Pharmacogenetics of antidepressants (from history to the present)

2021 ◽  
pp. 713-729
Author(s):  
Elena Sergeevna Ilyina ◽  
Natal’a Valer’evna Filippova ◽  
Yulia Borisovna Barylnik
Keyword(s):  
Clinical Practice ◽  
Depressive Disorders ◽  
Main Tool ◽  
Scientific Discipline ◽  
Research Data ◽  
Routine Clinical Practice ◽  
The Body ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Personalized Approach ◽  
Generalization Of Data

Pharmacogenetics is a relatively new scientific discipline, which is currently the main tool in personalized medicine. The aim of research in this area is to identify significant genetic markers for the introduction of their accounting in routine clinical practice. Generalization of data on the patient’s phenotype should be the key to predicting the pharmacokinetics and pharmacodynamics of the drug in the body. A personalized approach based on pharmacogenetic research data in psychiatry is extremely relevant due to the high social and budgetary costs of treating mental disorders around the world. Currently, there are data on the pharmacogenetics of most modern antidepressants, however, conducting such studies in patients with depressive disorders in most cases is impossible for implementation in routine clinical practice due to the impossibility of conducting the test in the laboratory of medical organizations and the lack of specialists competent in the clinical interpretation of the results of pharmacogenetic testing.

scholarly journals Effect of starting dose of regorafenib on overall survival of patients with metastatic colorectal cancer: a systematic review and meta-analysis

2019 ◽  
Vol 21 (3) ◽  
pp. 10-15
Author(s):  
Mikhail Yu Fedyanin ◽  
Elizaveta M Polyanskaya ◽  
Alexey A Tryakin ◽  
Ilia A Pokataev ◽  
Sergei A Tjulandin
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Overall Survival ◽  
Clinical Practice ◽  
Metastatic Colorectal Cancer ◽  
Meta Analysis ◽  
Research Data ◽  
Routine Clinical Practice ◽  
Starting Dose ◽  
Review Manager

Aim. To conduct a systematic review and meta-analysis of studies on the effect of starting dose of regorafenib on overall survival (OS) of patients with chemorefractory metastatic colorectal cancer. Materials and methods. We searched for research data in the PubMed. The analysis included all publications till 08.20.2019 which compared OS depending on the starting dose of regorafenib (160 mg or less) in the 1st course of therapy. Meta-analysis was conducted using Review Manager Ver. 5.3. Results. Two studies demonstrated decreased OS at starting dose of less than 160 mg (A. Adenis et al., 2016: risk ratio - RR 1.26, 95% confidence interval - CI 1.01-1.56; A. Aljubran et al., 2019: RR 2.25, 95% CI 0.93-5.43). Two studies showed an improvement in OS with a starting dose of less than 160 mg in the 1st course (T. Bekaii-Saab et al., 2018: RR 0.72, 95% CI 0.47-1,11; J. Gotfrit et al., 2017: RR 0.46, 95% CI 0.17-1.22). In two other studies, there was no effect of a starting dose of regorafenib on OS (K. Yamaguchi et al., 2019: RR 0.95, 95% CI 0.82-1.1; G. Argiles et al., 2019: RR 0,86, 95% CI 0.65-1.13). The meta-analysis did not reveal the effect of starting dose of the drug on OS: RR 0.97, 95% CI 0.78-1.21; p=0.79; I2=64. Conclusions. Reducing the starting dose of regorafenib in the 1st course does not decrease OS and can be recommended for routine clinical practice.

scholarly journals The results of DINASTIYA study - Diabeton MB: the observational program among the patients with type 2 diabetes mellitus under conditions of routine clinical practice

2012 ◽  
Vol 58 (5) ◽  
pp. 28-36
Author(s):  
M V Shestakova ◽  
O K Vikulova ◽  
D A Avaliani ◽  
S N Avdeeva ◽  
G P Aĭdinian ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Glycemic Control ◽  
Combined Treatment ◽  
Routine Clinical Practice ◽  
The Body ◽  
Daily Dose

The aim of the DINASTIYA study (the name of this study is the acronym composed of the selected letters from the Russian title: "DIabeton MB - Nablyudatel'naya programma sredi patsientov c Sakharnym diabeTom 2 tipa v uslovIYAkh rutinnoy praktiki") was to estimate the possibility of achieving the targeted parameters of glycemic control by means of the step by step increase of diabeton MB dose and to evaluate the safety of this therapy under conditions of routine clinical practice. Materials and methods: The program involved 2213 patients with poorly controlled type 2 diabetes mellitus who had been treated with diabeton MB during the preceding period (30-90 mg/day in the form of monotherapy or in combination with the maximum tolerated dose of metformin). The dose of diabeton MB was titrated under control of glycemia during 3 months. The combined treatment including metformin was given to 70% of the patients. The average daily dose of diabeton MB by the end of the study was 90.9 mg. As many as 70% of the petients received diabeton MB at a daily dose of 90-120 mg. Results: The statistically significant reduction of the fasting blood glucose (FG) level from 8.3±1.6 mmol/l to 6.2±0.9 mmol/l and postprandial glycemia (PPG) from 10.5±2.1 mmol/l to 7.6±1.0 mmol/l was documented within 3 month after the onset of therapy. The targeted FG and PPG levels (<6.5 mmol/l and <8.0 mmol/l) were achieved in 68.9% and 71.5% of the patients respectively. Simultaneously, the body weight decreased (by 1 kg on the average) and arterial pressure fell down (SAP - 8.4 and DAP - 3.9 mm HG respectively). Conclusion: The strategy of management of type 2 diabetes mellitus based on the step by step increase of the dose of diabeton MB allows the targeted parameters of glycemic control to be achieved in combination with the good tolerability of the treatment and the low risk of development of hypoglycemia.

Feasibility of Integrating Research Data Collection into Routine Clinical Practice Using the Electronic Health Record

2014 ◽  
Vol 192 (4) ◽  
pp. 1215-1220 ◽  
Author(s):  
David J. Chalmers ◽  
Sara J. Deakyne ◽  
Marisa L. Payan ◽  
Michelle R. Torok ◽  
Michael G. Kahn ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Data Collection ◽  
Electronic Health Record ◽  
Research Data ◽  
Routine Clinical Practice ◽  
Health Record ◽  
Electronic Health

Diagnosis and Management of Cardiomyopathies – A Focus on Genetics, Cardiac Magnetic Resonance and Clinical Features

2011 ◽  
Vol 7 (3) ◽  
pp. 225
Author(s):  
Gianfranco Sinagra ◽  
Michele Moretti ◽  
Giancarlo Vitrella ◽  
Marco Merlo ◽  
Rossana Bussani ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Molecular Genetic ◽  
Molecular Genetic Analysis ◽  
Routine Clinical Practice ◽  
Clinical Approach ◽  
Diagnosis And Management ◽  
Made In

In recent years, outstanding progress has been made in the diagnosis and treatment of cardiomyopathies. Genetics is emerging as a primary point in the diagnosis and management of these diseases. However, molecular genetic analyses are not yet included in routine clinical practice, mainly because of their elevated costs and execution time. A patient-based and patient-oriented clinical approach, coupled with new imaging techniques such as cardiac magnetic resonance, can be of great help in selecting patients for molecular genetic analysis and is crucial for a better characterisation of these diseases. This article will specifically address clinical, magnetic resonance and genetic aspects of the diagnosis and management of cardiomyopathies.

Theory-Practice Gap: The Experiences of Nigerian Nursing Students

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Titilayo Dorothy Odetola ◽  
Olusola Oluwasola ◽  
Christoph Pimmer ◽  
Oluwafemi Dipeolu ◽  
Samson Oluwayemi Akande ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Nursing Students ◽  
Developing Country ◽  
The Body ◽  
Clinical Staff ◽  
Clinical Settings ◽  
Practice Gap ◽  
The Difference ◽  
Analyse Data ◽  
Theory Practice Gap

The “disconnect” between the body of knowledge acquired in classroom settings and the application of this knowledge in clinical practice is one of the main reasons for professional fear, anxiety and feelings of incompetence among freshly graduated nurses. While the phenomenon of the theory-to-practice gap has been researched quite extensively in high-income country settings much less is known about nursing students’ experiences in a developing country context. To rectify this shortcoming, the qualitative study investigated the experiences of nursing students in their attempt to apply what they learn in classrooms in clinical learning contexts in seven sites in Nigeria. Thematic content analysis was used to analyse data gained from eight focus group discussions (n = 80) with the students. The findings reveal a multifaceted theory-practice gap which plays out along four tensions: (1) procedural, i.e. the difference between practices from education institutions and the ones enacted in clinical wards – and contradictions that emerge even within one clinical setting; (2) political, i.e. conflicts that arise between students and clinical staff, especially personnel with a lower qualification profile than the degree that students pursue; (3) material, i.e. the disconnect between contemporary instruments and equipment available in schools and the lack thereof in clinical settings; and (4) temporal, i.e. restricted opportunities for supervised practice owing to time constraints in clinical settings in which education tends to be undervalued. Many of these aspects are linked to and aggravated by infrastructural limitations, which are typical for the setting of a developing country. Nursing students need to be prepared regarding how to deal with the identified procedural, political, material and temporal tensions before and while being immersed in clinical practice, and, in so doing, they need to be supported by educationally better qualified clinical staff.

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