ABSTRACT
BACKGROUND AND PURPOSE: Animal data suggest the use of beta-human chorionic gonadotropin followed by erythropoietin to promote brain repair after stroke. The current study directly translated these results by evaluating safety of this sequential growth factor therapy through a 3-center, single-dose, open-label, noncontrolled, Phase IIa trial. METHODS: Patients with ischemic stroke 24 to 48 hours old and National Institutes of Health Stroke Scale score of 6 to 24 started a 9-day course of beta-human chorionic gonadotropin (once daily on Days 1, 3, and 5 of study participation) followed by erythropoietin (once daily on Days 7, 8, and 9 of study participation). This study also evaluated performance of serially measured domain-specific end points. RESULTS: A total of 15 patients were enrolled. Two deaths occurred, neither related to study medications. No safety concerns were noted among clinical or laboratory measures, including screening for deep vein thrombosis and serial measures of serum hemoglobin. In several instances, domain-specific end points provided greater insight into impairments as compared with global outcome measures. CONCLUSIONS: Results support the safety of this sequential, 2-growth factor therapy initiated 24 to 48 hours after stroke onset.
Subject(s)
Brain Ischemia/drug therapy , Chorionic Gonadotropin, beta Subunit, Human/administration & dosage , Chorionic Gonadotropin, beta Subunit, Human/adverse effects , Erythropoietin/administration & dosage , Erythropoietin/adverse effects , Stroke/drug therapy , Adult , Aged , Aged, 80 and over , Brain Ischemia/complications , Brain Ischemia/pathology , Drug Therapy, Combination , Female , Hemoglobins/metabolism , Humans , Male , Middle Aged , Stroke/complications , Stroke/pathology , Venous Thrombosis/etiology , Young AdultABSTRACT
The Student Senior Partner Program (SSPP) forms the core of the required medical student geriatrics curriculum at the University of California-Irvine School of Medicine (UCISOM). The program utilizes a longitudinal modular format that extends over the first three years of medical school. Instruction is presented in didactic, patient interactive, and facilitated small group discussion sessions. Initial educational outcomes have been positive. Ongoing challenges include faculty recruitment and retention, recruiting a group of senior partners that reflects the diversity of the community, and managing generational and ethno-cultural conflicts. The program offers unique opportunities for innovative development in geriatrics education.
