Compared to the general population, the suicide risk among Danish cancer patients diagnosed in 1971 -1986 was increased by 50% for men and 30% for women. We updated the earlier study to evaluate both long-term and recent trends in the suicide risk. Cancer patients with a first cancer diagnosed between 1971 and 1999 in Denmark were followed-up for completed suicide through 1999. Excluding nonmelanoma skin cancer, 564 508 cancer patients were included and 1241 suicides observed. Both the standardised mortality ratio (SMR) of suicide relative to the general population and the suicide rates were analysed with Poisson regression methods. The overall SMR was increased to 1.7 (95% CI. 1.6 -1.9) for men and 1.4 (95% CI: 1.3 -1.5) for women. Following the cancer diagnosis, the suicide risk was highest in the first 3 months for men and between months 3 and 12 for women. The risk was higher for nonlocalised cancer and for cancers with perceived poor prognosis. Breast cancer patients had a higher risk than other cancer patients with similar good prognosis. The suicide rates among cancer patients decreased with calendar time, but less so than the rates in the general population. The suicide risk among cancer patients has not decreased as much as in the Danish population and reasons for this should be explored. Breast cancer might be believed by patients to be more life threatening than it is. Assessment and treatment of depression could improve the quality of life for cancer patients who suffer from unrecognised depressions and in turn reduce the risk of suicide in cancer patients. British Journal of Cancer (2005) Somatic disease is a well-documented risk factor for completed suicide. Using register-based data, a 1.3 -3 times increased suicide risk has been found among cancer patients in many countries (Louhivouri and Hakama 1979;Fox et al, 1982;Allebeck et al, 1989;Levi et al, 1991;Storm et al, 1992;Harris and Barraclough, 1994;Crocetti et al, 1998;Tanaka et al, 1999;Miccinesi et al, 2004). Studies on suicides in cancer patients have suggested that suicide risk is inversely correlated with time since diagnosis, increased with advanced cancer stage, higher for men than women, and varying with cancer site and age.With 13 more years of incidence and follow-up, our study almost doubles the earlier study (Storm et al, 1992), which covered the risk of suicide and other violent deaths among 296 331 Danish cancer patients diagnosed in the period 1971 -1986. Compared to the general Danish population, the observed 568 suicides represented increased suicide risks of 50% for men and 30% for women; risk was higher with nonlocalised cancers, and it increased by calendar time.We conducted a detailed register and population-based cohort study among Danish cancer patients diagnosed and reported to the Danish Cancer Registry in the years 1971 -1999. MATERIALS AND METHODSAll cancer patients identified in the Danish Cancer Register (Storm et al, 1997) with a first cancer, excluding nonmelanoma skin cancer, in the period 1971 -1999, were follo...

The exponential increase in the number of drugs used to treat infant and childhood illnesses necessitates an understanding of the ontogeny of drug biotransformation for the development of safe and effective therapies. Healthy infants received an oral dose (0.3 mg/kg) of dextromethorphan (DM) at 0.5, 1, 2, 4, 6, and 12 months of age. DM and its major metabolites were measured in urine. CYP2D6 genotype was determined by polymerase chain reaction-restriction fragment length polymorphism. Genotyping data indicated a strong correlation between CYP2D6 genotype and DM O-demethylation (beta=-0.638; 95% CI: -0.745, -0.532; P<0.001). CYP2D6 activity was detectable and concordant with genotype by 2 weeks of age, showed no relationship with gestational age, and did not change with post natal age up to 1 year. In contrast, DM N-demethylation developed significantly more slowly over the first year of life. Genotype and the temporal acquisition of drug biotransformation are critical determinants of a drug response in infants.

Background. Recent metaanalyses of published controlled studies concluded that adult patients with cancer randomly assigned to receive parenteral nutrition had higher rates of infectious complications than control subjects. Methods. The infection risk associated with parenteral nutrition was assessed in 310 pediatric patients with cancer. These patients had central venous access devices (CVAD), Hickman/Broviac (H/B) catheters, or implantable subcutaneous ports in place for the delivery of chemotherapy and supportive care. Results. The median duration of CVAD placement was 363 days; a total of 450 patient years (i.e., the sum of the total years of catheters experienced from all patients studied) were examined. Overall, the infection rate was 0.06 infections/100 days. During the period of parenteral nutrition administration, the rate increased to 0.5 infections/100 days. Among patients who received parenteral nutrition, there were no significant differences in any clinical parameter between the patients who developed an infection and those who did not. When evaluating the entire study population, infection was more likely to occur in patients who had acute nonlymphocytic leukemia (P < 0.01) or H/B catheters (P < 0.01), or who received parenteral nutrition (P < 0.02); there was no relationship between infection and catheter duration, days hospitalized, or days neutropenic (absolute neutrophil count < 0.5 × 109/l). Only CVAD type and parenteral nutrition retained significance in a multivariate Cox proportional hazards model. After adjustment for diagnosis and CVAD type, the risk of infection was 2.4‐fold greater in patients given parenteral nutrition (95% confidence interval 1.5 to 3.9; P < 0.001). Conclusion. These data confirm that administration of parenteral nutrition is associated with an increased risk of infection in children who have CVAD in place for cancer therapy.