Depressive mood and tobacco use: moderating effects of gender and emotional attention.

INTRODUCTION: Depressive symptomatology is a predictive variable of tobacco use. The objective of the present study was to evaluate the influence that this symptomatology has on tobacco use when moderated by emotional attention. METHODS: A total of 289 participants (127 males, 162 females) completed a survey to measure perceived emotional intelligence, depressive symptomatology, tobacco use and sociodemographic variables. Results were analyzed using a multiple regression model that included self-perceived emotional attention as a moderating variable. RESULTS: In women, an interaction was found between depressive symptomatology and gender for predicting the number of cigarettes smoked (t=2.45; p=.01), but not in men (t=-.74; p=.45). This interaction was moderated by emotional attention (t=2.83; p=.005), such that women with medium and high levels of attention consumed a larger number of cigarettes. CONCLUSIONS: In women, the effect of depressive symptomatology on tobacco use was moderated by the amount of attention that women paid to those symptoms. Such a moderating effect of attention was not observed in men. We recommend that smoking cessation programs incorporate interventions designed specifically for women, in particular to help them manage depressive symptomatology.

[Clinical personality trait differences in the maintenance of abstinence and in relapses in the treatment of smoking cessation]. / Diferencias de rasgos clínicos de personalidad en el mantenimiento de la abstinencia y recaídas en tratamiento del tabaquismo.

Clinical personality trait differences in the maintenance of abstinence and in relapses in the treatment of smoking cessation. The aim of this study is to describe and compare personality characteristics of participants who quit smoking voluntarily by means of group treatment. The assessment instrument used was the Millon Clinical Multiaxial Inventory (MCMI). It was administered to a sample of 105 persons in Málaga (Spain) in The Spanish Cancer Association (Asociación Española Contra el Cáncer). The analysis consisted of comparing two sample groups: abstinence and relapse. The results revealed a higher rate of avoidant, masochistic and negativistic clinical personality traits in the relapse group. However, people with dependent personality traits maintained abstinence. There were also differences, in the direction of more relapses, in schizotypal and borderline personality disorders. This suggests that certain personality traits could be risk factors for relapse, whereas others increase the probability of success in the process of smoking cessation.

A single-nucleotide polymorphism in the aromatase gene is associated with the efficacy of the aromatase inhibitor letrozole in advanced breast carcinoma.

PURPOSE: To evaluate the efficacy of treatment with the aromatase inhibitor letrozole in breast cancer patients segregated with respect to DNA polymorphisms of the aromatase gene CYP19. PATIENTS AND METHODS: Postmenopausal patients (n = 67) with hormone receptor-positive metastatic breast cancer were treated with the aromatase inhibitor letrozole. PCR allelic discrimination was used to examine three single-nucleotide polymorphisms (SNP) in DNA obtained from breast carcinoma tissue. Two SNPs analyzed (rs10046 and rs4646) were located in the 3' untranslated region and one (rs727479) was in the intron of the aromatase CYP19 gene. The primary end point of treatment efficacy was time to progression (TTP). RESULTS: Median age was 62 years and median number of metastatic sites was 2. Observed allelic SNP frequencies were rs10046, 71%; rs4646, 46%; and rs727479, 63%. Of the 67 patients, 65 were evaluable for efficacy. Median TTP was 12.1 months. We observed no relationship between TTP and the rs10046 or rs727479 variants. In contrast, we found that TTP was significantly improved in patients with the rs4646 variant, compared with the wild-type gene (17.2 versus 6.4 months; P = 0.02). CONCLUSION: In patients with hormone receptor-positive metastatic breast cancer treated with the aromatase inhibitor letrozole, the presence of a SNP in the 3' untranslated region of the CYP19 aromatase gene is associated with improved treatment efficacy. Testing for the CYP19 rs4646 SNP as a predictive tool for breast cancer patients on antiaromatase therapy deserves prospective evaluation.

Biweekly docetaxel and vinorelbine as first-line chemotherapy in metastatic breast cancer.

This study was designed to evaluate the antitumor activity and tolerance of biweekly docetaxel plus vinorelbine as first-line chemotherapy in patients with metastatic breast cancer (MBC). Forty-one patients with measurable disease and no prior chemotherapy for MBC were treated with docetaxel 60 mg/m(2) plus vinorelbine 30 mg/m(2) on day 1, every 2 weeks for a maximum of 12 courses. Median age was 58 years (range, 23-75). Fourteen patients (34.1%) were premenopausal and 27 (65.9%) were postmenopausal. Most patients had received prior neoadjuvant/adjuvant chemotherapy (n = 27, 65.9%), radiation therapy (n = 22, 53.6%), and hormone therapy (n = 21, 51.2%). The most frequent sites of metastasis were bone (n = 18, 43.9%), pleuropulmonary (n = 16, 39%), and liver (n = 14, 34.1%). Twenty-seven patients (65.9%) had more than one site of metastasis. Three hundred and thirty-nine courses were given (median, 8 courses per patient; range, 1-12). Median relative dose intensity was 85% for both docetaxel and vinorelbine. Grade 3/4 toxicities included neutropenia (14 patients, 34.1%), febrile neutropenia (n = 14, 34.1%), and stomatitis (n = 4, 9.8%). No treatment-related deaths were reported. All patients were assessed for response in an intent-to-treat analysis. Four patients (9.8%) had a complete response and 19 (46.3%) had a partial response (overall response rate, 56.1%; 95% CI, 42%-70%). Six patients (14.6%) had stable disease and 12 patients (29.3%) had progressive disease. With a median follow-up of 15.1 months or until death, median duration of response is 12.6 months. Median time to progression is 12.4 months. Median survival time is 19.6 months. This biweekly combination of docetaxel plus vinorelbine is feasible and active as first-line chemotherapy in patients with MBC. This regimen is safe and well tolerated.

Relation between alcohol consumption and the success of Helicobacter pylori eradication therapy using omeprazole, clarithromycin and amoxicillin for 1 week.

OBJECTIVE: To study the relationship between daily alcohol consumption and the result of eradication therapy for Helicobacter pylori using omeprazole, clarithromycin and amoxicillin for 1 week. DESIGN: Clinical trial. SETTING: Urban health centre, general medicine section. PARTICIPANTS: One hundred and fifty-six patients with a diagnosis of peptic ulcus or chronic gastritis. Helicobacter pylori infection was confirmed by the urease test, the 14C-urea breath test, IgG serology or biopsy. INTERVENTIONS: A combination of omeprazole, 20 mg twice daily, clarithromycin, 500 mg twice daily, and amoxicillin, 1000 mg twice daily was administered for 1 week. No other drugs were given. Four to 8 weeks later a 14C-urea breath test was carried out to confirm eradication. MAIN OUTCOME MEASURES: Logistic regression was used to assess the relationship between eradication and daily alcohol consumption (main covariable), age, sex, smoking, length of illness, pathology studied (ulcus or gastritis) and therapeutic compliance. RESULTS: Eradication (intention to treat analysis) was successful in 118 patients (75.6%; 95% CI, 68.9-82.4). The only variable significantly associated with the result of the therapy was daily alcohol consumption, with a higher probability of failure in non-consumers (29.9%) than in consumers (12.2%), adjusted OR 3.24 (95% CI, 1.12-9.20; P = 0.03). Eradication was dose dependent: 70.1% in abstemious patients (n = 107), rising to 79.3% in users of 4-16 g of pure ethanol a day (n = 29) and to 100% in users of 18-60 g daily (n = 20) with a P value of 0.005 for the trend. CONCLUSIONS: Daily alcohol consumption appears to have an additive effect in this eradication therapy.