Time course of recovery during cardiac rehabilitation.

PURPOSE: Exercise-based rehabilitation programs improve effort tolerance in patients with cardiovascular disease. Little is known regarding the time course of recovery of objective and subjective indices of exercise tolerance. METHODS: Twenty-six patients were studied at 0, 4, 8, and 12 weeks following early entry into rehabilitation following acute myocardial infarction (AMI), coronary artery bypass graft surgery (CABGS), or valve surgery. Exercise tolerance was assessed objectively by percent predicted cycle power output (%PO), and subjectively by a self-efficacy questionnaire for ambulatory (ASE) and muscular (MSE) items and by a disease-specific, health-related, quality-of-life questionnaire (HRQL). RESULTS: With the exception of percent predicted cycle power output, all exercise tolerance measures improved throughout the rehabilitation program. Extrapolation of recovery curves suggest that recovery to 85% predicted can be achieved in 10, 11, 18, and 21 weeks for a disease-specific, health-related, quality-of-life questionnaire, self-efficacy questionnaire for ambulatory items, muscular items, and power output, respectively. CONCLUSIONS: The data demonstrate that evaluation of both objective and subjective indices of exercise tolerance may be important in documenting outcomes of participation in structured rehabilitation programs. The time course of recovery of objective and subjective indices of exercise tolerance may not be highly correlated.

Evaluation of gamma radiation levels for reducing pathogenic bacteria and fungi in animal sewage and laboratory effluents.

Sewage samples collected from animal wastes and from effluents at an animal disease laboratory were inoculated with known numbers of pathogenic organisms and subjected to various doses of gamma radiation from a 60Co source. Surviving test organisms were quantitatively determined by selective and enrichment techniques. The experiment was modeled as a quantal assay in which probit analysis was applied to obtain D10 values. The D10 value represents the irradiating dose required to reduce the population by 90%. The D10 value ranged from 13.4 krad for Campylobacter fetus to 156.6 krad for Streptococcus faecalis in animal sewage. However, the D10 value for the laboratory effluent was generally lower. Based on the estimated D10 values, the rating of the test organisms in decreasing order of radiosensitivity appeared as follows: Brucella abortus, Campylobacter fetus subsp. fetus, Campylobacter jejuni, Campylobacter coli, Campylobacter laridis, Mycobacterium fortuitum, Aspergillus fumigatus, Salmonella muenster, Candida albicans, Clostridium difficile and Streptococcus faecalis. If the D5 and D1 values were utilized, this listing would be only slightly altered.

Mycotic lymphadenitis in cattle and Swine.

Lymph nodes with granulomatous mycotic lesions from 100 cattle and 9 pigs were examined. More than 90% of cases of mycotic lymphadenitis in cattle occurred in the mesenteric nodes, whereas in swine lesions occurred at multiple sites. All observed mycotic infections were caused by zygomycetes. Histologically the granulomas were characterized by necrosis, mineralization, and fibrosis with infiltration of eosinophils, neutrophils, lymphocytes, and giant cells. Mucoraceous-type hyphae were identified in most of the lesions, and Absidia corymbifera, Rhizopus rhizopodiformis, and R. oryzae were isolated. Within the lesions, chlamydospores were produced by R. rhizopodiformis. Mycelia in a few lesions were suggestive of infections with fungi of the Mortierellaceae and Entomophthoraceae.

Feline phaeohyphomycosis: treatment with ketaconazole and 5-fluorocytosine.

Two cats with phaeohyphomycosis, one infected with Phialophora verrucosa and the other with Exophiala jeanselmei, were treated with ketaconazole alone and in combination with 5-fluorocytosine after recurrence of the infections following surgical excision. The drugs were given orally at various doses and for various lengths of time, but were ineffective. Hepatocellular damage occurred in one cat.

Bovine Mastitis due to Prototheca zopfi II.

The occurrence of protothecosis in a dairy herd quarantined under the National Brucellosis Eradication Program is reported. Infection was detected by milk culture and the presence of serum precipitins to a culture filtrate antigen preparation of Prototheca zopfi. The alga was always cultured from the milk when serum precipitins were present. Whey antibodies were demonstrated in infected quarters. Consumption of colostrum from an infected cow may have accounted for the brief appearance of serum precipitins in young calves. A naturally infected cow was monitored for 20 months. Serum antibodies disappeared six months after lactation ended but reappeared following parturition, with both algal cells and antibodies in the colostrum. Prototheca zopfi survived a 13 month dry period. There was no spread of infection to the calf. An experimental infection of a healthy cow was short lived but the presence of both serum and whey antibodies was demonstrated. Cross-reactions between Prototheca and Brucella abortus antigens were not observed, and the association between the diseases was found to be coincidental.

Candida rugosa: experimental mastitis in a dairy cow.

Candida rugosa was isolated from the milk of 70% of the cows in a dairy herd with mastitis problems. An experimental C. rugosa infection of the udder of a healthy cow resulted in a prolonged fever and an inflammatory reaction in the mammary gland and associated lymph nodes. Milk secretion in the 2 infected quarters was reduced from 8.51 to 1.51 per day. Histological examination revealed alveolar destruction with interstitial fibrosis accompanied by lymphocyte and macrophage accumulation. C. rugosa was cultured form the cisternal mammary tissue of the infected quarters but not from the alveolar tissue or associated lymph nodes. There was no evidence of tissue invasion. The signs described were probably due to toxic components in the fungal cell walls combined with the adverse effects of lowered pH in the milk during the proliferation of the yeast.

Feline Cutaneous Phaeohyphomycosis Caused by Phialophora verrucosa.

A cutaneous granuloma which developed on the muzzle of a nine year old cat was shown by histopathology to have been caused by a dematiaceous fungus which was cultured and identified as Phialophora verrucosa.

Bovine mycotic abortion caused by Acremonium kiliense Grutz.

Acremonium kiliense was cultured from the placenta and abomasal contents of an aborted bovine foetus; attempts to isolate viruses and bacteria were unsuccessful although the serum of the dam contained antibodies to Leptospira pomona. The fungus was nonpathogenic for mice but was able to survive in murine tissues for at least 13 weeks. The possibility of this case being a foetal infection as a result of insemination with contaminated semen is discussed.

Bovine mastitis due to Prototheca zopfi.

A report is given of a case of bovine mastitis caused by the alga Prototheca zopfi which was erroneously identified as the yeast Cryptococcus neoformans. The resistance of protothecal mastitis to treatment with antibiotics commonly used in veterinary practice is briefly discussed.

The origin and species of yeasts in commercial preparations of bovine semen.

Whereas yeasts were not normally isolated from raw semen samples 13% of commercial frozen semen samples and 71% of preputial washings contained yeasts. Nine genera and 25 species of yeasts have been identified from these two sources. Yeasts originating in the preputial cavity were generally saprobic members of the genera Candida, Cryptococcus, Rhodotorula, Saccharomyces, Torulopsis and Trichosporon. Those originating as contaminants during processing were more likely to be opportunistic pathogens of the genus Candida. Conception was not necessarily affected by the presence of large numbers of Candida krusei or C. macedoniensis in the uterus.

Isolation of dermatophytes, Candida species and systemic fungi from dermatologic specimens in Montréal, 1963 to 1973.

Of 10 057 specimens of scrapings from skin, nails and scalp examined for dermatophytes, yeasts, pityriasis versicolor and systemic mycoses between 1963 and 1973, 30.4 percent were positive for fungi. Skin produced the highest proportion (68.6 percent) of positive scrapings, scalp the lowest (4.2 percent). Trichophyton rubrum was the predominant species (23.6 percent); of lesser prevalence were Microsporum canis (9.3 percent), T. mentagrophytes (8.4 percent) and Epidermophyton floccosum (4.8 percent). Double infections were encountered on 102 occasions; T. rubrum and Candida parapsilosis were the most frequent cohabiting species. The introduction in 1966 of periodic acid-Schiff staining for routine examination of scrapings resulted in better diagnostic results, particularly in the case of culturally nonproductive specimens and cases of pityriasis versicolor. Blastomyces dermatitidis and Cryptococcus neoformans were isolated from two patients in the course of routine investigation for dermatophytes.