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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study suggests that both the quality of life and exercise capacity of anaemic hemodialysis patients is improved with EPO therapy. This was seen most convincingly in the dimensions of fatigue and physical symptoms. There was no difference in improvement in quality of life or exercise capacity between patients with a mean hemoglobin level of 102 g/L and those with a mean hemoglobin level of 117 g/L. There was an increase in diastolic blood pressure in the EPO-treated patients, especially those randomized to the high EPO group.
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PMID:A randomized double-blind study of recombinant human erythropoietin in anaemic hemodialysis patients. Canadian Erythropoietin Study Group. 205 67

In a double-blind, placebo-controlled trial of rHu-EPO (recombinant human erythropoietin) comprizing 19 haemodialysis patients (rHu-EPO: n = 9, placebo: n = 10) the patients' opinion about the influence of the treatment on the quality of life was investigated. At the commencement of the trial and after eight weeks, a score was registered by means of a structured interview with a range of 0-10 concerning the complaints most frequently expressed by haemodialysis patients. Erythropoietin was effective in the treatment of renal anaemia. In the therapeutic group, the mean haematocrit value increased from 0.206 to 0.338 (p less than 0.0005), while no change in the haematocrit value was observed in the placebo group. In the therapeutic group, significant decreases were found in the interview scores for fatigue, vertigo (p less than 0.001), dyspnoea (p less than 0.0025), muscular weakness (p less than 0.01) and palpitations (p less than 0.05). No significant differences were found in the placebo group. The treatment had no serious side-effects. On the basis of this material, it is concluded that erythropoietin treatment of haemodialysis patients is effective and that a marked improvement in the quality of life can be observed already after treatment for eight weeks.
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PMID:[Quality of life of hemodialysis patients before and after erythropoietin therapy. A double-blind, randomized, placebo controlled study]. 223 69

The benefits of EPO treatment, including improved exercise tolerance, amelioration of lassitude and fatigue, improved cognitive function, and enhanced quality of life in general, can be extended to symptomatic anemic chronic renal failure patients before their need for dialysis treatment. The favorable pharmacokinetics and erythropoietic response with weekly subcutaneous dosing of EPO make this treatment suitable and convenient for patients and health care providers alike. EPO treatment can be provided without undue concern about accelerating the deterioration of renal function, but patients require frequent follow-up and close monitoring while treatment is initiated and adjusted over the first 3 to 6 months, in order to promptly detect and treat any adverse reaction or failure to respond.
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PMID:Clinical application of recombinant erythropoietin in predialysis renal failure. 785 15

A 32-year-old man visited Kanto Teishin Hospital complaining of general fatigue in May, 1992. He had been diagnosed as having paroxysmal nocturnal hemoglobinuria since 1980, because of brownish urine in the morning. He received blood transfusion in 1980. In 1983, he was treated with medication. There was no remarkable improvement, however, and he stopped coming to the hospital. When he was admitted to our hospital, hemolytic anemia and hemosiderinuria were noticed. Sucrose hemolysis test and acidified-serum lysis test (Ham test) were both positive. Positive rates of decay accelerating factor and CD59 were 38.8% (control 100%) and 45.4% (control 100%), respectively. His diagnosis was thus confirmed. Bone marrow was slightly hypocellular, and erythroid cells were relatively hyperplastic (M/E ratio 0.68). The oral administration of iron and oxymetholone was not effective for anemia. He was treated with daily subcutaneous administration of recombinant human erythropoietin (EPO, 3,000U/body/day). His hemoglobin level increased from 7.5g/dl to 12.0g/dl in 4 weeks, and general fatigue disappeared. Since he had concurrent chronic hepatitis C, alpha-interferon was also administered and his hemoglobin level is now controlled between 10 and 11g/dl. This case suggests that EPO can be useful for treating hemolytic anemia, even though erythroid cells in the bone marrow are hyperplastic.
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PMID:[Improvement of anemia by recombinant human erythropoietin in paroxysmal nocturnal hemoglobinuria]. 823 Jul 45

Many cancer patients suffer from anemia, which has a major detrimental effect on their quality of life. Recombinant human erythropoietin (rHuEPO) is now widely used in cancer patients, as it improves hematocrit, lowers blood transfusion requirements, and improves quality of life. Recent research indicates that EPO has pleiotropic effects on the body well beyond the maintenance of red cell mass, but the mechanisms involved in relieving fatigue and improving quality of life in cancer patients are poorly understood. EPO receptors (EPO-Rs) have been detected in many different cells and tissues, providing evidence for autocrine, paracrine, and endocrine functions of EPO. Apart from its endocrine function, EPO may have a generalized role as an antiapoptotic agent that is associated with enhancement of muscle tone, mucosal status, and gonadal and cognitive function. The recent discovery of EPO-Rs in breast tumor vasculature, while raising important questions about the possible effects of pharmacological doses of rHuEPO on tumor cells, also suggests that the receptors could provide a useful target for drugs attached to EPO.
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PMID:EPO's alter ego: erythropoietin has multiple actions. 1245 56

Thirty per cent of cancer patients suffer from anemia before any treatment. This anemia is caused by haematopoiesis troubles related to cytokines production and by endogenous erythropoietin deficiency. Clinically, its symptoms, including fatigue, spoils patients'quality of life. Known as a prognostic factor for several cancers, anemia also lowers radiotherapy or chemotherapy efficiency by tumor hypoxia. Recombinant EPO restores normal haemoglobin level, quality of life and treatment efficiency.
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PMID:[Anemia in cancer patients before treatment]. 1285 24

Anemia and fatigue are frequent in lung cancer patients. Anemia is due to cancer and platinum-based chemotherapy. Anemia leads to a wide range of symptoms and affects health-related quality of life. Anemia also worsens outcome of therapy and prognosis. Efficient treatment exist: blood transfusion and recombinant erythropoietin. Early treatment of anemia is recommended as soon as diagnosis is made. But few patients receive optimal treatment. Its cost and unsolved question regarding therapeutic strategies may explain this phenomenon. This debate should not preclude correct treatment prescription. Clinical trials have to be preformed to clarify unsolved questions. As EPO administration can affect survival, this point should be of particular interest in future trials.
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PMID:[Anemia in lung cancer patients]. 1593 7

Patients with cancer-related anemia have an inadequate Epo response that is further impaired by cancer treatments such as chemotherapy. Significant number of studies have demonstrated that treatment of anemia in cancer patients using recombinant human EPO(rHuEPO, epoetin alfa) significantly increases hemoglobin(Hb) levels,reduces transfusion requirements,and improves quality of life,particularly by relieving fatigue. However,the findings of several studies have raised the possibility of an adverse effect of thromboembolism. The American Society of Clinical Oncology and the American Society of Hematology developed an evidence-based clinical practice guideline for the use of epoetin in patients with cancer. In cancer patients, the risk of bleeding depends not only on the platelet count, but also on the underlying disease, in accordance with coagulation defects. The cause of thrombocytopenia must be established prior to platelet transfusion since platelet transfusions may be relatively contraindicated in certain conditions e. g., heparin-induced thrombocytopenia(HIT), and thrombotic thrombocytopenic purpura/hemolytic uremic syndrome(TTP/HUS).
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PMID:[Approaches to anemia, thrombocytopenia, and DIC in cancer patients]. 1641 Jun 90

The aim of the 18 months follow up study was to assess the frequency of anemia during IFN/RBV therapy in patients with chronic hepatitis C; to manage anemia either with recombinant human erythropoietin (rHuEPO)--epoetin alpha or with RBV dose reduction and to compare the rate of SVR in patients with RBV dose reduction and with administration of epoetin alpha. Study enrolled 61 patients with chronic active hepatitis C aged 33-61 years. All patients had HCV genotype 1b. Out of them 41 were male and 20 female. Anemia (Hb <10 or >2 g/dL Hgb drop from baseline) developed in 41 patients out of 61 (67,21%) during the therapy. These 41 patients were randomized into two groups: 21 patients who received 40 000 IU epoetin alpha weekly (I group) and 20 patients in whom for managing anemia we used standard of care (SOC) or RBV dose reductions from 1000/1200 to 800/600 mg (II group). In all 21 patients of the I group the Hb level normalized without reduction of RBV dose. In this group of patients SVR at 6 months after completion of full course of treatment was achieved in 17 (66%) patients. Improvement of quality of life (QOL) was observed in all 21 patients. Out of 20 patients of II group with standard of care (SOC) 5 patients developed symptomatic anemia with fatigue and dyspnoea; RBV was stopped temporarily. In 15 patients RBV dose was reduced from 1200 mg to 600 mg for correction of anemia. In this group of patients SVR at 6 months after treatment completion was achieved in 7 (25%) patients. Lower RBV doses yield a lower treatment response in patients with HCV genotype 1. In anemic HCV-infected patients on RBV/PEG-IFN therapy, EPO maintains RBV dose and significantly improves anemia and QOL. EPO has the potential to improve adherence rate, which may in turn improve SVR.
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PMID:Ifn/Rbv treatment induced anemia and its correction with epoetin alpha in patients with hepatitis C. 1698 Jul 47

Biophysical skin parameters are indicators of age-related structural and functional changes in skin tissues. This randomized, double-blind, placebo-controlled study in healthy adults tested the effect of Efamol evening primrose oil [EPO, a gamma-linolenic acid (GLA) containing vegetable oil] on skin moisture, transepidermal water loss (TEWL), redness, firmness, elasticity, fatigue resistance and roughness. Efamol EPO was administered orally in soft gel capsules, 3 x 500 mg b.i.d. for 12 weeks. Measurements were taken at baseline and at weeks 4 and 12. The two treatment groups did not differ at baseline and at week 4. At week 12, however, all measured variables, with the exception of skin redness, were significantly different in the EPO group compared with placebo. Skin moisture, TEWL, elasticity, firmness, fatigue resistance and roughness had significantly improved by 12.9, 7.7, 4.7, 16.7, 14.2 and 21.7%, respectively. The two-sided levels of significance in favor of the EPO treatment ranged between 0.034 and 0.001. These findings lend further support to the notion that GLA is a conditionally essential fatty acid for the skin, i.e. it is unable to synthesize GLA, and therefore depends on preformed GLA for optimal structure and function.
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PMID:Systemic evening primrose oil improves the biophysical skin parameters of healthy adults. 1849 93


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