Rapid admission and retention on methadone

An open clinical trial was conducted to compare the effects of rapid (1-day) admission with slow (14-day) admission to methadone maintenance on pretreatment attrition, retention during treatment, and other outcomes. One hundred eighty-six illicit opioid users eligible for methadone maintenance were randomly assigned to rapid admission or slow admission, with 93 subjects assigned to each group. The random assignment produced two groups that were similar on 22 personal variables. All subjects admitted to treatment were followed for 1 year. Follow-up interviews were obtained with 155 (98%) of the 158 subjects admitted to treatment. During the period from initial contact to medication, only 4% of the rapid admission subjects but 26% of the slow admission subjects dropped out. The risk of dropout during slow admission was 6 times that during rapid admission. A higher percentage of rapid admission subjects, 43%, than of slow admission subjects, 39%, remained continuously in treatment for 1 year, but the difference was not significant. The two subgroups that remained in treatment for 1 year did about equally well on measures of illicit drug use and social performance. The findings indicate that pretreatment attrition can be markedly reduced by prompt medication, and the prompt medication does not adversely affect retention during treatment or other outcomes.     

Neonatal screening for cystic fibrosis: result of a pilot study using both immunoreactive trypsinogen and cystic fibrosis gene mutation analyses

We have evaluated a two-tier neonatal cystic fibrosis (CF) screening of immunoreactive trypsinogen (IRT) followed by CFTR gene mutation analysis using a systematic scanning of exons 7, 10, and 11, and, if necessary, by direct DNA sequencing. Over an 18-month period we screened 32,300 neonates born in the western part of Britanny. The first tier, involving IRT screening at 3 days of age, utilizes a low elevation of the trypsinogen level (600 ng/ml), which is highly sensitive. The second tier, which corresponds to the exhaustive screening for mutations in three exons of the gene, is highly specific for this population (Britanny). The false positive rate is very low, and no false negatives have been reported to date. This strategy has allowed the identification of five novel alleles (V322A, V317A, 1806 del A, R553G, G544S).     

Study on feeding of infants

OBJECTIVE: To evaluate feeding behaviour in infants, with regard to the duration of breast-feeding (BF), the beginning of artificial feeding (AF) and the introduction of complementary feeding (CF). DESIGN: Medical audit. Retrospective study. SETTING: Primary Care paediatrics. PARTICIPANTS: The 327 children born in 1994 and monitored by paediatricians from 4 Health Centres in Salamanca. MEASUREMENTS AND MAIN RESULTS: The mean duration of BF for the 327 children was 3.61 months, with 92.3% starting BF and 52.3% still doing it at 3 months. 30% began AF at birth; 33% between birth and 3 months; 29.6% between the third and sixth months; and 7.4% after 6 months. CF was started as follows: only 2.1% before 4 months; 92% had gluten introduced after 8 months, but only 1.2% before 6 months. 96.3% started on cow's milk after one year. CONCLUSIONS: Over 50% of children fed on breast milk for at least 3 months. Only 1.2% had gluten introduced before 6 months. 3.7% started on cow's milk before 12 months. 30% of children began AF at birth.