 (Leptospiral surface adhesin of 63kDa), binds strongly to laminin and collagen IV in a dose-dependent and saturable fashion. In addition, Lsa63 is probably expressed during infection since it was recognized by antibodies of serum samples of confirmed-leptospirosis patients in convalescent phase of the disease. Altogether, the data suggests that this novel identified surface protein may be involved in leptospiral pathogenesis.

Correlation of serum antibody titers against hepatitis C virus core protein with clinical features by western blot (immunoblot) analysis using a recombinant vaccinia virus expression system.

In order to study the relationships among the clinical features of hepatitis C patients, the presence of hepatitis C virus (HCV) RNA in their blood, and their serum antibody titers against the core protein of virus and to study the antibody levels in asymptomatic HCV carriers, a recombinant vaccinia virus containing a core protein gene was constructed. The recombinant virus expressed a protein with a molecular mass of 22 kDa in RK-13 cells as determined by Western blot (immunoblot) analysis. By using the cell lysate of virus-infected cells and serially diluted serum samples, core antibody titers in the groups of patients in the chronic hepatitis phase and in the convalescent phase as well as in asymptomatic carriers were determined by enhanced chemiluminescence Western blot analysis. Almost all patients in the chronic phase were shown to have high antibody titers of more than 1:500,000 and with no exception had of HCV RNA in their sera. On the other hand, patients who had recovered naturally and were in the convalescent phase were shown to have significantly lower antibody titers, and the antibody was not detected in the lowest serum dilution of 1:500 in 43% of these patients (three of seven total patients). Antibody levels of patients who showed a good response to interferon treatment decreased to intermediate levels between those of patients in the chronic phase and those of patients in convalescent phase. The antibody titers in asymptomatic carriers varied considerably from 1:500,000 to 1:500, and 41% (11 of 27 total individuals) of these carriers showed a high titer equivalent to that of those in the chronic phase. Core antibody was detected consistently in the individuals in whom HCV RNA was detected. This system for core antibody might be useful for identifying the stage of an apparent HCV infection.

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.

Plasma renin activity and plasma aldosterone in acute renal failure.

Plasma renin activity and plasma aldosterone were determined by radioimmunoassay methods in 20 patients in oliguric phase, in 11 patients in polyuric phase and in 7 patients in convalescent phase of acute renal failure of various origin. The oliguric phase of acute renal failure was characterized by significant increase of plasma renin activity and plasma aldosterone. There was no direct dependence between them. Direct dependence was found between plasma aldosterone and serum potassium in the oliguric phase of acute renal failure, indirect dependence between plasma aldosterone and serum sodium was found before as well as after haemodialysis. These findings prove a direct influence of hyperkalemia and depletion hyponatremia upon aldosterone secretion in the oliguric phase of acute renal failure. Haemodialysis led to a further increase of plasma renin activity caused by ultrafiltration as well as successive dehydration and application of some drugs. The mean value of plasma aldosterone was not significantly changed after haemodialysis. Plasma renin activity decreased very slowly in the polyuric and convalescence phase of acute renal failure, while plasma aldosterone concentration was already in polyuric phase non-significantly different from the control group. There was no direct dependence in the various phases of acute renal failure between plasma renin activity, plasma aldosterone, systolic and diastolic pressure. The renin-angiotensin-aldosterone system significantly participates in the pathogenesis of acute renal failure in man, but various causes of acute renal failure, different drugs, as well as therapeutic procedures do not make it possible to quantify it in detail. Charcoal haemoperfusion in acute poisonings led only to non-significant increase of plasma renin activity and decrease of plasma aldosterone.