Weekly docetaxel (Taxotere) in patients with metastatic breast cancer.

BACKGROUND: Docetaxel (Taxotere) has demonstrated high antitumour activity in first- and second-line treatment of metastatic breast cancer. This study analysed the efficacy and toxicity of docetaxel given weekly. PATIENTS AND METHODS: Thirty-five patients with metastatic breast cancer received docetaxel, 35 mg/m2 weekly for six weeks, followed by two weeks without treatment. Additional cycles (three weeks' treatment, two weeks' rest) were given until disease progression. All patients had received prior chemotherapy: 32 and 5 patients had received prior anthracycline-containing and taxane-containing regimens, respectively. Docetaxel was administered for a total of 359 doses (median 9. range 6-22). RESULTS: There was one complete response (3%), 11 partial responses (31%), 17 patients with stable disease (49%) and six with disease progression (17%). Overall response rate was 34% (95% confidential interval (95% CI): 18%-51). Median survival was 307 days; median progression-free survival was 2.6 months (range 1.5 to > or = 5.5 months). Three patients showed grade 3 neutropenia. 14 showed grade 3 alopecia, and various grade 1-2 non-haematological toxicities were observed. Treatment was delayed in two patients due to haematotoxicity. and stopped in one patient due to painful nail toxicity. CONCLUSION: Weekly administration of docetaxel at a dose of 35 mg/m2 is effective and of low toxicity in patients with metastatic breast cancer.

[A double-blind comparative study of the effectiveness and tolerance of paroxetine and amitriptyline in treatment of breast cancer patients with clinically assessed depression]. / Eine doppelblinde Vergleichsstudie zur Wirksamkeit und Verträglichkeit von Paroxetin und Amitriptylin bei der Behandlung von Brustkrebs-Patientinnen mit klinisch nachgewiesener Depression.

OBJECTIVE: In this double-blind, non-placebo controlled study [corrected], 179 patients with treated breast cancer who fulfilled the ICD-10 criteria for an acute depressive episode underwent an 8-week course of antidepressant treatment with either the tricyclic amitriptyline (75-150 mg, n = 87) or the serotonin-reuptake inhibitor paroxetine (20-40 mg, n = 88). METHODS: The change in clinical status relative to baseline was measured with the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impression (CGI), the Functional Living Index-Cancer (FLIC) and the Patient Global Evaluation. RESULTS: Both treatment groups showed significant improvement in all parameters at weeks 3, 5 and 8. At no time was there a significant difference in the efficacy of the antidepressants used. Adverse events, most of which were transitory, were reported by 53% of the patients in the paroxetine group and 60% in the amitriptyline group. The 8-week treatment was completed by 81% of the paroxetine and 76% of the amitriptyline patients. CONCLUSIONS: The results of this study show that depression in breast-cancer patients can be correctly diagnosed and adequately treated by non-psychiatrists. The treatment with both medications was carried out in dose ranges which correspond to that employed in physically well patients.

[Problem infections of the external genital area in the female]. / Probleminfektionen des äusseren Genitalbereiches der Frau.

On account of difficult diagnostic procedures and often atypical clinical pictures, the following diseases must be regarded as problematic infections: infections with chlamydia, mycoplasma, urea-plasma, and herpes virus, as well as unspecific infections with aerobic and anaerobic bacteria. Since vulvitis and vaginitis are frequently associated with vaginal discharge, they may present a problem to dermatologists and gynecologists.

Ofloxacin versus doxycycline in gynecological infections.

40 patients were investigated with either ofloxacin (2 X 20 mg/7d) or doxycycline (2 X 100 mg/7d). E. coli (28 from 61 strains) was the predominant strain isolated. Microbiological efficacy: 51 from 61 strains were eliminated: 29 from 32 strains in the ofloxacin group and 22 from 29 strains in the doxycycline group. Two patients in the ofloxacin and four in the doxycycline group were not cured. There were two side effects (sickness) in the doxycycline and two in the ofloxacin group.

Pharmacokinetics of ceftriaxone in serum and in gynecological tissues.

The suitability of Ceftriaxone in gynecologic infections has been investigated in twenty-two patients. The long half life of Ceftriaxone seems to demonstrate its suitability for an effective preoperative prophylaxis in gynecology.

Ticarcillin/clavulanic acid treatment of gynecological infections.

Forty patients have been treated with a Ticarcillin/Clavulanic acid combination. This drug has proven to be effective in the treatment of gynecological soft tissues and wound infections.

Temocillin treatment of gynaecological infections with special reference to blood and tissue concentrations.

Tissue concentrations of temocillin were determined in samples from gynaecological surgical patients. Measurable concentrations of temocillin were observed during the entire time period investigated (up to 7 hours post administration). Inhibitory concentrations for the majority of susceptible bacteria were achieved. The therapeutic results observed in 40 patients with various infections (90% fully effective, 5% partially effective) confirm the high efficacy of temocillin in the treatment of gynaecological infections.

Clinical results and concentrations of cefmenoxime in serum, amniotic fluid, mother's milk, and umbilical cord.

Cefmenoxime administered intravenously was used to treat a variety of gynecologic and obstetric infections in 40 patients. Many were mixed infections. The mean age of the patients was 39.7 +/- 2.39 years. The dosage of cefmenoxime was 2 g per day (n = 30) or 1 g per day (n = 10). Cefmenoxime levels were assayed microbiologically in serum, milk, amniotic fluid, and placental tissues. The overall bacteriologic cure rate was 86 percent. Clinically, 100 percent of the patients were treated successfully. Side effects were generally mild, and in no case was treatment discontinued. Twelve hours after the last bolus injection, levels of cefmenoxime were 1.1 microgram/ml in serum and 1.75 microgram/ml in milk. Thirty minutes after a 1 g bolus injection in patients undergoing cesarean section, mean maternal serum concentrations were 33 micrograms/ml. Concentrations were 7.4 micrograms/ml in umbilical cord blood and 2.3 micrograms/ml in amniotic fluid.

[Cutaneous coumarin necrosis of the breast]. / Kutane Cumarinnekrose der Brust.

In a 62-year-old female patient petechial haemorrhages of the right breast were observed after the 4th day of treatment with phenprocoumon. Within a few hours large cutaneous necroses developed. Histology showed lymphocytic vasculitis with vessel wall destruction and erythrocytic extravasates as well as necrobiotic changes of the middle and lower corium. High-dosage treatment with prednisolone was started after withdrawal of phenprocoumon. Progression of the necrosis to the left breast could be prevented. However, necrosis of the haemorrhagic area of the right breast could not be arrested. Aetiology and pathomechanisms of coumarin-induced necrosis have to date not been ascertained. Allergic precipitating mechanisms probably were of no importance in our patient.