Adherence to the infant vitamin D supplementation policy in Ireland.

PURPOSE: From September 2010 until November 2019, Ireland's infant vitamin D supplementation policy recommended administration of 5 µg/day of vitamin D3 from birth to 12 months to all infants, regardless of feeding method. This study aims to examine policy adherence. METHODS: In the prospective COMBINE birth cohort study (recruited 2015-2017), detailed longitudinal supplement data were examined in 364 infants across the first year of life, according to product type, dose, frequency, and duration. Vitamin D supplement use at 2, 6, and 12 months in COMBINE was compared with the BASELINE cohort (recruited 2008-2011, n = 1949). RESULTS: In COMBINE, 92% of infants initiated supplementation at birth. The median supplementation duration was 51 (40, 52) weeks, with a range of 3-52 weeks. While supplementing, most parents (92%) used an exclusive vitamin D supplement as recommended and 88% gave 5 µg/day. Half (51%) gave vitamin D daily and a further 33% supplemented at least 3-6 times/week. Overall, 30% adhered fully to the policy, providing 5 µg vitamin D3 daily from birth to 12 months. A further 16% were broadly compliant, giving 5 µg frequently for the full 12 months. Vitamin D supplement use at 2, 6, and 12 months in COMBINE was 93%, 89%, and 72%, considerably higher than our earlier BASELINE cohort at 49%, 64%, and 44% at the same time points (all P < 0.001). CONCLUSIONS: We report a high level of vitamin D supplementation initiation at birth, with full to broad policy adherence among more than half of infants. There is scope to improve overall compliance by focusing on supplementation frequency.

Antibody-guided irradiation of hepatic metastases using intrahepatically administered radiolabelled anti-CEA antibodies with simultaneous and reversible hepatic blood flow stasis using biodegradable starch microspheres.

Two monoclonal antibodies to carcinoembryonic antigen (CEA) were radiolabelled with 131I and used for the treatment of hepatic metastases in a patient who had a primary colonic carcinoma. Approximately 100 mCi of 131I-labelled antibody were administered via the hepatic artery on two occasions. On the second occasion, radiolabelled antibody was given concurrently with biodegradable starch microspheres in an attempt to enhance tumour uptake of antibody by achieving temporary stasis or delay of hepatic blood flow. The procedure was carried out uneventfully. There was clinical improvement and a fall in circulating CEA levels after each course of treatment. Furthermore, after the second course of therapy the clinical improvement was sustained for a longer period (more than 3 months) and there was evidence of diminution in the size of some of the liver metastases. Regional administration of 131I-labelled anti-CEA antibody concurrently with biodegradable starch microspheres appears to be a promising new method for the treatment of hepatic metastases from colonic carcinoma.

Massive retroperitoneal lymphadenopathy as a terminal event in hairy cell leukaemia.

A case of hairy cell leukaemia complicated as a terminal event by massive retroperitoneal lymphadenopathy is described. The patient had recently been treated with lithium carbonate and had previously been demonstrated to suffer from a systemic vasculitis, either or both of which may have contributed to the development of this rare complication.