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Old drug saves lives. Hydroxyurea, a drug first synthesized in 1869, has been found to extend the lives of people afflicted with sickle-cell anemia. Hydroxyurea has been used in recent years to treat cancer and AIDS, but a 1995 study funded by the National Heart, Lung, and Blood Institute determined that it effectively reduced severe pain crises and pneumonia-like illness in patients with sickle-cell anemia — resulting in FDA approval for its use. A follow-up study, recently concluded by Martin H. Steinberg, a professor at the School of Medicine and director of the school’s Center of Excellence in Sickle-Cell Disease, found a 40 percent drop in mortality rates for patients who took the drug over a nine-year period.

Sickle-cell anemia affects nearly 72,000 Americans, most of them African-American or Hispanic. Nearly two million Americans carry the gene for sickle-cell disease — a gene that controls one of the components of hemoglobin, the protein that carries oxygen in the blood. The abnormal hemoglobin characteristic of the disease tends to clump within the red blood cells, distorting them into characteristic sickle shapes, which often get stuck in small blood vessels, causing oxygen starvation in tissues and organs and excruciating pain.

Hydroxyurea stimulates the body to make “fetal hemoglobin,” a form of the protein that is resistant to clumping, but that generally disappears from the bloodstream soon after birth. Patients in the study who took hydroxyurea had fewer episodes of severe pain and chest congestion, and large amounts of fetal hemoglobin in their blood.

Although hydroxyurea is easily obtained and relatively inexpensive (about 0 per month), it takes time and patience for doctors to determine the correct dosage. Some patients resist taking the drug because they are concerned about potential side effects — including birth defects, leukemia, and a drop in the number of white blood cells. These fears, according to Steinberg, are based largely on the high doses of the medication that are used in chemotherapy. The current study found no unusual rate of cancer associated with the drug.

This research appeared in the April 2, 2003, issue of the Journal of the American Medical Association (JAMA). The same issue carried an editorial arguing that the next big challenge is to assure that all who would benefit from hydroxyurea are able to get it.


Healing alternatives. According to a new study by Zlatka Russinova, a Sargent College research assistant professor, and colleagues at the school’s Center for Psychiatric Rehabilitation (CPR), many people with serious mental illness use meditation, yoga, prayer, and other nontraditional health practices to further their recovery.

Part of a larger national study, the SAR study surveyed 157 people with a variety of diagnoses. Most reported using two or more alternative health practices. Half reported religious and spiritual practices — prayer, worship attendance, and religious or spiritual reading. Other common practices included meditation (43 percent), massage (31 percent), and yoga (20 percent), as well as herbs, chiropractic, nutritional supplements, and guided imagery.

Participants used these practices to increase emotional calmness and stability, find inner strength and meaning in life, improve self-awareness and self-esteem, increase their sense of well-being, and improve their physical health as well as cognitive, social, and overall functioning.|

“ Our expanding knowledge about the healing potential of these practices,” says Russinova, “opens new avenues to support recovery from mental illness.” The researchers found a relationship between diagnosis and the type of alternative healing practice employed, according to Nancy Wewiorski, a research specialist at CPR and codirector of the study. People diagnosed with depression or bipolar illness, for example, tended to use meditation and guided imagery more frequently than those with a diagnosis of schizophrenia spectrum disorder.

The SAR study was funded by the National Institute of Disability and Rehabilitation Research and the Center for Mental Health Services and was published in the October 2002 issue of the American Journal of Public Health.

"Research Briefs" is written by Joan Schwartz in the Office of the Provost. To read more about BU research, visit http://www.bu.edu/research.

       

15 May 2003
Boston University
Office of University Relations