Improving Uptake of Hydroxyurea in Patients with Sickle Cell Disease: A Retrospective Study of a Clinic-based Change in Consenting Practices.

INTRODUCTION: Sickle cell disease (SCD) can shorten lives and may result in severe clinical complications. Hydroxyurea (HU) is inexpensive, widely available, and National Institutes of Health (NIH) recommends HU for SCD. Despite these benefits, utilization of HU is low. Barriers to taking HU include inaccurate perceptions of serious side effects such as hair loss, a significant barrier in the African American community. However, at doses for treating SCD, the incidence of side effects is extremely low. Using a retrospective medical record review, the impact of a revised consent procedure for HU that addressed these barriers was evaluated. METHODS: SCD patients 2-20yo eligible for HU were examined. Patients prescribed HU versus those not prescribed HU were compared one year before and one year after revising consent procedures. RESULTS: Change in clinic practice (including revised consent procedures) resulted in 158% more patients agreeing to HU therapy (p<.001). DISCUSSION: The revised consent procedures are not resource intensive and easy to implement. Future research should address treatment acceptability, intimidation, and cultural sensitivity.

Experimental determination and allometric prediction of vitreous volume, and retina and lens weights in Göttingen minipigs.

OBJECTIVES: To determine the vitreous volume, and retinal and lens wet weights in male and female Göttingen minipigs of different age groups. PROCEDURES: Vitreous, lens and retina were isolated from fresh minipig eyes. Vitreous volume, lens and retina weight were measured and allometric scaling was utilized to predict these parameters. RESULTS: There were no gender differences in body weights or retina and lens weights in the three age groups examined in this study. For vitreous volumes, females had a significantly larger volume (approximately 10%-12%) than males in the 4-6 and 6-8 month, but not in the 8-11-month group. The mean body weight increased from 12.2 +/- 2.6 kg (4-6 months) to 19.4 +/- 4.0 kg (8-11 months). In the same period, the mean vitreous volume increased from 2.00 +/- 0.28 to 2.67 +/- 0.31 mL, while the mean retinal and lens weights increased from 114 +/- 22 to 126 +/- 17 mg, and from 298 +/- 26 to 392 +/- 15 mg, respectively. Allometric analysis between six species for vitreous volume and four species for lens weight covering a weight range of 260-fold was not able to estimate the vitreous volume, but it did predict the lens weight in 8-11 months minipigs. CONCLUSIONS: Overall these measurements add important context to intraocular pharmacology studies, and will help in the improved design and interpretation of such experiments.