Platelet E-News – September 17, 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

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ITP Research and Treatments

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.

Research Sheds New & Exciting Light on Why People Get ITP - Read article in Blood written by PDSA Medical Advisor John Semple, PhD

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.

www.cslbehring.com

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.

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General Health and Medicine

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.”

www.douglassreport.com

http://www.efluxmedia.com/news_Detergents_and_Air_Fresheners_Smell_Nice_but_Possibly_Intoxicate_20873.html

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Hospitals, Insurance and Medical Care

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

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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

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