Platelet E-News – July 12, 2008

This e-newsletter is a monthly publication of the Platelet Disorder Support Association.  The information in this newsletter is for educational purposes only.  For advice on your unique medical condition, please consult a health care professional.

Contents:

ITP Research and Treatments

General Health and Medicine

Hospitals, Insurance and Medical Care

Nutrition, Fitness, and Lifestyle

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ITP Research and Treatments

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.

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General Health and Medicine

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.

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Hospitals, Insurance and Medical Care

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.

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Nutrition, Fitness, and Lifestyle

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

www.wholegrainscouncil.org

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.

http://www.realage.com/ct/tips/6293

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