PubMed · 5178654
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D J Leithauser, L Gregory, S M Miller. 1966. Immediate ambulation after extensive surgery.. https://pubmed.ncbi.nlm.nih.gov/5178654/
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To determine differences in recommendations for convalescence after inguinal herniorrhaphy, a questionnaire was mailed to 294 general practitioners in the Copenhagen area. Sixty-two percent returned the questionnaire. After primary hernia repair a period of 1-12 weeks off work was recommended (mean 2.6, 4.1 and 7.8 weeks in patients with light, moderate or heavy work load, respectively). After repair for recurrent hernia 1-24 weeks off work were recommended (mean 3.5, 5.4 and 8.3 weeks in patients with light, moderate or heavy work load, respectively). Restrictions in lifting (> 5 kg) were recommended for 1-16 weeks, mean 6.1 and 7.4 weeks after primary and recurrent repair, respectively. It is concluded that there is a need for propagation of new data regarding shortened convalescence after herniorrhaphy in order to maximise the advantages of new surgical and analgesic techniques.
Only a small proportion of cancer patients undergo radical radiotherapy to the head and neck, but their needs are particularly complex. Radiation reactions often exacerbate existing functional difficulties and may severely limit 'normal' life. Few existing studies examine what happens when radiotherapy is over, yet this is the time when reactions are at their peak and day to day links with the hospital are severed. This naturalistic inquiry uses a combination of methods to explore the experiences of 12 patients after completion of radiotherapy to the head and neck. The impact of radiotherapy and the profound disruption to daily life is shown by the uncertainty and unpredictability of symptoms, the waiting, ambiguity and loss of self integrity which occurs throughout this time. Despite considerable physical and emotional trauma, patients showed remarkable resilience and a profound reluctance to ask for help. The findings demand that we re-examine our styles of communication, and consider how well we give information and listen to what is really happening. It is imperative that we provide greater consistency and continuity of care during radiotherapy, recognize the impact of the whole experience and respond to the post-treatment needs of this unique patient group.
Infection with the Epstein-Barr virus (EBV) is common worldwide. A significant number of infected individuals develop infectious mononucleosis (IM). IM is manifested in most patients as a benign disease with mild symptoms. However, serious complications may develop in a subset of patients. Because EBV-infected B lymphocytes produce various cytokines that may provide the cells with a proliferative advantage, cytokine concentrations in serum samples taken from IM patients were measured in order to identify the cytokines responsible for the clinical manifestations of the disease. The concentrations of interleukin-1beta (IL-1beta), IL-2, IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-alpha), and lymphotoxin (LT) were measured using an enzyme-linked immunosorbent assay (ELISA) in serum obtained from 14 IM patients during the acute phase of the disease and during convalescence, 5 patients with identical clinical manifestations who did not have IM (sick controls), and 11 healthy volunteers. It was found that the serum levels of TNF-alpha and IL-6 were significantly high in patients with acute IM compared with the serum levels in healthy individuals (P = 0.008 and P < 0.001, respectively) but returned to normal at convalescence (P = 0.009 and P = 0.005 respectively). However, whereas TNF-alpha concentrations were significantly higher (P = 0.04) in patients with acute IM than in the sick controls, no significant difference in IL-6 concentrations was found between the two groups of patients. Changes in IL-10 concentration were not statistically significant, and IL-1beta, IL-2, IL-8, and LT were detected only sporadically. The data in this study suggest that TNF-alpha may have a specific role in causing the clinical manifestations of IM. Further studies should determine the clinical significance of TNF-alpha inhibition in IM.