Polymorphisms of glutathione S-transferase mu 1, theta 1, and pi 1 genes and prognosis in Hodgkin lymphoma.

We examined the influence of the glutathione S-transferase mu 1 (GSTM1), theta 1 (GSTT1), and pi 1 (GSTP1) polymorphisms, which are involved in the metabolism of alkylating agents and anthracyclines, on the outcome of patients with Hodgkin lymphoma (HL) treated with conventional chemotherapy. Genomic DNA from 125 consecutive cases was analyzed by polymerase chain reaction and enzymatic digestion for polymorphism determination. The GSTM1 undeleted genotype was associated with more advanced tumor stage and worse disease-free survival. The GSTT1 undeleted genotype was associated with higher recurrence rate. In contrast, higher toxicity of chemotherapy was attributed to absence of the GSTT1 gene. Concerning overall survival, lower tumor stage (p = 0.006) and International Prognostic Score (p = 0.02), lower peripheral leukocyte count (p = 0.0003), higher serum albumin level (p = 0.08), and GSTT1 undeleted genotype (p = 0.04) were predictive of a better outcome of patients. In multivariate analysis comparing staging and GST polymorphism, only tumor stage and GSTT1 genotype remained in the model. Our results suggest that the GSTT1 polymorphism influences the outcome of Brazilian patients with HL. However, studies of toxicity, pharmacokinetics, and protein function may clarify whether carriers of the distinct genotypes should receive different doses of chemotherapeutic agents.

Polymorphisms of glutathione S-transferase Mu 1, glutathione S-transferase theta 1 and glutathione S-transferase Pi 1 genes in Hodgkin's lymphoma susceptibility and progression.

We tested in this study whether the polymorphisms of the glutathione S-transferase Mu1 (GSTM1), glutathione S-transferase Theta 1 (GSTT1) and glutathione S-transferase Pi 1 (GSTP1), involved in metabolism of chemical agents, cell proliferation and cell survival, alter the risk for Hodgkin lymphoma (HL). Genomic DNA from 110 consecutive patients with HL and 226 controls was analysed by polymerase chain reaction and restriction digestion for the polymorphism analyses. Similar frequencies of the GSTM1 and GSTT1 genotypes were seen in patients and controls. In contrast, the frequency of the GSTP1 wild genotype (59.1%versus 36.3%, P = 0.004) was higher in patients than in controls. Individuals with the wild genotype had a 2.68 (95%CI: 1.38-5.21)-fold increased risk for the disease than others. An excess of the GSTP1 wild genotype was also observed in patients with tumors of stages III + IV when compared with those with tumors of stages I + II (39.1%versus 20.0%, P = 0.03). These results suggest that the wild allele of the GSTP1 gene is linked to an increased risk and high aggressiveness of the HL in our cases but they should be confirmed by further studies with larger cohorts of patients and controls.

Análise da gestante: prevençäo pela educaçäo na Unidade Básica de Saúde do Jardim Bandeirante / Pregnancy's analysis: prevention and education in the Jardim Bandeirante Health Basic Unit

O presente trabalho avaliou o perfil da gestante na Unidade Básica de Saúde do Jardim Bandeirantes, através de entrevistas em domicílios e desenvolveu um trabalho educativo com a equipe do posto e lideranças comunitárias, com orientaçöes das áreas de medicina, enfermagem, odontologia, farmácia, fisioterapia e nutriçäsobre os cuidados do pré-natal. As avaliaçöes pré teste e pós teste daas reuniöes educativas demonstraram que as gestantes tiveram ganho de conhecimento em todos os itens das palestras. Os conteúdos abordados foram: atendimento prestado à mulher durante a gravidez,maiores sinais de perigo na gravidez, os sinais do parto, o desenvolvimento do feto e modificaçöes do corpo da mäe, estímulo ao aleitamento materno, orientaçäo sobre postura e exercícios que visem prevenir desconforto na gravidez, informaçöes sobre uso abusivo de tabaco, álcool, drogas e automedicaçäo da gravidez, orientaçäo sobre higiene da mäe e do bebê