Platelet E-News – November 16, 2005

Contents:

  • New Treatment for Adult ITP: Phase I Research Study
  • Breathing and Blood Pressure
  • Patient-Centered Primary Care: A Vision
  • Chronic Disease: A Global Problem
  • Treating Children with ITP: IVIG or Steroids?
  • ASH Opens Blood Archives
  • Vitamin D and Healthy Gums
  • NIH Publishes Conference Report: Dietary Supplements, Coagulation, and Antithrombotic Therapies
  • Natural Herbal Treatment Developed by MDs (advertisement)

 

NEW TREATMENT FOR ADULT ITP: PHASE I RESEARCH STUDY

GMA161 – Genzyme Corporation in collaboration with MacroGenics, Inc. is currently conducting a Phase I research study for people over the age of 17 years who have been diagnosed with chronic idiopathic thrombocytopenic purpura (ITP). The study is designed to investigate the safety of a single infusion of GMA161, a monoclonal antibody, as well as the way the drug enters and leaves the body. In addition, throughout the study, platelet counts and other blood cell numbers will be measured.

For more details about eligibility criteria and contact information for participating medical centers, please visit: http://www.clinicaltrials.gov/ct/show/NCT00244257.

You can find a listing of this and other clinical trials at: http://www.itppeople.com/clinical.htm.

BREATHING AND BLOOD PRESSURE

Italian investigators demonstrate that slow breathing can reduce blood pressure. They explain that this is accomplished by enhancing baroreflex sensitivity, the sensitivity of nerve cells in the wall of the heart that sense changes in blood pressure and initiate changes in heart function to maintain normal pressure. The study included 46 subjects; 20 patients with essential hypertension and 26 healthy controls. Slow breathing increased baroreflex sensitivity in the hypertensive patients and the control subjects. The authors conclude, "slow breathing had the effect of acutely normalizing the baroreflex sensitivity in these patients," Dr. Bernardi and his group conclude, "It seems that slow breathing induces a generalize decrease in the excitatory pathways regulating respiratory and cardiovascular systems."
Bernardi, L., et.al., Hypertension 2005;46:714-718, http://www.medscape.com/viewarticle/514756

PATIENT-CENTERED PRIMARY CARE: A VISION

The Institute of Medicine (IOM) notes that “a chasm exists between the kind of care that patients receive and the kind of care they should have, and calls for fundamental change in the system of care. It further argues that these changes would both be better for patients and make the provision of care more satisfying for clinicians.” Dr. Davis proposes seven attributes of patient centered care;
1. Access to care
2. Patient engagement in care
3. Information systems
4. Care coordination
5. Integrated and comprehensive team care
6. Patient-centered care surveys
7. Publicly available information
It has been reported that 25% of primary care physicians currently incorporate these attributes in their practices. Marked improvement will require major changes including a new system of primary care payment. One proposed structural change would ensure that everyone had a “medical home”; everyone regardless of whether insured by public programs or private insurance would have a place to enter the health care system. The task is monumental with rewards to match.

Davis, K., et.al., Journal of General Internal Medicine, 2005;20(10):953-957, http://www.medscape.com/viewarticle/514194.

CHRONIC DISEASE: A GLOBAL PROBLEM

It is estimated by the World Health Organization (WHO) that 17 million people die prematurely each year from chronic diseases and that international action to prevent chronic disease could save 36 million people world wide over the next decade. The three most important causes of chronic diseases are unhealthy diet, physical inactivity, and tobacco use. The personal, social, and economic impact of these diseases is significant. Families are fractured and the economic losses amount to billions of dollars. It is estimated that in the period 2005 – 2015, China, India, and the Russian Federation will each forgo billions of dollars of national income to premature death due to chronic disease. The WHO report includes inexpensive and cost-effective measures that could produce rapid health gains. These include: salt reduction in processed foods, improved school meals, and taxation of tobacco products. The latter approach is not only cost-effective but would increase revenue as well.

http://www.who.int/mediacentre/news/releases/2005/pr47/en/

TREATING CHILDREN WITH ITP: IVIG OR STEROIDS?

Researchers in Toronto report that children treated with steroids for acute ITP are 26% less likely to have a platelet count greater that 20,000 48 hours after therapy than children treated with IVIG. This finding resulted from a meta analysis of data from randomized, controlled trials and was reported originally in the Journal of Pediatrics in October 2005.

Beck, C., Nathan, P., Parkin, P., Blanchette, V., Macarthur, C., “Corticosteroids Versus Intravenous Immune Globulin for the Treatment of Acute Immune Thrombocytopenic Purpura in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials” The Journal of Pediatrics, October 2005 (Vol. 147, Issue 4, Pages 521-527) see also IgG Today, Newsletter of IgG America, November 2005. http://www.jpeds.com/article/PIIS0022347605003422/abstract

ASH OPENS BLOOD ARCHIVES

The American Society of Hematology (ASH) has made available full-text, searchable PDF versions of all articles dating back to 1946. Access is free to all. Only articles from the last 12 months are under access control. However, even articles published during the last 12 months can be obtained by patients at no cost by emailing a request to the journal. For an explanation of the procedure to obtain articles published during the last 12 months, go to:
http://www.bloodjournal.org/misc/Patient_Request.shtml.
To use the Blood archive, go to: www.bloodjournal.org.

ASH Newslink, November 2005.

VITAMIN D AND HEALTHY GUMS

Researchers at Boston University reported on data from a nationwide survey examining the teeth and gums of 6,700 nonsmokers. They found that bleeding gums were 20% less likely in those with the highest levels of Vitamin D. The authors suggest that Vitamin D may keep gums healthy by fighting inflammation.

Nutrition Action Healthletter, November 2005, p 10.

NIH PUBLISHES CONFERENCE REPORT: DIETARY SUPPLEMENTS, COAGULATION, AND ANTITHROMBOTIC THERAPIES

The National Institutes of Health (NIH) announced that a 230 page volume, Thrombosis Research, will be available December 10, 2005. This publication represents the work of the NIH Conference on Dietary Supplements, Coagulation, and Antithrombotic Therapies. The volume examines the effects of dietary supplements and various therapies on coagulation.

Representatives from 10 patient care organizations participated including Joan Young, President of PDSA. In addition to the representatives from patient care organizations, more than 35 speakers presented.

http://www.sciencedirect.com/science/journal/00493848

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