Contents:
ITP Research and Treatments
General Health and Medicine
Hospitals, Insurance and Medical Care
Nutrition, Fitness, and Lifestyle
---------------------------------------------------------------------------------------------------------------------------------------------------------------
Needle-free Lidocaine for Children’s Pain Relief
In a comparison of needle-free powder lidocaine delivered with helium gas into the skin or a sham-placebo delivery system, pain scores were lower in the lidocaine group after the procedures. Pain relief occurred within 1 to 3 minutes. These results may be relevant for children with ITP, who get frequent infusions and shots.
Zempsky WT, et al. Needle-Free Powder Lidocaine Delivery System Provides Rapid Effective Analgesia for Venipuncture or Cannulation Pain in Children: Randomized, Double-Blind Comparison of Venipuncture and Venous Cannulation Pain After Fast-Onset Needle-Free Powder Lidocaine or Placebo Treatment Trial. Pediatrics. May 2008, 121(5):979-987.
FDA Postpones Promacta Decision
The FDA has extended the priority review period for Promacta (eltrombopag) because it needs more time to review the application, according to the drug’s developers, GlaxoSmithKline and Ligand. A 16-member outside advisory panel has recommended approval of the drug. The agency has until mid September to complete its review. If approved, Promacta would be the first oral short-term treatment for chronic ITP. Long-term studies are expected to be available by the end of the year.
Ligand Says FDA Extends Blood-Clot Drug Review. Associated Press, June 20, 2008.
Rituximab May Work at Lower Dose
One or two doses of rituximab may be as effective as four, according to a preliminary Australian study in a dozen patients with immune-mediated blood disorders, like ITP. This shorter dose could provide considerable cost savings and fewer trips to the doctor’s office or hospital for infusions.
Fairweather H, Tuckfield A, Grigg A. Abbreviated dose rituximab for immune-mediated hematological disorders. American Journal of Hematology. March 3, 2008, 83(7):554-557.
Antirejection Drug Linked to Brain Viral Infection
The drug CellCept (mycophenolate mofetil) may increase the risk for a potentially fatal viral infection of the brain called progressive multifocal leukoencephalopathy (PML) in transplant recipients, according to the FDA. The drug is used to prevent organ rejection, and is sometimes used for ITP patients. In April, the FDA began investigating another organ rejection drug, Myfortic (mycophenolic acid) in the development of PML. Any patient taking CellCept who experiences confusion or other cognitive symptoms should be evaluated.
Splenectomy May Increase Cardiovascular Trouble
Comparing ITP patients who retained their spleens and those who had their spleens removed, researchers at the University of Miami revealed that patients without a spleen had higher levels of cell-derived microparticles (C-MP), a risk factor for blood clotting, plaque build up in the arteries, and cardiovascular disease. Their study shows that the spleen acts as a filter to remove these harmful microparticles from the body.
Fontana V, Jy W, Ahn ER, Dudkiewicz P, Horstman LL, Duncan R, Ahn YS. Increased procoagulant cell-derived microparticles (C-MP) in splenectomized patients with ITP. Thrombosis Research, March 10, 2008, e-pub.
Receptors on the Liver Reduce Clotting in Sepsis
Sepsis is an infection in the bloodstream that can be life-threatening when it activates inflammation and blood clotting. Research from the University of California, San Diego, revealed how millions of receptors on the liver, called Ashwell receptors, can decrease blood clotting during sepsis by eliminating two clotting factors--platelets and von Willebrand Factor--during the infection. The research suggests that a low platelet count during sepsis may be a good sign.
Grewal PK, Uchiyama S, Ditto D, Varki N, Le DT, Nizet V, Marth JM. The Ashwell receptor mitigates the lethal coagulopathy of sepsis. Nature Medicine. June 2008, 14(6):648-655.
Parasitic Worms May Protect Digestive Tract
Noting that autoimmune digestive disorders, such as inflammatory bowel disease, ulcerative colitis and Crohn’s disease rose significantly about the same time that sanitation methods improved, one researcher suggests that parasitic worms keep their hosts healthy by calming the host’s immune system. Perhaps the human immune system relied on parasitic worms for proper functioning. Reintroducing worms (microscopic eggs from Trichuris suis, the common pig whipworm) in mice resolved these inflammatory diseases. Small studies in humans showed improvements among patients with Crohn’s disease and ulcerative colitis. Scientists are intrigued. Larger trials are under way.
Velasquez-Manoff M. The Worm Turns. New York Times Magazine, June 29, 2008, pg. 17.
Hazards from Mercury in Dental Fillings
On its website, the FDA is alerting consumers about the potential dangers of mercury dental fillings, with plans to issue a more specific rule next year. “Dental amalgams contain mercury, which may have neurotoxic effects on the nervous system of developing children and fetuses,” the website notes. The FDA does not suggest removal of mercury filings. Mercury has been linked to brain and kidney damage at certain levels. One expert suggests that people with weakened immune systems, such as those with ITP taking steroids or those without a spleen, should avoid mercury fillings. Dental fillings without mercury are available. FDA is requesting comments by July 28, 2008.
http://www.fda.gov/cdrh/consumer/amalgams.html
Heavey S. Mercury teeth fillings may harm some: FDA. Reuters.com, June 4, 2008.
More Benefits of Vitamin D – Heart Attack Protection
Men with low Vitamin D levels have higher risk for heart attack than those with normal levels, according to 10-year Harvard University study. Vitamin D may protect against heart attack by lowering blood pressure, reducing inflammation, or reducing plaques in the arteries, according to the researchers. The body makes vitamin D during sunlight exposure. Milk is usually fortified with vitamin D. People can learn their vitamin D levels through a simple blood test.
Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-Hydroxyvitamin D and Risk of Myocardial Infarction in Men. Archives of Internal Medicine, June 9, 2008, 168(11):1174-1180.
Drug Companies Help Uninsured Buy Meds
Needymeds.com is a free web-based service that links consumers to discount drug programs, called prescription assistance programs or PAPs. Most drug companies help people with no insurance get access to needed medications at low or no cost. Needymeds.com is a free, not-for-profit Web resource. It connects patients to programs for more than 3,500 medications. The site logs 10,000 visitors a day, including people who need the free medications and lots of drug companies lining up to give it away.
Moyer J. Drugmakers Offer Aid to People ‘On the Edge.’ Washington Post, July 1, 2008, pp. F3.
Moving Toward E-Prescribing
The country’s two electronic prescribing networks are merging and will be called SureScripts-RxHub, to simplify the connections among doctors, pharmacies and insurance companies. Electronic prescribing holds promise for avoiding handwriting errors and dangerous drug interactions. But, according to a recent Washington Post article, only 2% of U.S. prescriptions are submitted electronically. The Centers for Medicare and Medicaid released a final rule setting standards and promoting e-prescribing. But they are not mandatory. Congress is attempting to offer financial benefits to doctors who e-prescribe.
Goldfarb ZA. E-Prescription Networks to Merge. Washington Post, July 1, 2008, D1, D3. Keating T. CMS Releases Final Rule on E-Prescribing. Hematology & Oncology News & Issues May 2008, pp. 42.
FDA Rules Brown Rice is a Decent Fiber Source
The FDA is now allowing brown rice packaging to carry whole grain health claims to boast its heart-health benefits. One half cup of cooked brown rice contains two grams of fiber. The FDA-approved claim, which is already allowed on other whole-grain products, states, “Diets rich in whole grain foods and other plant foods and low in total fat, saturated fat and cholesterol may reduce the risk of heart disease and some cancers.” To learn more visit: Whole Grains Council
If Disinfectant Harms Mouse Fertility, What About Humans?
Two chemicals widely used in cleaning supplies in homes, offices, and hospitals caused birth defects and fertility problems in mice whose cages were cleaned with these chemicals, according to an article in Nature. Two quarternary ammonium compounds, ADBAC and DDAC, were identified as the chemicals used in Virex disinfectant. The researcher who made the connection calls for more study to see if there should be concern for humans.
Lab disinfectant harms mouse fertility. Nature. June 19, 2008, pp. 964.
Laugh Your Way to Health
Laughter lowers blood sugar, a benefit for diabetics and nondiabetics, alike. In one 2003 study in Japan, people who watched a comedy show were better able process sugar from meals than those who watched a non-funny lecture. Poor blood sugar control is a risk for diabetes as well as heart disease, kidney failure, and blindness.
Hayashi K, et. al., Laughter Lowered the Increase in Postprandial Blood Glucose. Diabetes Care, 2003, 26:1651-1652.
Yoga Puts a Smile on Your Face
A few simple yoga stretches and poses can boost happiness, according to a 5-week study reported on RealAge.com.
Contents:
ITP Research and Treatments
General Health and Medicine
Hospitals, Insurance and Medical Care
Nutrition, Fitness, and Lifestyle
---------------------------------------------------------------------------------------------------------------------------------------------------------------
Romiplostim Shows Sustained Effects, but FDA Approval Postponed
Long-term results of a treatment study of romiplostim (Amgen’s Nplate), showed sustained platelet count increases in adult patients with ITP, along with reduced need for concurrent and rescue ITP medications. After average treatment of 65 weeks, 83% of patients achieved a platelet response above 50,000 platelets per microliter. Results were presented at the June meeting of the European Hematology Association. Romiplostim stimulates the thrombopoietin receptor for platelet production. In related news, the FDA has postponed its decision, which was expected in late July, on approval of the sale of Nplate for patients with ITP whose disease has not responded to other treatments.
Romiplostim Data Show Potential Long-Term Efficacy and Safety in Adults with Chronic Immune Thrombocytopenic Purpura (ITP). Medical News Today, June 17, 2008; www.medicalnewstoday.com
Ed., Zimmerman, D. Amgen Says US FDA Decision on Clot Drug Delayed. Reuters, UK, July 23, 2008.; www.amgen.com
ITP Treatment, Sym001, Moves to Phase 2 Testing
Sym001 has moved into phase 2 testing for treatment of ITP. The drug is a recombinant, polyclonal anti-Rhesus D antibody product, in development by Symphogen and Biovitrum. Up to 55 nonsplenectomized, RhD-positive patients with ITP will be enrolled in the phase 2 study at 23 sites in Europe. The study will determine appropriate dosages to use for Phase III trials by assessing increases in platelet levels and exploring the mechanism of action of Sym001.
Symphogen and Biovitrum Recruit First Patient for Phase II ITP Study, Pharmaceutical Business Review, July 17, 2008. For more details, visit www.symphogen.com
Are Better Anticoagulants in Development?
In an editorial, Nigel Key of University of North Carolina, expresses concerns that new anticoagulant drugs in development may be no better than warfarin, and may hold the same bleeding risks that the older drug does. Effective and safe anticoagulation therapy will be a major health care priority, with the aging U.S. population.
Key NS. Anticoagulant-related Bleeding: Into the Unknown? HemOnc Today, June 25, 2008
Antidepressants Can Boost GI Bleeding; Acid-Reducing Drugs May Help
Two types of anti-depressants, SSRIs and SNRIs (specifically venlafaxine), may increase risk for upper gastrointestinal bleeding. A Spanish study indicates that acid-suppressing drugs appear to reduce that risk for bleeding. This population-based study compared 1,300 adults with upper GI bleeding to 10,000 controls without bleeding. Selective serotonin reuptake inhibitors( SSRI) and selective serotonin and norepinephrine reuptake inhibitors (SNRI) users had double or more risk of bleeding, even more so if the patient was also taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, or corticosteroids. Acid-suppressing drugs reduced the risk.
De Abajo FJ. Garcia-Rodriguez LA. Risk of Upper Gastrointestinal Bleeding Associated with Selective Serotonin Reuptake Inhibitors and Venlafaxine Therapy. Archives of General Psychiatry. 2008;65(7):795-803
Comparing the Presidential Candidates’ Health Proposals
The National Hemophilia Foundation has published a guide on where the presidential candidates stand on key health-care issues, with special attention to issues that might affect individuals with bleeding and clotting disorders. The guide is available through the Foundation at 800-42-HANDI or www.hemophilia.org.
Ragni M. Patients and Politics: Interpreting the Footprints of Donkeys and Elephants for Patients. The Hematologist. July/August 2008, Pg. 14.
Some Governments Getting Serious About Chemical Exposures
Governments are beginning to examine the dangers posed to human health by chemicals in our air, water, food, and products we use. Many cancers and autoimmune diseases might result from chemical pollution. The European Union is requiring industry to prove the safety of chemicals and consumer products before they reach the market, according to a story in the Montreal Gazette. Currently Health Canada is testing 5,000 Canadians for chemical contamination and preliminary results should be available in November. Early results from Europe and the U.S. indicate we are all contaminated with some chemical toxins.
Marsden W. We’re on Chemical Overload. The Montreal Gazette, June 20, 2008, http://www.canada.com/montrealgazette
Antibiotic-Resistant Bacteria Found in Pork
Scientists are beginning to detect bacteria that are resistant to antibiotics in pigs and pork products. University of Iowa public-health doctors found the antibiotic-resistant strain in 147 of 299 pigs tested. These bugs have not yet sickened people in North America, though they’ve been found in 10% of ground pork collected in some Canadian provinces, and caused problems in Scotland and the Netherlands.
Burton TM. Bacteria in Pork Showing Resistance to Antibiotics. The Wall Street Journal, June 16, 2008. Reprinted at:
www.organicconsumers.org/articles/article_13009.cfm
Immune System May Spark Depression
During sickness or infection, the body’s immune system releases proteins called cytokines that trigger inflammation to fight the disease, and in some cases, may cause depression in those who are susceptible. Previous studies have linked cytokines to depression and fatigue. Researchers are attempting to treat depression by blocking the action of cytokines. Depression caused by inflammation is most prevalent in patients with autoimmune diseases, cancer, and infectious diseases.
Maxmen A. Sick and Down. Science News, July 19, 2008, Pg. 26-29.
Tier 4 Drugs and the Cost Conundrum
Many of the newer biological drugs come with high price tags, for example, $50,000 to $100,000 per year--and insurers are putting them into their tier 4 category, requiring patients to pay up to 20% to 33% of the overall cost of these medications, which can easily exceed what their budgets can bear. A health system president and an NIH bioethicist express concern that the tier 4 system as a cost-containment tactic is growing and they make suggestions for getting smarter about which interventions are covered and who gets them based on what really works.
Lee TH, Emanuel EJ. Tier 4 Drugs and the Fraying of the Social Impact. New England Journal of Medicine, July 24, 2008, 359(4):333-335.
Companies Filling Patient Advocate Needs
More companies are offering advocacy services to consumers—either directly or through employers. The services aim to help users “find the right doctor, haggle over insurance coverage and manage other medical system headaches,” according to The Washington Post. Companies like Health Advocate charge $365/year, some charge more and offer telephone or Web-based support. Flagship Global Health, Care Counsel, and Enhanced Care Solutions offer similar services. One non-profit option is the Patient Advocate Foundation, a free service that helps people with chronic, debilitating and life-threatening conditions.
Stobbe M. Patients Turn to Advocates to Navigate Health-Care System. The Washington Post. July 29, 2008. Pg. F6.
Relaxation Techniques Alter Gene Activity
Harvard’s Herbert Benson, a long-time advocate of meditation to reduce stress, has shown that gene expression changes with meditation, yoga and other relaxation techniques that reduce cellular damage from chronic stress. Gene expression changed with stress reduction activity, not only in long-term practitioners, but also in people new to relaxation techniques. They compared gene expression in 19 long-term relaxation practitioners, 19 healthy controls, and 20 newcomers who took up 8 weeks of relaxation-response training.
Dusek JA, Otu HH, Wohlhueter AL, Bhasin M, Zerbini LF, et al. (2008) Genomic Counter-Stress Changes Induced by the Relaxation Response. PLoS ONE 3(7): e2576.
Meditation Can Change the Brain
Herbert Benson and others were interviewed for a recent program on British television (Alternative Therapies, BBC Two, Monday, March 17, at 9pm), exploring the evidence that meditation can make people healthier and happier, altering brain structure. In research by Dr. Sarah Lazar, MRI scans of brains of long-term meditators showed differences in areas of the brain’s cortex, in areas that process emotion. Research also indicated greater activity in brain circuits involved in paying attention. The idea that meditation could improve the wellbeing of patients, even those struggling with mental illness, is exciting for researchers and patients.
http://news.bbc.co.uk/1/hi/health/7319043.stm
Even Cooked Vegetables Carry Risks For Travelers
Most travelers know to avoid the water, unpeeled fruit and raw vegetables, but a new study indicates that even cooked vegetables eaten abroad can carry more risk of contamination. A comparison of cooked vegetables at restaurants in Guadalajara, Mexico, versus Houston, Texas found higher levels of dangerous bacteria in the Mexican restaurants than in the Texas establishments.
Zuger A. Is Any Vegetable a Safe Vegetable? Journal Watch General Medicine, July 24, 2008.
Book Reviews the Dangers of Milk Containing Growth Hormones
A 2006 book calls itself an exposé of the dangers of milk containing rBGH (recombinant Bovine Growth Hormone), used to boost milk production “and Monsanto’s longstanding attempt to suppress this information.” The book presents a comprehensive summary of the scientific literature since 1985. This is another topic related to the future of food and its effects on health.
Got (Genetically Engineered) Milk? By Samuel Epstein. Trafford Publishing, 2006.
EPA Bans Carbofuran Residue on Food
The Environmental Protection Agency (EPA) stated that the chemical residue of the toxic pesticide carbofuran poses an unacceptable risk to small children. The agency’s ban applies to domestic and imported food. Carbofuran, one of the most widely used pesticides in the world, is a neurotoxin that threatens animals as well as humans. In the past it caused the deaths of millions of birds. Some of the crops it is used on include rice, bananas, grapes, coffee, potatoes, soybeans, corn, and sugar cane.
Eilperin J. In Surprise Move, EPA Bans Carbofuran Residue on Food. The Washington Post, July 25, 2008. A2.
http://www.epa.gov/OGWDW/contaminants/dw_contamfs/carbofur.html
---------------------------------------------------------------------------------------------------------------------------------------------------------------
This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org
To unsubscribe: send an email to: admin@pdsa.org and place ‘remove’ in the subject line. To change your e-mail address, send an e-mail with your old and new address to: admin@pdsa.org
Contents:
ITP Research and Treatments
General Health and Medicine
Hospitals, Insurance and Medical Care
---------------------------------------------------------------------------------------------------------------------------------------------------------------
FDA Approves New Treatment for Chronic ITP in Adults
The FDA has approved the use of Nplate (Romiplostim), from Amgen, for splenectomized and nonsplenectomized adults with ITP. The approval was based on safety and efficacy data from two phase 3 studies published in February. Patients taking Nplate had more durable platelet responses and higher platelet counts than control patients. Safety concerns include fibrous deposits in the bone marrow in some patients and a possible drop in platelet counts below their original level after discontinuing therapy. The FDA is requiring that all patients enroll in a special program to track the long-term safety of Nplate therapy. Amgen is launching the Nplate NEXUS program to provide access to chronic ITP patients, including the uninsured, underinsured, or those unable to afford the co-pay. Nplate is the first approved mimic of thrombopoietin, a natural protein in the body that increases platelet production.
www.fda.gov/bbs/topics/NEWS/2008/NEW01876.html
For more information about Nplate see www.nplate.com
Research Sheds New Light on Why People Get ITP
In his review of three papers published in a recent issue of the journal Blood, Dr. John W. Semple, Toronto (a member of the PDSA Medical Advisory Board), explains that defective T regulatory cells (Tregs) “are at the heart of the autoimmune dysregulation in ITP”…and suggests that therapies targeted at Tregs may alleviate the disease. The three studies shed light on how Tregs may initiate and/or mediate the autoimmunity of ITP. One of the studies suggests that rituximab is effective for patients with ITP because it normalizes abnormal autoreactive T-cell responses.
Semple JW. ITP three R’s: regulation, routing, rituximab. Blood, August 15, 2008, 112(4):927-28.
CSL Behring to Acquire Talecris, Provider of IVIg
Pharmaceutical company CSL Behring has signed an agreement to acquire Talecris, a major supplier of plasma-derived protein therapies for medical conditions, including a brand of IVIg often used to treat ITP.. The companies have filed for regulatory approval of the purchase.
ITP Reduces Quality of Life
Patients with ITP scored worse on seven of eight sectors of a health-related quality of life survey, compared with controls, according to researchers at Johns Hopkins School of Medicine. Lower platelet counts were associated with worse scores. Splenectomized patients scored lower than nonsplenectomized patients on five scales: bother, psychological, fear, social activity, and work. Patients from PDSA were recruited to complete the survey until 1,000 surveys were completed. The answers from ITP patients were age and gender matched with a control group.
Full article available at:
www.ingentaconnect.com
Chemical Plays Role in Autoimmune Disorders
Interleukin-17 (IL-17), a chemical messenger in the body, appears to play a role in autoimmune disorders such as rheumatoid arthritis and lupus, according to researchers at University of Alabama. According to the lead author, Hui-Chen Hsu, Ph.D., IL-17 appears to shape the ability of B cells to create more disease-causing antibodies. He said understanding IL-17’s ability to regulate unwanted B cells will help in preventing and treating autoimmune disease.
http://www.aarda.org/research_display.php?ID=54
http://www.arthritis.org/protein-role-autoimmune.php
Vitamin K Affects Bone Health
Higher vitamin K levels improve bone health in healthy children. In children with juvenile idiopathic arthritis (JIA), vitamin K may be one of multiple risk factors for low bone mass, according to the Dutch authors of the study. Children with arthritis with low vitamin K levels had lower bone mass. “The question remains whether JIA patients would benefit from increased dietary vitamin K intake.”
van Summeren MJ, Vermeer C, Engelbert RH, et al. Extremes in vitamin K status are related to bone ultrasound properties in children with juvenile idiopathic arthritis. Clinical Experimental Rheumatology. May-June 2008;26(3):484-91.
Natural Therapy Can Help Mild Depression
People with mild to moderate depression should try natural therapies rather than antidepressant medications, according to James S. Gordon, MD, director of the Center for Mind-Body Medicine in Washington, D.C., and author of a new book on the subject, “Unstuck: Your Guide to the Seven-Stage Journey Out of Depression.” Dr. Gordon argues that depression is not a disease, but rather a state that occurs when “our lives aren’t working.” He recommends regular aerobic exercise, breathing exercises, fish oil supplements, and some form of psychotherapy, as well as finding things you enjoy and can do daily. For patients with severe depression, he recommends seeing a mental health professional.
Defeating Depression Naturally. Self Healing, June 2008, pg. 5.
Reduce Your Exposure to Cell Phone Radiation
While people continue to debate the health hazards of cell phones--do they cause brain cancer or not?—you can take steps to limit your exposure to cell phone radiation, according to a CNN report. Devra Davis, Director of the University of Pittsburgh’s Center for Environmental Oncology recommends the following: use the speakerphone, use a wired headset with a “ferrite bead” that absorbs the radiation so you don’t, and use a Bluetooth earpiece (which emits 100 times less radiation than the actual cell phone). But don’t wear the Bluetooth earpiece all the time; it still emits radiation. Other advice: don’t keep the phone in your pocket or clipped to a belt, it might not be good for your bone marrow; use a hollow tube earpiece; and finally, get a phone with less radiation.
To find the radiation level of several cell phones, visit:
http://reviews.cnet.com/cell-phone-radiation-levels/?tag=mncol;tx
http://www.cnn.com/2008/HEALTH/07/31/ep.cell.phones.cancer/index.html
Multi-Tasking May Overtax Brain
Multi-tasking can lead to reduced efficiency of the brain, reducing productivity, according to several studies recently discussed in Scientific American. The take-home message from mercola.com is: simplify and reduce daily options; don’t belabor largely irrelevant choices. “Save your brain power for the decisions that really matter.”
http://www.sciam.com/article.cfm?id=tough-choices-how-making
Are Air Freshener’s Dangerous?
Most air fresheners emit chemicals classified as toxic or hazardous by U.S. federal law, yet they’re not listed on the product label, according to a University of Washington study, which examined liquid spray air fresheners, plug-in air fresheners, fabric softeners, laundry detergents, dryer sheets, and solid disc deodorizers. Among substances found were acetone (found in nail polish remover) and three chemicals the EPA considers hazardous air pollutants—acetaldehyde, 1,4-dioxane, and methyl chloride. A report of the study on the online Douglass Report suggests readers stop using store-bought air fresheners. Instead, “cut open a lemon or orange, gather some mint leaves, or just open a box of baking soda.”
Average Emergency Room Wait Time Nears 1 Hour
Patients are waiting longer than ever in hospital emergency rooms, according to a new report from the Centers for Disease Control. The wait has risen from 38 minutes a decade ago to close to an hour today. More patients are visiting emergency rooms, yet there are fewer emergency rooms to visit. About 40% of ER patients had private insurance, 25% were covered by state programs for children, 17% were covered by Medicare, and 17% were uninsured. Results were from a national survey of 362 hospital emergency departments.
To see the CDC report visit
http://www.cdc.gov/nchs/data/nhsr/nhsr007.pdf
Payment Before Treatment
More hospitals are asking for payment up front before treatment, states an article in AARP Bulletin. Of the nation’s 3000 nonprofit community hospitals, one in seven require patients to pay or make arrangements for payment prior to being admitted, according to a 2006 IRS survey. Hospitals are required by law to treat medical emergencies before asking for payment. To avoid pre-admission sticker shock, know what your plan covers. And apply for “charity care” if you need it; Federal law requires hospitals receiving federal funds—and most do—to devote a percentage of services to charity cases. The article also suggests ways to negotiate a lower bill.
Kirchheimer S. Cash Before Care. AARP Bulletin, July-August 2008. PG. 21-22.
http://bulletin.aarp.org/yourhealth/caregiving/articles/cash_before_care_0.html
---------------------------------------------------------------------------------------------------------------------------------------------------------------
This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org
To unsubscribe: send an email to: admin@pdsa.org and place ‘remove’ in the subject line. To change your e-mail address, send an e-mail with your old and new address to: admin@pdsa.org
Contents:
ITP Research and Treatments
General Health, Medicine, Hospitals and Medical Care
Nutrition and Lifestyle
---------------------------------------------------------------------------------------------------------------------------------------------------------------
Public Education Campaign to Include Bleeding Disorders
The American Society of Hematology has developed a Web site, Blood: The Vital Connection, to help consumers understand the important role of blood in overall health. It also contains information on disorders of the blood, including bleeding and clotting disorders, anemia, and cancer, as well as how specific populations of people, such as women, are affected by these conditions.
www.bloodthevitalconnection.org
New Thrombopoietin Treatment Well Tolerated in Healthy Volunteers
Dutch researchers completed a phase 1 clinical trial of a new thrombopoietin mimetic peptide being developed to treat thrombocytopenia. Given in one intravenous dose to healthy human subjects, the drug, RWJ-800088, was well tolerated. Liem-Moolenaar M, Cerneus D, Molloy CJ, End D, et al. Pharmacodynamics and pharmacokinetics of the novel thrombopoietin mimetic RWJ-800088 in humans.
Chemical Pharmacology & Therapeutics 2008, 84(4): 481-487.
FDA Announcements and Warnings
FDA Delays Final Decision on Approval of Promacta for Patients with ITP
Although the FDA set an action date of September 19 for a decision on GlaxoSmithKline's drug PROMACTA (eltrombopag) as a treatment for ITP, the agency has not yet made a decision. In late May, the FDA’s Oncology Drugs Advisory Committee voted 16-0 for approval, but the agency does not always take committee advice. The FDA had no comment. GSK continues to work with FDA toward Promacta approval.http://www.gsk.com/media/pressreleases/2008/2008_pressrelease_10110.htm
FDA Issues Warning on Rituxan
One patient taking Rituxan (rituximab) for arthritis has died from a rare brain infection, called progressive multifocal leukoencephalopathy, or PML. The Food and Drug Administration alerted doctors administering Rituxan to their patients to watch for neurological problems. The drug’s maker, Genentech, has updated the labeling. Earlier in the year, two patients died after taking Rituxan for lupus. Some patients with ITP take Rituxan.http://www.fda.gov/medwAtch/safety/2008/rituxan_DHCP_Final%209411700.pdf
FDA Orders Black Box Warnings on Four Arthritis Drugs
The drugs, Enbrel (etanercept), Remicade (infliximab), Humira (adalimumab) and Cimzia (certolizumab), suppress the immune system to keep it from attacking the body. They are commonly used to treat arthritis, as well as other autoimmune diseases, including ITP. The drugs lower the body’s defenses to certain infections, including a type of fungal infection called histoplasmosis, which mimics the flu and can be deadly. The FDA ordered a “black box” or strongest, warning to be placed in the drug’s prescribing information. Patients should call their doctors if they develop persistent fever, cough, shortness of breath, or fatigue, which are all signs of fungal infection.http://www.usatoday.com/news/health/2008-09-04-fda-arthritis_N.htm?csp=34
NIH Director Zerhouni Stepping Down This Month
NIH Director Elias Zerhouni will leave NIH at the end of October to pursue new opportunities. He has held the position since May 2002. In his statement to the nonprofit community, he wrote, ”You have every right to share credit for the agency’s achievements as you form a unique and essential component of our success.”
http://www.nih.gov/news/health/sep2008/od-24.htm
FDA Publishes List of Drugs with Potential Safety Issues
Four times a year, the FDA will publish a list of drugs it is evaluating for potential safety issues. A 2007 law requires the FDA to make these quarterly reports to the public. A drug’s appearance on the list only means the FDA is evaluating it, not that the FDA has concluded that risks exist. Find the current list, which is for Jan-March 2008, at: http://www.fda.gov/cder/aers/potential_signals/potential_signals_2008Q1.htm#list
Treating Patients' Anxiety Can Improve Chronic Disease
Noting that persistent anxiety can erode mental and physical health, Harvard Women’s Health Watch reviewed the research and treatment options. Anxiety has been linked with irritable bowel syndrome (IBS), chronic respiratory disease, and heart disease. Medications alone are less effective than psychotherapy, but may be helpful when used in combination. Bottom line: consult a doctor if you feel anxiety. Close to 1 in 3 people with anxiety go through life untreated.
Anxiety and Physical Illness. Harvard Women’s Health Watch, July 2008, Pg 6-7.
Protect Yourself from Genetic Discrimination
An interactive, online guide to the Genetic Information Nondiscrimination Act (GINA) is now available through the Coalition for Genetic Fairness. The guide describes what GINA means and summarizes protections it offers. GINA, fully effective November 2009, is the first federal legislation that provides protections against discrimination based on an individual’s genetic information in health insurance coverage and employment.
www.geneticfairness.org/ginaresource.html
Doctors’ Clothing May Harbor Dangerous Germs
With rising concern over drug-resistant bacteria and hospital infections, health care workers are admonished to wash hands well and often. But their ties, white coats, and long sleeves may be a problem as well. Staff in the British National Health Service are no longer allowed to wear ties or long sleeves, which can accumulate germs as doctors move from patient to patient. European countries that have adopted strong infection-control practices – hand washing, sterilization, and strict clothing rules, see much lower rates of drug-resistant staph infections than the U.S., where controls are lax.
Parker-Pope T. The Doctor’s Hands are Germ-Free. The Scrubs Too?
The New York Times, September 23, 2008.
www.nytimes.com/2008/09/23/health/23well.html
Mediterranean-like Diet Lowers Risk of Chronic Disease
People who strictly adhere to a Mediterranean type diet are at lower risk of death as well as heart disease, cancer, and Parkinson’s and Alzheimer’s diseases, according to a meta-analysis of 12 prospective studies by researchers at the University of Florence, Italy. The diet includes high intake of vegetables, fruits, beans, cereals, and fish, with moderate consumption of red wine with meals.
Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean Diet and Health Status: Meta-Analysis. BMJ September 11, 2008;337a1344. www.bmj.com/cgi/content/full/337/sep11_2/a1344
Mobile Phone Radiation Linked to Sleep Disruption
When men and women were exposed to three hours of real or sham radiation, at a radiation level equivalent to that emitted by a mobile phone, participants exposed to real radiation took longer to reach deep sleep, and they stayed in deep sleep for a shorter time. Headaches occurred with extended exposure to radiation as well. Researchers from Wayne State University in the U.S. and the Karolinska Institute, in Sweden, conducted the study involving 35 men and 36 women.
www.naturalnews.com/023790.html
Cinnamon Inhibits Mold in Food
Breadmakers may begin using cinnamon in packaging to keep bread from getting moldy. Spanish researchers developed an anti-mold wax paper containing 6 percent cinnamon oil that greatly inhibits mold growth, prolonging freshness by 10 days. The new wrapper was found to be safe and environmentally friendly. Chang K. Cinnamon Is Key Ingredient in Anti-Mold Wrapper.
The New York Times. September 2, 2008., Pg. F3.
---------------------------------------------------------------------------------------------------------------------------------------------------------------
This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org
To unsubscribe: send an email to: admin@pdsa.org and place ‘remove’ in the subject line. To change your e-mail address, send an e-mail with your old and new address to: admin@pdsa.org
Contents:
ITP Research and Treatments
General Health and Medicine
Hospitals, Insurance, and Medical Care
---------------------------------------------------------------------------------------------------------------------------------------------------------------
FDA Approves New Drug To Treat ITP
PROMACTA® (eltrombopag), the first oral thrombopoietin (TPO) receptor agonist, has been granted accelerated approval by the United States Food and Drug Administration (FDA) to treat adults with chronic immune (idiopathic) thrombocytopenic purpura (ITP). The drug is expected to be made available by next week.
FDA Approves New Drug To Treat ITP
http://www.gsk.com/media/pressreleases/2008/2008_pressrelease_10127.htm
Anticoagulants Can Inhibit Vitamin K and Harm Kids’ Bones
Children taking anticoagulants, such as warfarin, may have lowered levels of vitamin K, which may harm bone health, according to a study from the Netherlands. The researchers recommend close monitoring of bone status in children on anticoagulant therapy.
Avgeri M, Papadopoulou A, Platokouki H, Douros K, Rammos S, Nicolaidou P, Aronis S. Assessment of Bone Mineral Density and Markers of Bone Turnover in Children Under Long-term Oral Anticoagulant Therapy.
Journal of Pediatric Hematology/Oncology, August 2008, 30(8):592-597.
Oncologists Seeing More Patients but Making Less Profit
Many ITP patients see hematologist-oncologists, and these specialists in blood diseases and cancer are spread thin, according to a survey reported in July by Onmark, a national group purchasing organization for community-based medical practices. Oncologists are carrying larger patient loads, as drug prices rise and profits go down.
Community-based oncologists: seeing more patients, making less profit. Hematology & Oncology News & Issues, Oct. 2008, Vol 7 (10), p14.
Common Autoimmune Disease Remains Underdiagnosed and Undertreated
Sjögren’s syndrome is one of the three most common autoimmune disorders, affecting 3 million Americans, 90% of whom are women. Many of its symptoms mimic those of other conditions, so its diagnosis is often missed. In Sjögren’s syndrome, the body attacks its own secretory glands and tissues. Most common symptoms are dry mouth and dry eyes. Diagnosis is delayed on average six years. Delayed treatment can lead to organ damage, plus people with Sjögren’s face a high risk of developing lymphoma and should be alerted to its early signs. Since 2002, there have been internationally accepted criteria for diagnosing the disorder.
http://www.sjogrens.org/syndrome/diagnosis.html
Brody, J. An Autoimmune Disorder, in Camouflage. The New York Times, October 7, 2008, p D7.
Animal Study Shows BSE (Mad Cow Disease) Can be Transmitted by Blood Transfusion
BSE can be transmitted through blood transfusion according to a study in sheep, which suggests that safeguards put in place to protect the human blood supply were justified (The FDA asked blood centers to exclude potential donors who have spent six or more cumulative months in the U.K. between 1980 and 1996 from donating blood.). Transmission even occurred when blood was collected from animals before they developed signs of disease. BSE is a rare neurodegenerative disorder that cannot be detected before the patient experiences problems, such as unsteadiness or involuntary movements.
Houston F, McCutcheon S, Goldmann W, Chong A, Foster J, Siso S, Gonzalez L, Jeffrey M, Hunter N. Prion diseases are efficiently transmitted by blood transfusion in sheep Blood, Jul 22, 2008, Epub.
B12 May Protect Against Brain Shrinkage and Risk of Dementia in Older People
Older adults with lower blood levels of vitamin B12 were more likely to experience brain shrinkage over a 5-year period than those with higher levels, according to a U.K. study. B12 is available from meat, milk, and eggs. Other studies have linked increased levels of B12 to reduced levels of homocysteine, an amino acid reported to increase risk for dementia.
Vogiatzoglou A, Refsum H, Johnston C, Smith SM, Bradley KM, de Jager C, Budge MM, Smith AD. Vitamin B12 status and rate of brain volume loss in community-dwelling elderly. Neurology. 2008 Sep 9;71(11):826-32.
Vitamin D News:
Leading Pediatrician Group Says Children Should Get Double the Recommended Amount of Vitamin D
The American Academy of Pediatrics says children—from newborns to teens—should get 400 units of vitamin D each day, double the amount in current recommendations. Growing evidence suggests that vitamin D not only keeps bones strong, but may reduce risk for cancer, diabetes, and heart disease. Good sources are milk, fortified cereals and oily fish, such as tuna, mackerel, and sardines. Sun exposures—15 minutes a day without sunscreen—also helps the body make vitamin D. But Academy experts suggest that supplementation may be necessary to reach 400 daily units.http://aappolicy.aappublications.org/cgi/content/full/pediatrics;122/5/1142
How to Get Enough Vitamin D: Supplements, Daily Sun Exposure and Special Sun Lamps
It is difficult to get enough vitamin D through foods and sun alone, especially during the winter months when the sun is too weak to trigger the body’s natural ability to make vitamin D. Other good options include: vitamin D supplements (look for vitamin D3), 10-15 minutes of sun exposure during summer months, or a special medium-pressure sunlamp. The FDA has sanctioned some sunlamps made by Sperti, such as the KDB D/UV lamp, as a vitamin D producer for people who need more vitamin D.Ask Tufts Experts, Tufts University Health & Nutrition Letter. November 2008, pg. 7
Vitamin K News:
Vitamin K, So Important to ITP Patients, Is Found in Variety of Foods
Vitamin K helps blood to clot. Foods high in vitamin K include leafy green vegetables (spinach, escarole, kale, seaweed, endive, collard greens, turnip greens, and Swiss chard). Medium sources of vitamin K are: broccoli, Brussels sprouts, Romaine lettuce, parsley, green cabbage, spring onions, coleslaw, pistachios, and mustard greens.Ask Tufts Experts, Tufts University Health & Nutrition Letter. November 2008, pg. 7
Vitamin K2 Reduces Hardening of the Arteries, Protects Heart
Higher intake of vitamin K2—which is different from the vitamin K found in leafy greens—is associated with a 20 percent reduction in hardening of the arteries, according to a study of dietary habits and cardiovascular health in 564 postmenopausal women. Sources of K2, also called menaquinones, are meats and cheeses.Joline W. Beulens, Michiel L. Bots, Femke Atsma, Marie-Louise Bartelink, Matthias Prokop, et al. High dietary menaquinone intake is associated with reduced coronary calcification. Atherosclerosis. published online 26 August 2008.
Holiday Alert: Overdoing the Cinnamon May Mean Too Much Anti-coagulation
Some people take cinnamon for its insulin-like properties to combat insulin resistance and diabetes. But too much cinnamon might not be a good thing. Cinnamon is a source of coumarin, an anti-coagulant that can cause liver inflammation. Different types of cinnamon contain different amounts. The more expensive, Ceylon cinnamon contains less (.0004% coumarin). The more common Cassia cinnamon, contains .5% coumarin. Overdoing cinnamon consumption may be a special risk during the holiday season.
Television Viewing Increases Food Intake Even After the Set is Turned Off
From a study of 16 college students, those who watched television while eating lunch ate more later in the day, after the TV was off. The U.K authors suggest that this effect may be related to an effect of television watching on the person’s ability to remember the amount eaten in the previous meal.
Higgs S, Woodward M. Television watching during lunch increases afternoon snack intake of young women.
Appetite. online 23 July 2008.
Half of US Doctors Report Giving Placebo Treatments Without Telling Patients
Of a random sample of U.S. physicians, about half said they regularly give patients placebo treatments—usually vitamins or OTC analgesics. The survey, by NIH and Mayo Clinic researchers, included 1200 practicing internists and rheumatologists, and more than half responded. About two thirds believed that using a placebo treatment was ethically acceptable. Physicians who use placebo treatments most commonly describe them to patients as a potentially beneficial medicine or treatment not typically used for their condition. Only 5 percent called it a placebo treatment.
Tilburt JC, Emanuel EJ, Kaptchuk TJ, Curlin FA, Miller FG. Prescribing “placebo treatments”: results of a national survey of US internists and rheumatologists. BMJ. October 23, 2008;337:a1938.
FDA Sets Stricter Guidelines for Conflict of Interest on Advisory Committees
Individuals who play a crucial role or have a financial interest greater than $50,000 in companies that may be affected by an FDA advisory committee’s actions will not be allowed to participate on that committee, according to new FDA guidance released in August. FDA Advisory committee members must also disclose financial interests held by spouses or minor children.
www.fda.gov/oc/advisory/newacguidance0808.html
Is Risk-Sharing a Solution for Rising New Drug Costs?
In August, the U.K.’s National Institute for Health and Clinical Excellence (NICE) issued a draft guidance that four novel drugs for advanced renal cancer not be used because the manufacturer had not shown cost-effectiveness. Cost constraints are signaling a change in how health-care innovation is assessed, with decision-makers struggling to balance limited health-care budgets with benefits to patients from new (and often more expensive) drugs. A risk sharing between manufacturer and payer may be the way to go, according to an editorial in Nature Reviews Drug Discovery. For example, the U.K.’s National Health Service only pays for the drug Velcade (bortezomib) when a patient shows a response to treatment.
Tackling the Clinical Value Conundrum. Nature Reviews Drug Discovery. November 2008. www.nature.com/nrd/journal/v7/n11/full/nrd2746.html
---------------------------------------------------------------------------------------------------------------------------------------------------------------
This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org
To unsubscribe: send an email to: admin@pdsa.org and place ‘remove’ in the subject line. To change your e-mail address, send an e-mail with your old and new address to: admin@pdsa.org
Contents:
ITP Research and Treatments
General Health and Medicine
Hospitals, Insurance, and Medical Care
---------------------------------------------------------------------------------------------------------------------------------------------------------------
ITP Increases Risk for Blood Clots
Although patients with ITP experience a low platelet count and bleeding, they are at risk for blood clots, according to a British review of patient records from 1992 to 2005. In a case review of 840 adults with ITP versus 3,360 adults without the disease, those with ITP had slightly higher risk of clotting. Commenting on the study, David Kuter, of Massachusetts General Hospital listed several possible reasons: In ITP patients, platelets are younger and more active. Although platelets are shattered by antibodies in ITP, the fragments can cause clotting. And ITP treatments may cause platelet count to rise too rapidly. The research has not yet been published; it was presented at December’s meeting of the American Society for Hematology (ASH).
Long-Term Safety Data For Nplate Is Promising
Romiplostim (Nplate) appears safe in the long-term (over 48 weeks) for patients with ITP, according to two studies reported at ASH. Bleeding events decreased over time, with no increase in blood clotting, which occurred in 4% of patients. Nplate received FDA approval in August for patients whose ITP had not responded to other therapies. Long-term safety is important since platelet counts fall after the drug is stopped. Both studies were sponsored by Amgen, the drug’s maker.
Rituximab Boosts Effectiveness of Dexamethasone in ITP
Addition of rituximab (Rituxan) to dexamethasone improved initial response, sustained response, and active rescue of patients previously untreated for ITP. 101 patients were randomly assigned to receive dexamethasone alone or dexamethasone plus rituximab. Both initial response at 30 days and sustained response at 6 months were higher in those who received both drugs. The Italian authors suggest that rituximab plus dexamethasone is worth using before splenectomy.
Close To Half Of ITP Patients On Eltrombopag Reduce Other Medications
Of 69 patients in an open-label study of eltrombopag (Promacta), 33 were able to reduce or stop other medications at least temporarily during the 18-month study, according to University of California, San Francisco researchers. Corticosteroids were the medications most frequently stopped.
Eltrombopag Increased Platelet Counts And Reduced Bleeding In ITP
Patients receiving eltrombopag were eight times more likely than those on placebo to achieve target platelet counts in RAISE, a placebo-controlled, double blind, randomized phase 3 study. 197 patients with chronic ITP received either 6 months of daily oral eltrombopag (Promacta) or placebo. More patients in the eltrombopag group were able to stop or reduce other medications and they required less rescue medication than the placebo group. The benefit occurred in patients with and without their spleens. Promacta received accelerated approval from the FDA in November. The study was funded by GlaxoSmithKline, the drug’s maker.
Vitamin K May Fight Diabetes In Men
In a surprise finding from a study of vitamin K supplements to protect bones, Tufts researchers found that the vitamin also reduces insulin resistance—a precursor to diabetes—in older men. The 3-year, randomized, double-blind study in 355 men and women ages 60 to 80 found that a 500-microgram supplement of vitamin K1 can make a difference. The authors note that people can easily get 500 micrograms from their diet. Good sources are green leafy vegetables (kale, spinach, escarole, endive, collard greens, turnip greens, Swiss chard, Romaine lettuce) and broccoli, Brussels sprouts, spring onions, and pistachios. One cup of cooked kale carries 1,062 micrograms of vitamin K1, which is also important for blood clotting.
Vitamin K May Fight Diabetes. Tufts Health & Nutrition Letter. December 2008, pg. 1-2.
Vitamin C Reduces Bone Loss In Men
Bone health is not just about calcium and vitamin D, according to a Tufts University study. A review of bone mineral density (BMD) in 344 men and 540 women, average age 75, and vitamin C intake in the Framingham Osteoporosis Study indicated that men with high intakes of vitamin C—through diet or supplements—had higher BMD in the hip bones. Protection began at 250 milligrams of vitamin C. For people who don’t eat the recommended 5 to 9 servings of fruit and vegetables, supplementation may be necessary to reach this level.
Vitamin C Joins the Fight for Healthier Bones. Tufts Health & Nutrition Letter. December 2008, pg. 8.
Group Urges USDA To Tighten Not Loosen Rules On Genetically Engineered Crops
The U.S. Department of Agriculture (USDA) is rushing through regulations that weaken oversight of all genetically engineered (GE) crops, according to the Center for Food Safety. “The proposed rule has the same gaping holes as the policy it is replacing, and creates a few new ones, as well.” Biotech companies, which grow crops engineered to produce drugs will be able to assess their own crops to determine whether USDA should regulate them. Companies will be allowed to grow untested GE crops with no oversight. The proposed rule bars state and local regulation of GE crops that is more protective than federal regulations.
http://www.centerforfoodsafety.org/USDA_GERegs_PR10_08_08.cfm
Hidden Dangers For Patients Taking Multiple Medications
Many drug combinations have not been tested for safety. “Elderly people are especially vulnerable because they often have several medical problems for which they see different doctors, each prescribing drugs, often without knowing what else the patient is taking,” according to a 2007 article by Jane Brody in the New York Times. Tell your doctors and pharmacist every medication you take so they can determine dangers. Discovery Health has a website for checking drug interactions:
http://health.discovery.com/webapps/drugchecker.do
In Tough Economic Times Patients Scrimp On Medications
People are trying to save money by not filling their prescriptions. Prescription drug sales are down, according to IMS Health, a research firm that tracks prescriptions. Doctors talk of patients scrimping on Lipitor, the cholesterol-lowering medicine, and on their osteoporosis medication. The average co-pay for drugs on insurers’ preferred lists rose to $25 in 2007 from $15 in 2000, according to the Kaiser Family Foundation.
Saul S. In Sour Economy, Some Scale Back on Medications. The New York Times. October 22, 2008.
Splitting Pills Not Always Safe
Pill splitting can save on prescription costs—a 200 mg dose typically costs the same as a 100 mg dose—but not every pill can be split safely. Correct dosage is essential for medications for epilepsy, certain heart problems, and for hormone medications. Other pills that shouldn’t be split: extended release pills, pills containing more than one medication, pills coated to protect the stomach, pills that crumble easily, pills that are difficult to swallow because of bitter taste, and power or gel capsules. Pills that are scored to make cutting easier indicate FDA approval for splitting. But don’t split by hand or knife; buy a pill splitter, which costs about $10.
House Calls. Health After 50, Johns Hopkins, pg. 8.
Fewer Primary Care Doctors Accepting Medicare Patients
More Medicare patients are having trouble finding a new primary care doctor to care for them. The trend appears to be based on physician fears about potential cuts in reimbursement rates from the Federal government and the slow pace of reimbursement and layers of paperwork required. The Medicare Payment Advisory Commission reported in December that nearly 30 percent of 2.6 million Medicare beneficiaries who sought out a new primary care doctor over the past year had trouble finding one. That number is up from 25 percent in 2005. In Virginia, just 2.5 physicians are accepting Medicare per 100 beneficiaries, according to the American College of Emergency Physicians. The national average is 3.2 per 100.
Jenkins CL. The Doctor is Out. The Washington Post, December 9, 2008, Pg. F1, F4.
---------------------------------------------------------------------------------------------------------------------------------------------------------------
This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org
To unsubscribe: send an email to: admin@pdsa.org and place ‘remove’ in the subject line. To change your e-mail address, send an e-mail with your old and new address to: admin@pdsa.org
CONTENTS:
Platelet Disorder Support Association
8751 Brecksville Road Suite 150
Cleveland, OH 44141
440.746.9003 | pdsa@pdsa.org
The Platelet Disorder Support Association is a 501(c)3 organization and donations are tax deductible to the fullest extent allowed by law.
© Copyright 1997 - 2026, Platelet Disorder Support Association. All rights reserved.
IMPORTANT!
The Platelet Disorder Support Association does not provide medical advice or endorse any medication, vitamins or herbs. The information contained herein is not intended nor implied to be a substitute for professional medical advice and is provided for educational purposes only. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment, discontinuing an existing treatment and to discuss any questions you may have regarding your unique medical condition.
