Platelet E-News – August 21, 2009

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

Hospitals, Insurance, and Medical Care

General Health and Medicine

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General Health and Medicine

THE SPLEEN FINALLY GETS SOME RESPECT
Scientists have discovered that the spleen, sometimes considered expendable, plays a more important role in the body’s defense system than previously known: the spleen stores and mobilizes white blood cells to promote healing during a crisis event. In addition to filtering the blood and recycling iron and other particles from red blood cells, researchers from Massachusetts General Hospital and Harvard Medical found that the spleen stores large numbers of a type of white blood cell called monocytes.  In the event of a serious trauma to the body, like a heart attack, large wound, or severe infection, the spleen will send multitudes of monocytes into the bloodstream to promote healing.   The new findings could help explain the results of a 1977 study where veterans who had a splenectomy were twice as likely to die from cardiovascular disease as a control group.

http://www.nytimes.com/2009/08/04/science/04angier.html

Swirski FK, et al, “Identification of splenic reservoir monocytes and their deployment to inflammatory sites” Science. 2009 Jul 31;325(5940):612-6

http://www.ncbi.nlm.nih.gov/pubmed/19644120

EMERGING THERAPIES FOR TREATMENT OF STUBBORN H. PYLORI INFECTIONS
Many different therapies have been tried to eradicate H. pylori, a bacteria sometimes associated with ITP.  Researchers at St. John’s University scoured scientific articles to determine treatment success patterns.  They concluded that more data are needed, especially in the US, to support levofloxacin triple therapy.  A rifabutin-based regimen may be better tolerated, but due to cost and other factors, its use could be limited.  Tinidazole has also been tried, but may not be as effective in the US due to drug-resistant trains of the bacteria. 

http://www.medscape.com/viewarticle/706086

Tomasz Z Jodlowski, et al. "Emerging Therapies for the Treatment of Helicobacter pylori Infections," The Annals of Pharmacotherapy, 2008 Nov;42(11):1621-39.

ITP PATIENTS TREATED WITH ROMIPLOSTIM (NPLATE) WERE ABLE TO REDUCE IVIg USAGE
Fewer ITP patients who received the thrombopoietin (TPO) mimetic romiplostim (Nplate) required IVIg rescue therapy than the placebo group, report researchers who quantified the use of IVIg in two 24-week, placebo-controlled studies.  Of the 125 patients enrolled, just 14% of the romiplostim patients required IVIg therapy compared to 50% in the controls.  In addition, fewer patients in the romiplostim group required more than one IVig treatment.  This information could help physicians understand the impact of romiplostim on IVIg requirements.

Vinod Pullarkat, et al. “Quantifying the reduction in immunoglobulin use over time in patients with chronic immune thrombocytopenic purpura receiving romiplostim (AMG 531),” in Letters to American Journal of Hematology, Vol. 84, No. 8, pages 538 – 540, May 2009.

HALF OF ITP PATIENTS USING ELTROMBOPAG (PROMACTA) WERE ABLE TO REDUCE STEROIDS AND OTHER MEDS
About half of chronic ITP patients taking eltrombopag (Promacta), a thrombopoietin mimetic, along with other medications in an extended clinical trial, were able to stop or reduce the use of the other meds.  In this open-label study of eltrombopag, of the 69 patients who were on concomitant meds at the start, 33 reduced or stopped their other medications at least temporarily.  Of these, 18 were able to completely stop additional meds.  Corticosteroids (ex. Prednisone) were the medications most frequently reduced or stopped. 

“ASH: Half of Patients on New ITP Drug Could Reduce Other Meds,” MedPage Today, Dec. 10, 2008. http://www.medpagetoday.com/HematologyOncology/Hematology/12112

Patrick Fogarty, et al., “Oral Eltrombopag Treatment Reduces the Need for Concomitant Medications in Patients with Chronic Idiopathic Thrombocytopenic Purpura,” Abstract in Blood 2008; 112, 1174.

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Hospitals, Insurance, and Medical Care

NEW FDA REGULATIONS ISSUED FOR DENTAL AMALGAM
The FDA has issued its final regulations regarding dental amalgam, also known as "silver filling," used to fill dental cavities.  The agency re-categorized the mercury component from low risk to moderate. The FDA said that the mercury levels released by the fillings are "not high enough to cause harm in patients," although at high levels elemental mercury can be hazardous to your health.   The FDA is now requiring additional product information, including details of the risks and benefits of dental amalgam, so dentists and their patients can make informed decisions.

http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/ucm171120.htm

SERIOUS ILLNESSES CAN CAUSE FAMILIES TO EXPERIENCE ISOLATION
People who are very ill often isolate themselves from others: Friends and family often do not know what to say or do, according to certified child-life specialist, Jeanne Higgins Bergin, who has much experience in helping families of critically ill children cope with the situation.  Instead of avoidance, she suggests those close to people who are ill “acknowledge the situation, be empathetic, reach out and offer specific ways to help the family.” 

Louise Bonnett-Rampersaud, “Serious Illness can Isolate a Family:Gestures of support help greatly,” The Washington Post, Tuesday, August 4, 2009

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/03/AR2009080302088.html

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General Health and Medicine

CERTAIN PLANT PIGMENTS HELP PROTECT AGAINST BONE LOSS
Carotenoids, the red, orange, and yellow pigments that give fruits and vegetables their unique color, may help protect against bone loss in older men and women.  Researchers at Tufts, Boston University, and Hebrew SeniorLife examined data from the Framingham Osteoporosis Study and concluded that those subjects eating a greater amount of food containing carotenoids, particularly lycopene, experienced some protection against loss in bone mineral density.  This was more evident at the hip in men and at the lumbar spine in women than in other bones.  The antioxidant qualities of the more than 600 different types of carotenoids may help explain their association with bone health.

Sahni S, et al, “Inverse association of carotenoid intakes with 4-y change in bone mineral density in elderly men and women: the Framingham Osteoporosis Study.“Am J Clin Nutr. 2009 Jan;89(1):416-24

http://www.ncbi.nlm.nih.gov/pubmed/1905658

http://www.ajcn.org/cgi/content/abstract/89/1/416

(Note: prednisone is associated with a decrease in bone density)

MINDFULNESS FOCUS HELPS CALM THE BODY AND MIND
It is easy to think that multitasking will help you get more done, relieve stress, and be a good skill to develop.  However, research shows that just the opposite, concentrating on one thing at a time, can help you improve your health. The practice is called ‘mindfulness’ and has been used to improve many things from heart disease to relationship problems.  “Mindfulness is the practice of purposely focusing your attention on the present without drifting into concerns about the past or future or getting caught up in making judgments about what's happening.” Meditation is an easy way to practice mindfulness, but just paying attention to what is happening without thinking about something else can be beneficial.  

https://www.health.harvard.edu/newsletters/Harvard_Heart_Letter/2009/May/Mindfulness-in-a-hectic-world

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