PDSA E-News: April 30, 2014


Steroid Treatment Changes Platelet Activation

Activated platelets tend to aggregate (leading to clotting) but they cannot do so when the platelet numbers are low, as in ITP. Researchers examined platelet activation in 55 ITP patients and 55 controls, with and without ADP (adenosine diphosphate) stimulation both before and after the patients received steroid treatment. They found that platelets in ITP patients exist in an activated state. The fold activation of platelets treated with ADP was more in healthy controls than in ITP patients. Treatment with steroids caused platelets in steroid-responsive patients to respond more to the ADP activation. The researchers concluded steroids may cause changes in the ability of platelets to become activated with an agonist like ADP. Their results offer new insights into how steroid therapy aids in treating ITP.

Bhoria P, Sharma S, Varma N, Malhotra P, Varma S, Luthra-Guptasarma M.  "Effects of steroids on the activation status of platelets in patients with immune thrombocytopenia (ITP)."   Platelets.  2014 Mar 11.

Rituximab Treatment Impairs Vaccine Response and Raises Infection Risk

244B-cell depletion from rituximab treatment may impair vaccine responses and increase risk of infection in ITP patients. Researchers investigated the response to Streptococcus pneumonia vaccines given to 24 patients six months after they received rituximab treatment. The study found antibody responses to vaccines were impaired at least six months after rituximab. The findings showed importance of timing of vaccinations and the possible means of infection after ITP patients receive rituximab.

Nazi I, Kelton JG, Larche M, Snider DP, Heddle NM, Crowther, MA, Cook RJ, Tinmouth AT, Mangel J, Arnold DM. "The effect of rituximab on vaccine response in patients with immune thrombocytopenia." Blood 2013 Sep 12; 122(11):1946-53. 


New Optical Device Rapidly Measures Blood Clotting Properties

Researchers have developed a new optical device about the size of a tissue box that provides rapid test results with only a small amount of blood. The technique, called laser speckle rheology (LSR), was found very sensitive to the coagulation of blood. It allows doctors to evaluate a patient's coagulation status in real-time especially in operating rooms, emergency departments, and intensive care units for patients with any type of coagulation disorder. This would aid doctors in quickly deciding how much blood to give to a bleeding patient. Clinical testing at the point of care is the next phase of research.

Tripathi M, et al, "Assessing Blood Coagulation Status with Laser Speckle Rheology," Biomedical Optics Express, Vol. 5, Issue 3, pp. 817-831 (2014).


BPA Replacement in Paper Receipts Can Alter Hormones

243In the past, we learned how BPA (bisphenol A) a chemical used in the linings of canned food, plastics, and cash-register receipts could disrupt hormones and have adverse effects on humans and wildlife. Since then many companies switched to thermal paper cash-register receipts made with an alternative chemical, bisphenol S (BPS). Now recent research shows that BPS also disrupts the hormone estrogen, even at low levels. With BPS on receipts that we handle every day it is very easy to get residue on the fingers and hands. To reduce your exposure, always wash hands after handling receipts and throw them away if unneeded. Some stores now offer electronic, online receipts instead of paper.



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