scholarly journals 4462 Effects of Injectable, Erythropoietin and Glucocorticoids Combinational Therapy on Erythrocyte Sedimentation Rate Following Spinal Cord Injury

2020 ◽  
Vol 4 (s1) ◽  
pp. 48-48
Author(s):  
Anna Nia ◽  
Kamil Khanipov ◽  
George Golovko

OBJECTIVES/GOALS: Inflammation following traumatic injury to the spinal cord persists long after the primary insult and is known to increase complication rates and prolong recovery time. We investigated the effects of Erythropoietin (EPO) in combination with Glucocorticoids on the levels of erythrocyte sedimentation rate (ESR), an overall measure of inflammation. METHODS/STUDY POPULATION: Electronic medical records from approximately 38 million patients in 27 Healthcare Organizations were analyzed using the TriNetX Analytics platform. Patients with spinal cord injuries (SCI) were defined with the ICD-10 code, G95 and two unique cohorts were defined for patients treated with injectable EPO in combination with injectable Glucocorticoids within 6 months of SCI or only injectable Glucocorticoids with no injectable EPO. ESR rates were queried from patient cohorts to evaluate the potential effects of the two treatment pathways on the ESR. Most recent lab results within 6 months before initiating treatment and 1-year post-treatment were defined as “before” and “after” treatment, respectively. Changes in ESR lab results were evaluated using unpaired t-test with Welch’s Correction. RESULTS/ANTICIPATED RESULTS: A total of 14,370 patients satisfied the inclusion criteria. 89 patients were treated with injectable EPO in combination with Glucocorticoids within 6 months of SCI. The ESR lab results were available for 33 patients before treatment with a mean of 63±33 mm/h. The ESR lab results were available for 22 patients after treatment with a mean of 51.7±34.1 mm/h. 14,281 patients were treated with Glucocorticoids (no injectable EPO) within 6 months of SCI. The ESR lab results were available for 2,042 patients before treatment with a mean of 29.2±30.5 mm/h. The ESR lab results were available for 2,184 patients after treatment with a mean of 32.6±30 mm/h. Patients treated with combinational therapy showed a reduction in ESR of 11.3 mm/h, while those treated with only Glucocorticoids showed an increase in ESR of 3.4 mm/h. DISCUSSION/SIGNIFICANCE OF IMPACT: The present results demonstrated that combinational therapy with injectable, EPO and glucocorticoids exhibited a significant reduction in ESR level. The study suggests that EPO and glucocorticoid might have a synergistic effect on reducing the inflammation following SCI. This approach might help reduce the therapeutic dose of glucocorticoids. Conflict of Interest Description: The authors declare that they have no competing interests. CONFLICT OF INTEREST DESCRIPTION: The authors declare that they have no competing interests.

Author(s):  
Thomas E. Feasby ◽  
Gary G. Ferguson ◽  
J.C.E. Kaufmann

SUMMARY:This patient presented as a subacute progressive cervical myelopathy and the differential diagnosis included cervical spondylotic myelopathy and intramedullary mass. Microscopically, vascular lesions plus a patchy myelomalacia indicated a vasculitis. However, there was no suggestion of a generalized vasculitis at autopsy and the only supporting laboratory study was a raised erythrocyte sedimentation rate. It would seem that a vasculitis similar to polyarteritis nodosa or other collagen disease may be confined to the spinal cord.


2008 ◽  
Vol 24 (5) ◽  
pp. 351
Author(s):  
Young Ki Kim ◽  
Seong Woo Hong ◽  
Jung Woo Chun ◽  
Yeo Goo Chang ◽  
In Wook Paik ◽  
...  

2021 ◽  
pp. 1-7
Author(s):  
Zahra Soleimani ◽  
Fatemeh Amighi ◽  
Zarichehr Vakili ◽  
Mansooreh Momen-Heravi ◽  
Seyyed Alireza Moravveji

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.


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