Prediction of long-term outcome for heroin addicts admitted to a methadone maintenance program

Ten pre-treatment and nine during-treatment variables were correlated to outcome 5 years after admission to a methadone program for 171 subjects who were in treatment for at least 6 months. The pre-treatment variables were employment, education, criminal involvement, opiate and non-opiate drug abuse, periods of abstinence, age, sex, and ethnic group. During-treatment variables were employment, arrests or incarcerations, opiate and nonopiate drug abuse, living with an addict, marital status, and months of methadone treatment. Three measures of ‘successful’ outcome were defined. In general, subjects with more involvement with criminal justice before treatment, heavy alcohol use before or during treatment, continued daily heroin use or living with an addict during treatment, or minority ethnicity were more likely to have a poor outcome. However, the correlation coefficients for even the most significant correlations were weak; the highest was r = 0.26. We conclude that none of these 19 variables provide a basis for a priori judgment about whether or not a patient applying for admission to a methadone program is likely to have a favorable long-term outcome.     

Levo-alpha-acetylmethadol (LAAM) in the treatment of heroin addicts. I. Dosage schedule for induction and stabilization

One hundred and seventy-nine patients who were dependent on street narcotics were inducted into LAAM. Ninety-two were inducted using a slow schedule: 20, 20, 30, 30, 40, 40, 50, 50, 60, 60, 70, 70, 75 mg on successive clinic visits (Mon., Wed., Fri.). Only 23% of the patients followed this schedule to 50 mg; 55% requested and received a faster induction. Eighty-seven patients were inducted using a rapid schedule: 20, 30, 40, 40, 50 mg. This schedule was acceptable to the majority of patients and caused no complaints of overdosing. We suggest that this schedule be used in clinics where patients who have been shown to be dependent are inducted directly onto LAAM.     

Sexually transmitted viral hepatitis and enteric pathogens

Hepatitis viruses, enteric pathogens, and anorectal infections may commonly be transmitted by various sexual practices. Because of their larger numbers of sexual partners and sexual practices such as anilingus and anal intercourse, homosexual men are at particularly high risk of acquiring hepatitis B, giardiasis, amebiasis, shigellosis, campylobacteriosis, and anorectal infections with Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, herpes simplex virus, and human papilloma viruses. The evidence for sexual transmission of these infections as well as their diagnosis and treatment are discussed.     

Palatal insufficiency: a surgical technique for reconstruction

Nasal regurgitation and hypernasality are the major complications after extirpation of the soft palate, retromolar trigone, and tonsillar areas. The surgical procedure described herein provides satisfactory correction of the defect. The combined approach of advancement-rotation palatoplasty and an advanced lateral pharyngeal wall flap appears to be an alternative solution to the use of an obturator or inferiorly based pharyngeal flap.     

The Ina and Inb blood group antigens are located on a glycoprotein of 80,000 MW (the CDw44 glycoprotein) whose expression is influenced by the In(Lu) gene.

The Ina and Inb blood group antigens were found to be located on an erythrocyte membrane glycoprotein of 80,000 MW by immunoblotting with human anti-Ina and anti-Inb antibodies under non-reducing conditions. This glycoprotein is shown here to be identical to that defined by monoclonal antibodies to CDw44, and a new murine monoclonal antibody (BRIC 35) is added to this cluster. Experiments with endo-beta-galactosidase and Endo F preparations suggest that the glycoprotein contains one or more N-glycans but that these oligosaccharides do not contain extensive poly-N-acetyllactosaminyl sequences. Experiments using membranes prepared from sialidase-treated normal erythrocytes, from Tn erythrocytes and from Cad erythrocytes suggest that the glycoprotein does not contain a substantial content of O-glycans. The Inb antigen and the epitope defined by a murine monoclonal antibody (BRIC 35) show reduced expression on Lu(a-b-) erythrocytes which result from the effect of the dominant inhibitor gene In(Lu). Evidence is presented here that the Inb antigen is expressed on normal granulocytes and lymphocytes and on the haemopoietic cell lines HEL, K562 and HL-60, a lymphoblastoid cell line and lymphocytes from two patients with B-CLL.