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C Katona

Publications and source records attributed to C Katona.

60 records · Page 4Linked to original sources
PubMedDate not supplied

Putative role of dihydropyrimidine dehydrogenase in the toxic side effect of 5-fluorouracil in colorectal cancer patients.

Dihydropyrimidine dehydrogenase (DPD) is the first and rate limiting enzyme in the catabolism of 5-fluorouracil (5-FU). It has been reported from various laboratories that the plasma concentration of 5-FU was influenced by DPD activities in various normal human organs (e.g. liver or lymphocytes). Since the congenital deficiency in DPD caused severe, in some cases lethal, FU-related toxicity, it was decided to collect data about the DPD activity in colorectal cancer patients in order to investigate the possible correlation between the enzyme activity and appearance of the side effects of 5-FU. Assuming that DPD activity in lymphocytes represents the 5-FU catabolic capacity of the organism, DPD activity was determined in the lymphocytes of 48 patients with colorectal cancer after surgery during the therapeutic course with 5-FU and folinic acid. On the basis of the enzyme activity, patients were divided into three categories: low (DPD <5.03 pmol/min/10(6) lymphocytes); medium (DPD = 5.04-13.25 pmol/min/10(6) lymphocytes), and high (DPD > 13.26 pmol/min/10(6) lymphocytes) activity groups. By evaluating the toxic side effects during the 5-FU + folinic acid treatment, the following results were obtained. In the low DPD activity group, 9 of 11 patients had 5-FU-related side effects (mucositis, diarrhea, myelotoxicity, angina pectoris, hypertension). In 3 patients, no change of the therapy was needed, in 3 patients symptoms could be reversed by dose reduction of 5-FU while in 3 patients interruption of 5-FU therapy was needed. In the medium DPD activity group, mild toxicity (diarrhea, transitory hypertension) occurred in 5 of 29 and in the high activity group (diarrhea) in 1 of 8 patients, respectively. In these last two groups, no dose reduction of 5-FU was necessary. The present study furnished further evidence for the possible correlation between the 5-FU side effects and DPD function. Consequently, it is recommended to measure DPD activity prior to 5-FU based chemotherapy, which might be helpful in avoiding drug-related toxicity by adjusting the dose of 5-FU individually.

Adult↗
PubMedDate not supplied

Epidemiology of depressive symptoms in elderly primary care attenders.

408 elderly primary care attenders were screened using the Geriatric Depression Scale (GDS) and the 30-item General Health Questionnaire (GHQ). 36% were identified as 'cases' on the GDS and 32% on the GHQ. The 'cases' and a random sample of 'non-cases' were interviewed using the Geriatric Mental State Examination (GMS), the Bedford College Life Events and Difficulties Interview (LEDS), the National Adult Reading Test (NART), and systematic inquiry concerning physical health. Sensitivity and specificity of the GDS were 85% and 68%, and of the GHQ 77% and 67%. General practitioner identification of cases showed a sensitivity of 78% and a specificity of 60% against the GMS. Depression was significantly associated with life events, chronic difficulties, poor physical health and current lack of a confiding relationship. Subjective complaints of depression were associated with low premorbid intelligence and lifelong lack of a confiding relationship. The availability of a confiding relationship appears to have a protective effect against depressive illness associated with life events and chronic difficulties.

Aged↗