losartan-potassium and Convalescence

Currently, no data on the optimal time point after acute ischemic stroke (IS) at which high-sensitivity C-reactive protein (hs-CRP) level is most predictive of unfavorable outcome. We tested the hypothesis that hs-CRP levels during both acute (48 h after IS) and convalescent (21 days after IS) phases are equally important in predicting 90-day clinical outcome after acute IS. We further evaluated the impact of erythropoietin (EPO), an anti-inflammatory agent, on level of hs-CRP after acute IS.. Totally 160 patients were prospectively randomized to receive either EPO therapy (group 1, n = 80) (5,000 IU each time, subcutaneously) at 48 h and 72 h after acute IS, or placebo (group 2, n = 80). Serum level of hs-CRP was determined using ELISA at 48 h and on day 21 after IS and once in 60 healthy volunteers.. Serum level of hs-CRP was substantially higher in all patients with IS than in healthy controls at 48 h and day 21 after IS (all p < 0.001). Levels of hs-CRP did not differ between group 1 and 2 at 48 h and day 21 after IS (all p > 0.5). Multivariate analysis showed that hs-CRP levels (at 48 h and day 21) were independently predictive of 90-day major adverse neurological event (MANE) (defined as recurrent stroke, NIHSS≥8, or death) (all p < 0.03), whereas EPO therapy was independently predictive of reduced 90-day MANE (all p < 0.02).. EPO therapy which was independently predictive of freedom from 90-day MANE did not alter the crucial role of hs-CRP levels measured at 48 h and 21-day in predicting unfavorable clinical outcome after IS.

Topics: Aged; Brain Ischemia; C-Reactive Protein; Case-Control Studies; Convalescence; Erythropoietin; Female; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; ROC Curve; Statistics, Nonparametric; Stroke; Treatment Outcome

To determine the effectiveness of a 10-day subcutaneous erythropoietin (rHuEpo) course of 300 units per kg per dose plus oral iron compared to oral iron alone in anemic infants during their convalescent phase of illness.. Prospective, randomized trial performed at a 40-bed, teaching, referral, level III, neonatal intensive care unit. Infants with a gestational age at birth of less than 32 weeks, hematocrit of less than or equal to 28% with a corrected reticulocyte count of less than or equal to 5%, postconceptual age of less than 48 weeks or 5 months chronological age, and a diagnosis of anemia of prematurity were considered for inclusion. Major outcome parameters included hematocrit, corrected reticulocyte count and red cell transfusion requirements.. A total of 60 infants were enrolled (n=30 per group). Infants randomized to rHuEpo had a significantly higher post-treatment hematocrit and corrected reticulocyte count than infants in the iron only group (p<0.001). There was a trend towards fewer red cell requirements in the rHuEpo group.. The rHuEpo regimen studied here was associated with an acute improvement in hematocrit and corrected reticulocyte counts. This study did not demonstrate a statistically significant decrease in transfusion therapy, in part related to increased subsequent use of rHuEpo in the control group. Taken together, these data demonstrate that this regimen can effectively treat anemia in convalescent premature infants.

Topics: Anemia, Neonatal; Convalescence; Drug Administration Schedule; Epoetin Alfa; Erythrocyte Transfusion; Erythropoietin; Hematinics; Hematocrit; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Injections, Subcutaneous; Prospective Studies; Recombinant Proteins; Reticulocyte Count; Treatment Outcome

An 80-year-old man with multiple comorbidities presented to the emergency department with tachypnea, tachycardia, fever, and critically low O

Topics: Aged, 80 and over; Anemia; Antiviral Agents; Betacoronavirus; Biomarkers; Clinical Laboratory Techniques; Convalescence; Coronavirus Infections; COVID-19; COVID-19 Testing; Critical Illness; Erythropoietin; Fever; Humans; Iran; Male; Pandemics; Pneumonia, Viral; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral; SARS-CoV-2; Tachycardia; Tachypnea; Tomography, X-Ray Computed; Treatment Outcome

The aim of this study is to analyse functional changes in murine erythropoietic tissues over 20 days post cyclophosphamide (CY) treatment. The project was focused on the capability of femoral and splenic erythropoietic responsive cells (ERC) to proliferate with human recombinant erythropoietin (rh Epo) stimulation after cytotoxic treatment.. CF-1 mice were injected i.p. with CY (200 mg/Kg). Individual lots were studied at 0, 2, 5, 7, 10, 14, 17 and 20 days post cytotoxic treatment. Haematologic parameters [packed red cells (PRC) reticulocytes, white blood cells] were scored. Erythropoietic differentiation was assessed by the 59Fe uptake assay and the proliferative profiles of erythropoietic progenitors were determined by 3H-thymidine incorporation assay with several doses of rh Epo (0-250 mU/mL). Total and differential cellularities were scored in bone marrow (BM) and spleen.. A drastical decrease of total nucleated BM cells was noticed at 2 days post CY, although cellularity was restored by the 7th day. Spleen, however, failed in showing significant decrease. The maintenance of PRC was achieved through a deep erythropoietic reorganization. 59Fe uptake revealed changes in erythroid differentiation in both tissues. Spleen maturative contribution to whole erythropoiesis was always less than medullary supply, except on day 10 post CY when a transient compensatory red cell contribution was noticed. Proliferative assays revealed that erythropoietic recovery in BM post CY was delayed in comparison with myelopoietic restoration. Splenic erythroid proliferative pattern correlated with differentiation data.. Myelopoietic and erythropoietic progenitors showed different recovery patterns post CY administration in BM and spleen. Medullary hemopoietic lineages restoration described a particular sequence: myelopoiesis restitution was previous to the erythroid one. Medullary erythropoiesis occurred without drastic changes in erythropoietin sensitivity while the spleen showed a transient dramatic increment on 10 days post CY red proliferation. Experimental data strongly suggest that erythropoietic recovery after CY insult mainly depends on microenvironmental regulations rather than on hormone titers.

Topics: Anemia; Animals; Antineoplastic Agents; Bone Marrow; Cell Count; Cell Nucleus; Convalescence; Cyclophosphamide; Erythroid Precursor Cells; Erythropoiesis; Erythropoietin; Female; Hematopoiesis; Humans; Iron Radioisotopes; Mice; Protein Synthesis Inhibitors; Recombinant Proteins; Spleen; Time Factors