Platelet E-News: June 27th, 2012

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 and Platelet Disorders Research and Treatments

Hospitals, Insurance, and Medical Care

General Health and Medicine

--------------------------------------------------------------------------------------------------------

ITP and Platelet Disorders Research and Treatments

 

CAN THE AIR YOU BREATHE AND THE FOOD YOU EAT CAUSE ITP?

 

Dioxin is a common pollutant found in cigarette smoke, the fat of some animal food sources, and other places. Scientists have found that dioxin can change the immune system and a mother can pass these changes to her children. Specifically dioxin can change CD8+ T-cells, a type of white blood cell important in regulating the immune response. Exposure to dioxin can also increase inflammation.

This information is important for people with ITP since CD8+ T-cells have been shown to impair the ability of the bone marrow to produce platelets and ITP is considered an inflammatory disease.

King H. "Seminar addresses developmental origins of immune disease." Environmental Factor. June 2012. http://www.niehs.nih.gov/news/newsletter/2012/6/science-immune/index.htm

"Dioxins and their effects on human health." World Health Organization http://www.who.int/mediacentre/factsheets/fs225/en/

Scherer L. "Megakaryocyte apoptosis a novel therapeutic target in ITP management." MedWire News. November 7. 2007. http://www.medwire-news.md/62/70814/Thrombosis/Megakaryocyte_apoptosis_a_novel_therapeutic_target_in_ITP_management.html

Imbach P. "Oxidative stress may cause ITP." Blood. 2011 Apr 28;117(17):4405-6. http://www.ncbi.nlm.nih.gov/pubmed/21527538

SPLENECTOMY CAN CHANGE RED BLOOD CELLS

A recently published case report of Pappenheimer bodies in the red blood cells of someone who had a splenectomy, along with other medical conditions, reminds us of a condition known to some researchers for many years but largely unknown among patients. That is, small bits of iron can collect in the red blood cells of splenectomized people, iron which can only be seen if the blood is stained using a Wright stain. Alwin Max Pappenheimer first described this phenomenon in a paper published in 1945.

A more well-known change to red blood cells following splenectomy are inclusions of bits of DNA called Howell-Jolly bodies, seen as purple spots on the standard blood stain.

Lesesve JF et al. "Multiple Pappenheimer bodies after Splenectomy." Eur J Haematol. 2012 May 16. http://www.ncbi.nlm.nih.gov/pubmed/22587707

Sears DA, Udden MM. "Pappenheimer Bodies: A Brief Historical Review." American Journal of Hematology 75:249–250 (2004). http://onlinelibrary.wiley.com/doi/10.1002/ajh.20008/pdf

HOW MANY PEOPLE HAVE ITP? NEW INFO

To determine the number of people diagnosed with primary ITP at a given time (prevalence), researches in Oklahoma contacted 93 hematologists and tracked the number of patients who were given a diagnostic code of ICD-9-CM 287.3 (primary thrombocytopenia). Eight-seven physician offices responded with details. The results showed an average annual prevalence of 8.1 per 100,000 people for children and 12.1 per 100,000 people for adults. Men over 80 years old had the highest prevalence.

Note: While this study was carefully designed, the prevalence of ITP could be higher than these statistics show if they included secondary ITP and ITP patients who see heath care providers other than those answering the survey.

Terrell DR. "Prevalence of primary immune thrombocytopenia in Oklahoma." Am J Hematol. 2012 May 14. http://www.ncbi.nlm.nih.gov/pubmed/22674643

STEROIDS LINKED TO SUICIDE

Nearly 273,000 people were given oral corticosteroids (ex. prednisone) in the UK between 1990 and 2008. Compared to people with the same diseases but treated differently, the corticosteroid group had nearly seven times the rate of attempted or successful suicide and increased rates of depression, mania, delirium, confusion, disorientation, and panic disorder. Younger people were more susceptible to suicide attempts and older men were more apt to have delirium/confusion/disorientation and mania. Researchers suggest that physicians educate patients and their families about these risks and closely monitor that aspect of their care.

Fardet L et al. "Suicidal Behavior and Severe Neuropsychiatric Disorders Following Glucocorticoid Therapy in Primary Care. Am J Psychiatry. 2012 May 1;169(5):491-7. http://psychiatryonline.org/article.aspx?articleid=519047&journalid=13

 

Hospitals, Insurance, and Medical Care

THE FUTURE OF HEALTH INSURANCE

No matter what the US Supreme Court decides about the 2010 healthcare law, one trend seems certain: companies will continue to move to high-deductible healthcare insurance plans for their employees. While these plans are sometimes called "consumer-driven," these plans reduce costs for employers and can increase costs for employees, especially those with chronic diseases. In some cases they can prompt employees to pay more attention to preventive services and shop for lower-cost providers. Unfortunately, they can also delay people from seeking needed care.

Hancock J. "High-deductible insurance plans become more common." The Washington Post, June 2, 2012. http://www.washingtonpost.com/business/high-deductible-insurance-plans-become-more-common/2012/06/01/gJQAbNlt9U_story.html

HEALTH IN AMERICA: THE NUMBERS TELL ALL

The Centers for Disease Control recently released a 583-page report on the state of health in the US as of 2011, a report containing charts and statistics by age, gender, disease, socioeconomic status, location, and ethnicity. In general, people are getting fatter, still smoking, and not getting enough exercise, but are living slightly longer than in 2000. People in rural areas smoke more, have more disabilities, and are more likely to delay healthcare and be uninsured. The average per person expenditure on healthcare was $8,000 in 2009.

"Health, United States, 2011," Centers for Disease Control, May 16, 2012. http://www.cdc.gov/nchs/hus.htm

 

General Health and Medicine

MORE THAN HALF OF CANCERS MAY BE PREVENTABLE. HERE'S HOW.

You probably already know many of the things that can help prevent cancer….stop smoking, eat more vegetables, get more exercise, reduce radiation exposure, etc. There have been many studies that demonstrate the positive effects of these lifestyle changes. They are not mysteries. So why are people still dying of smoking-induced lung cancer and other preventable cancers? According to the study's authors, it will take a coordinated effort, education programs, a change in focus to prevention, and a belief in their worth, among other things, to have more of these healthy lifestyle practices meet their potential in preventing cancer.

"More than half of cancers may be preventable using existing resources." HemOnc Today, May 25, 2012. http://www.healio.com/hematology-oncology/cancer-prevention/news/print/hematology-oncology/%7B446D4252-D395-4D62-8D54-1FED81C1B8A6%7D/More-than-half-of-cancers-may-be-preventable-using-existing-resources

Colditz GA. "Applying What We Know to Accelerate Cancer Prevention." Sci Transl Med. 28 March 2012: Vol. 4, Issue 127, p. 127rv4. http://stm.sciencemag.org/content/4/127/127rv4.abstract?sid=0d40430a-59f9-4989-b323-36e39288bb56

ANOTHER REASON TO BE WARY OF STATINS

New research shows that statins, drugs prescribed to reduce cholesterol, can contribute to fatigue. In a study of 1062 men and women without cardiovascular disease given Zocor®, Pravachol®, or a placebo, from 20% to 40% of people on statins experienced general fatigue and fatigue upon exertion, with women more prone to these effects.

Note: Many people with ITP already experience fatigue. Statins can interact with eltrombopag, interfere with platelet function, can promote bleeding in the brain for those who have had a previous brain bleed, can promote muscle pain, and have an effect on T-cells (ITP is a T-cell mediated disease),

Golomb BA et al. "Effects of statins on energy and fatigue with exertion: Results from a randomized controlled trial. Arch Intern Med 2012. http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinternmed.2012.2171

 

--------------------------------------------------------------------------------------------------------

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

back to top

BBB Cleveland logoGuideStar Seal - 2017 goldNORD Member Badge 2018THSNA logo