Doe
With over forty percent of diabetics now being recommended
for iron reduction therapy and with studies showing
regression of vision loss one might / could ? .. expect this
treatment to become .. standard of care?
With a little bit of .. pressure .. it could .. ?
------------------------------------------------------------
--------------
----------
The “accelerated approval” program. In this scenario,
the treatment gets approval on the basis of “surrogate
markers,” such as regression of a tumor, rather than
demonstrated clinical benefit, such as increased survival.
Treatments can go into a “priority review” if a
treatment would be a significant improvement over drugs
already on the market. And they can “fast track” a
treatment by submitting data on a rolling timetable, as the
research marches along, not just at the end of the process.
------------------------------------------------------------
--------------
-------------------------------------
-----------------------------------------
The article states that among type II insulin-resistant
diabetic patients, 40% have elevated ferritin and should be
considered for phlebotomy therapy.
------------------------------------------------------------
--------------
------------------------------------------
Diabetes Metab 2002 Sep;28(4 Pt 1):335-9
[Do the insulin resistance associated hepatic iron overload
must be researched during diabetes mellitus type II?]
[Article in French]
Roblin X, Chevassus P, Boudemaghe T, Palayodan A Departement
de Medecine Interne et Hepato-gastro-enterologie, Centre
hospitalier de Gap, 05007 Gap Cedex.
[Medline record in process]
The insulin resistance-associated hepatic iron overload is
the first aetiology of iron overload disorders in France. If
we do not know its mechanism, the prevalence among type II
diabetic patients is around 40%. Hyperferritinaemia is
present in all cases, but is not specific of the diagnosis.
This pathology features liver fibrosis among 10% of the
patients and some cases of primary liver cancer have been
described. Moreover, a large body of evidence favors the
direct involvement of iron in the development of extra
hepatic neoplasia, while therapeutic phlebotomy to maintain
low to normal body iron stores can prevent all known
complications of insulin resistance-associated hepatic iron
overload. In addition, treatment of type II diabetes
mellitus and other features of insulin resistance syndrome
is essential. In conclusion, it is important to detect this
syndrome during type II diabetes mellitus.
PMID: 12442073, UI: 22328961
http://www.biospace.com/news_story.cfm?StoryID=16417520&ful-
l=1
These data suggest the key to minimizing vision loss is
earlier detection through increased screenings and
treatments that inhibit progression of diabetic macular
edema toward the center of the macula.
------------------------------------------------------------
--------------
---------------------------
Graefes Arch Clin Exp Ophthalmol. 2001 Dec;239(12):909-14.
Related Articles, Links
Effect of isovolemic hemodilution in central retinal vein
occlusion.
Glacet-Bernard A, Zourdani A, Milhoub M, Maraqua N, Coscas
G, Soubrane G.
University Eye Clinic of Creteil, Intercommunal and Henri
Mondor (Assistance Publique des Hjpitaux de Paris)
Hospitals, University of Paris XII, France.
agnes.glacet@chicreteil.fr
BACKGROUND: Hemorheologic abnormalities have recently been
shown to play a role in the pathogenesis of retinal vein
occlusion (RVO), and several studies have demonstrated the
efficacy of isovolemic hemodilution in these eyes. This
study was designed to investigate further the effects of
hemodilution, with regard to the duration of symptoms before
the treatment. METHODS: In a prospective study, 142 eyes
with central or hemicentral RVO were treated by isovolemic
hemodilution. The target hematocrit value was 35%. Mean
duration of follow-up was 10 months. A subgroup of 50
patients treated within 2 weeks of the onset of symptoms was
compared first with patients treated later by hemodilution,
and then retrospectively with controls with central RVO and
without hemodilution. RESULTS: Hemodilution therapy resulted
in a decrease in hematocrit level from 42% to 32% on
average, with no major side effect. After treatment, a
significant decrease was observed in hemorheologic
parameters (fibrinogen, erythrocyte aggregation), except in
plasma viscosity. Retinal circulation times were
significantly shortened. Visual acuity (VA) improvement
immediately after treatment (in 43% of eyes) was correlated
with better final visual outcome (P<0.05). At the end of follow-
up, VA was better in patients treated within the first 2
weeks than in those treated later and in controls (41% had
VA of 20/40 or more in the early-treatment group versus 23%
in the late-treatment group, P<0.01). Final retinal ischemia
was also greater in the late-treatment group and in
controls. Hemodilution in 12 patients with long-standing RVO
and macular edema was ineffective. CONCLUSION: Our study is
consistent with previous investigations that confirmed the
efficacy of isovolemic hemodilution in RVO on hemorheologic
parameters, retinal circulation times and final VA. It also
underlined strongly the benefit of early treatment within
the first 2 weeks of the RVO. Further studies are required
to confirm these results.
PMID: 11820695 [PubMed - indexed for MEDLINE]
------------------------------------------------------------
--------------
------
Who loves ya. Tom
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com (http://jesuswasavegetarian.7h.com/)
Man Is A Herbivore!
http://pages.ivillage.com/ironjustice/manisaherbivore DEAD
PEOPLE WALKING
http://pages.ivillage.com/ironjustice/deadpeoplewalking
for iron reduction therapy and with studies showing
regression of vision loss one might / could ? .. expect this
treatment to become .. standard of care?
With a little bit of .. pressure .. it could .. ?
------------------------------------------------------------
--------------
----------
The “accelerated approval” program. In this scenario,
the treatment gets approval on the basis of “surrogate
markers,” such as regression of a tumor, rather than
demonstrated clinical benefit, such as increased survival.
Treatments can go into a “priority review” if a
treatment would be a significant improvement over drugs
already on the market. And they can “fast track” a
treatment by submitting data on a rolling timetable, as the
research marches along, not just at the end of the process.
------------------------------------------------------------
--------------
-------------------------------------
-----------------------------------------
The article states that among type II insulin-resistant
diabetic patients, 40% have elevated ferritin and should be
considered for phlebotomy therapy.
------------------------------------------------------------
--------------
------------------------------------------
Diabetes Metab 2002 Sep;28(4 Pt 1):335-9
[Do the insulin resistance associated hepatic iron overload
must be researched during diabetes mellitus type II?]
[Article in French]
Roblin X, Chevassus P, Boudemaghe T, Palayodan A Departement
de Medecine Interne et Hepato-gastro-enterologie, Centre
hospitalier de Gap, 05007 Gap Cedex.
[Medline record in process]
The insulin resistance-associated hepatic iron overload is
the first aetiology of iron overload disorders in France. If
we do not know its mechanism, the prevalence among type II
diabetic patients is around 40%. Hyperferritinaemia is
present in all cases, but is not specific of the diagnosis.
This pathology features liver fibrosis among 10% of the
patients and some cases of primary liver cancer have been
described. Moreover, a large body of evidence favors the
direct involvement of iron in the development of extra
hepatic neoplasia, while therapeutic phlebotomy to maintain
low to normal body iron stores can prevent all known
complications of insulin resistance-associated hepatic iron
overload. In addition, treatment of type II diabetes
mellitus and other features of insulin resistance syndrome
is essential. In conclusion, it is important to detect this
syndrome during type II diabetes mellitus.
PMID: 12442073, UI: 22328961
http://www.biospace.com/news_story.cfm?StoryID=16417520&ful-
l=1
These data suggest the key to minimizing vision loss is
earlier detection through increased screenings and
treatments that inhibit progression of diabetic macular
edema toward the center of the macula.
------------------------------------------------------------
--------------
---------------------------
Graefes Arch Clin Exp Ophthalmol. 2001 Dec;239(12):909-14.
Related Articles, Links
Effect of isovolemic hemodilution in central retinal vein
occlusion.
Glacet-Bernard A, Zourdani A, Milhoub M, Maraqua N, Coscas
G, Soubrane G.
University Eye Clinic of Creteil, Intercommunal and Henri
Mondor (Assistance Publique des Hjpitaux de Paris)
Hospitals, University of Paris XII, France.
agnes.glacet@chicreteil.fr
BACKGROUND: Hemorheologic abnormalities have recently been
shown to play a role in the pathogenesis of retinal vein
occlusion (RVO), and several studies have demonstrated the
efficacy of isovolemic hemodilution in these eyes. This
study was designed to investigate further the effects of
hemodilution, with regard to the duration of symptoms before
the treatment. METHODS: In a prospective study, 142 eyes
with central or hemicentral RVO were treated by isovolemic
hemodilution. The target hematocrit value was 35%. Mean
duration of follow-up was 10 months. A subgroup of 50
patients treated within 2 weeks of the onset of symptoms was
compared first with patients treated later by hemodilution,
and then retrospectively with controls with central RVO and
without hemodilution. RESULTS: Hemodilution therapy resulted
in a decrease in hematocrit level from 42% to 32% on
average, with no major side effect. After treatment, a
significant decrease was observed in hemorheologic
parameters (fibrinogen, erythrocyte aggregation), except in
plasma viscosity. Retinal circulation times were
significantly shortened. Visual acuity (VA) improvement
immediately after treatment (in 43% of eyes) was correlated
with better final visual outcome (P<0.05). At the end of follow-
up, VA was better in patients treated within the first 2
weeks than in those treated later and in controls (41% had
VA of 20/40 or more in the early-treatment group versus 23%
in the late-treatment group, P<0.01). Final retinal ischemia
was also greater in the late-treatment group and in
controls. Hemodilution in 12 patients with long-standing RVO
and macular edema was ineffective. CONCLUSION: Our study is
consistent with previous investigations that confirmed the
efficacy of isovolemic hemodilution in RVO on hemorheologic
parameters, retinal circulation times and final VA. It also
underlined strongly the benefit of early treatment within
the first 2 weeks of the RVO. Further studies are required
to confirm these results.
PMID: 11820695 [PubMed - indexed for MEDLINE]
------------------------------------------------------------
--------------
------
Who loves ya. Tom
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com (http://jesuswasavegetarian.7h.com/)
Man Is A Herbivore!
http://pages.ivillage.com/ironjustice/manisaherbivore DEAD
PEOPLE WALKING
http://pages.ivillage.com/ironjustice/deadpeoplewalking
