ABSTRACT
Recent pre-clinical evidence suggests that the active metabolite of tamoxifen, endoxifen, is a substrate for efflux pump P-glycoprotein. The aim of our study was to evaluate, if the polymoprhisms within ABCB1 gene alter tamoxifen adjuvant treatment efficacy in premenopausal women. Totally 71 premenopausal women with estrogen receptor positive breast cancer indicated for tamoxifen adjuvant treatment were followed retrospectively for median period of 56 months. The gentic polymorphisms of CYP2D6 and ABCB1 were analyzed and potential covariates as tumor grading, staging, age at the diagnosis, comedication, quantitative positivity of ER or PR were also evaluated. Cox proportional-hazards regression model indicated that patients carrying at least one variant allele in ABCB1 rs1045642 had significantly longer time to event survival compared to wild type subjects. Non-significant trend was noted for better treatment outcome of patients carrying at least one variant allele in the SNP rs2032582, while for the CYP2D6 polymorphism poor metabolizer phenotype resulted in worse outcome in comparison to extensive metabolizers subjects with HR of 4.04 (95 % CI 0.31-52.19). Similarly, patients using CYP2D6 inhibitors had non-significantly shorter time-to-event as compared to never users resulting in hazard ratio of 2.06 (95 % CI 0.40-10.63). ABCB1 polymorphisms may affect outcome of tamoxifen adjuvant treatment in premenopausal breast cancer patiens. This factor should be taken into account in addition to the CYP2D6 polymorphism or phenotypic inhibition of CYP2D6 activity.
Subject(s)
Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Cytochrome P-450 CYP2D6/genetics , Premenopause/genetics , Tamoxifen/administration & dosage , ATP Binding Cassette Transporter, Subfamily B/genetics , Adult , Antineoplastic Agents, Hormonal/administration & dosage , Chemotherapy, Adjuvant , Female , Genotype , Humans , Middle Aged , Premenopause/drug effects , Treatment OutcomeABSTRACT
OBJECTIVE: Comparison of two methods of so-called rapid assessment of Chlamydia trachomatis in the urogenital system, i.e. the hybridization method GEN-Probe PACE 2 and the amplification LCR (ligase chain reaction) method. In 1995-1996 the authors made a screening examination to detect Chlamydiae in the urogenital tract by means of the hybridization method GEN-Probe PACE 2 and the amplification LCR method in selected groups of patients of the Second Gynaecological and Obstetric Clinic, First Faculty Hospital, Prague. The methods were evaluated as to their sensitivity. The examinations of the samples were made in the serological laboratory of the First Dermatological Clinic of the First Faculty Hospital Charles University, Prague. The amplification method is twice as sensitive as the hybridization method.
Subject(s)
Cervix Uteri/microbiology , Chlamydia trachomatis/isolation & purification , In Situ Hybridization, Fluorescence , Nucleic Acid Amplification Techniques , Adult , Chlamydia Infections/diagnosis , Chlamydia trachomatis/genetics , DNA Ligases , Female , Humans , Polymerase Chain Reaction , Pregnancy , Pregnancy Complications, Infectious/diagnosis , RNA, Ribosomal/analysis , Sensitivity and SpecificityABSTRACT
Vaginal swabs taken from 2,096 promiscuous women were examined microscopically and more swabs from 1,813 women were cultivated. The women examined were divided into 4 different age groups (15-20 years, 21-25 years, 26-30 years and over 30 years). The occurrence of trichomonadosis was diminishing with the age: 65.0%--51.2%--47.7%--41.8%. The occurrence of gonorrhoea was bit lower among the youngest women (25.9%) than among the older ones, the lowest occurrence being among the group of over 30 years (12.7%). The high occurrence of the mentioned infections underlines the risk of infection during sexual intercourse with promiscuous women.
Subject(s)
Sexual Behavior , Trichomonas Vaginitis/epidemiology , Adolescent , Adult , Age Factors , Czechoslovakia , Female , Gonorrhea/complications , Gonorrhea/epidemiology , Humans , Trichomonas Vaginitis/complications , Trichomonas Vaginitis/parasitology , Trichomonas vaginalis/isolation & purification , Vagina/parasitology , Vaginal SmearsABSTRACT
Over the past 25 years a total of 7492 strains of Neisseria gonorrhoeae have been isolated in Czechoslovakia, mainly in Prague (64%). All these strains have been tested for susceptibility to the following antibiotics: penicillin G, ampicillin, tetracycline, spectinomycin, erythromycin, doxycycline, kanamycin, rifampin, chloramphenicol, gentamicin, cephalothin, cephaloridine, lincomycin and clindamycin. In addition, seven derivatives of newer antibiotics of penicillin and cephalosporin series were tested in 1981. The study showed that in 1957 the MIC of 0.03 units of penicillin per ml was effective against 95% of strains, but in 1981 only 37% of isolates were sensitive to this concentration. The first gonococcal strains with the MIC value of 4.0 units/ml to penicillin were detected in 1981. This tendency towards decreased gonococcal susceptibility to benzylpenicillin is alarming. Over the last eight years there have been described sporadic isolations of strains relatively resistant to tetracycline (MIC = 8.0 mg/l). The susceptibility to spectinomycin has been tested in over 4000 gonococcal strains, since 1967. The test showed that this antibiotic remained highly effective against the gonococcal infection with over 95% of gonococci with the MIC value of 16.0 mg/l. No fully spectinomycin resistant strains have been found. Penicillin G as well as spectinomycin and cefotaxim are still considered the antibiotics of the first choice in the treatment of gonorrhoea. The alternative antibiotics may include cefuroxim, chloramphenicol and, in cases of sensitive strains, tetracyclines.
