Publications by authors named "Alexander Tarasov"

5 Publications

  • Page 1 of 1

Pharmacogenetic Testing: A Tool for Personalized Drug Therapy Optimization.

Pharmaceutics 2020 Dec 19;12(12). Epub 2020 Dec 19.

Biobanking Group, Branch of Institute of Biomedical Chemistry "Scientific and Education Center", 109028 Moscow, Russia.

Pharmacogenomics is a study of how the genome background is associated with drug resistance and how therapy strategy can be modified for a certain person to achieve benefit. The pharmacogenomics (PGx) testing becomes of great opportunity for physicians to make the proper decision regarding each non-trivial patient that does not respond to therapy. Although pharmacogenomics has become of growing interest to the healthcare market during the past five to ten years the exact mechanisms linking the genetic polymorphisms and observable responses to drug therapy are not always clear. Therefore, the success of PGx testing depends on the physician's ability to understand the obtained results in a standardized way for each particular patient. The review aims to lead the reader through the general conception of PGx and related issues of PGx testing efficiency, personal data security, and health safety at a current clinical level.
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http://dx.doi.org/10.3390/pharmaceutics12121240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765968PMC
December 2020

Long-Term Outcomes of Holmium Laser Enucleation of the Prostate: A 5-Year Single-Center Experience.

J Endourol 2020 Oct 4;34(10):1055-1063. Epub 2020 Aug 4.

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

To analyze the long-term efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia. A total of 127 patients who underwent HoLEP at our institution between 2013 and 2015 were included. Patients were observed for 5 years postoperatively. We evaluated the length of the surgery, the mass of the removed tissue, prostate-specific antigen level, the maximal flow rate (Qmax), postvoid residual (PVR), the length of catheterization and hospitalization, and the International Prostate Symptom Score (IPSS) and IPSS quality of life (QoL) at each clinic visit. PVR, Qmax, IPSS, and QoL all improved significantly immediately after the operation ( < 0.001). By the end of the 5th postoperative year, all the parameters showed a statistically meaningful decline: Qmax reduced by 5.8 mL/s (22.6%) and IPSS by 1.4 points (29.1%). Around 8.6% of the patients continued therapy with α-blockers. There were no differences in efficacy by the age of the patients or the volume of the prostate. Long-term complications and need for repeat operations were not affected by the volume of the prostate or patient age. The improvement of PVR, Qmax, IPSS, and QoL score seen in the early postoperative period after performing HoLEP remains evident at 5 years postoperatively. Long-term complications and the need for reoperation do not depend on the age of the patient or on the initial volume of the prostate.
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http://dx.doi.org/10.1089/end.2020.0347DOI Listing
October 2020

How Lasers Ablate Stones: Study of Laser Lithotripsy (Ho:YAG and Tm-Fiber Lasers) in Different Environments.

J Endourol 2021 Jun 29;35(6):931-936. Epub 2020 Jan 29.

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

There are two main mechanisms of stone ablation with long-pulsed infrared lasers: photothermal and photomechanical. Which of them is primary in stone destruction is still a matter of discussion. Water holds importance in both mechanisms but plays a major role in the latter. We sought to identify the prevailing mechanism of stone ablation by evaluating the stone mass loss after lithotripsy in different media. We tested a holmium:yttrium-aluminum-garnet (Ho:YAG) laser (100 W; Lumenis), a thulium-fiber laser U1 (TFL U1) (120 W; NTO IRE-Polus, Russia), and a SuperPulse thulium-fiber laser U2 (TFL U2) (500 W; NTO IRE-Polus). A single set of laser parameters (15 W = 0.5 J × 30 Hz) was used. Contact lithotripsy was performed in phantoms (BegoStones) in different settings: (a) hydrated phantoms in water, (b) hydrated phantoms in air, (c) dehydrated phantoms in water, and (d) dehydrated phantoms in air. Laser ablation was performed with total energy of 0.3 kJ. Phantom mass loss was defined as the difference between the initial phantom mass and the final phantom mass of the ablated phantoms. All lasers demonstrated effective ablation in hydrated phantoms ablated in water; no visual differences between the lasers were detected. The ablation of dehydrated phantoms in air was also effective with visible vapor during ablation and condensation on the cuvette wall. Dehydrated phantoms in water and in air show minimal to no ablation accompanied with formation of white crust on phantom surface. Among laser types, TFL U2 had the highest phantom mass loss in all groups except for dehydrated phantoms ablated in air. Our results suggest that both photothermal and thermomechanical ablation mechanisms (explosive vaporization) occur in parallel during laser lithotripsy. In Ho:YAG and TFL U2 stone ablation explosive vaporization prevails, whereas in TFL U1 ablation photothermal mechanism appears to predominate.
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http://dx.doi.org/10.1089/end.2019.0441DOI Listing
June 2021

Retrospective Assessment of Endoscopic Enucleation of Prostate Complications: A Single-Center Experience of More Than 1400 Patients.

J Endourol 2020 02;34(2):192-197

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Endoscopic enucleation of the prostate (EEP) is a safe method of treating benign prostatic hyperplasia, regardless of prostate volume and type of applied energy. To date, however, there has been no study that examines complication rates with respect to the type of applied energy. This study aims to address this problem by providing a retrospective analysis of >1400 patients who have undergone prostate enucleation. We performed a retrospective analysis of all patients undergoing EEP between 2013 and 2018 at a single tertiary institution. This analysis included patients who had undergone one of three forms of EEP: holmium laser enucleation of the prostate (HoLEP), thulium fiber laser enucleation of the prostate (ThuFLEP), or monopolar enucleation of the prostate (MEP). We compared intraoperative and early postoperative complications, as well as complications at 3 and 6 months follow-up. A total of 1413 patients were included in this study; 36% patients underwent HoLEP, 57.5% had ThuFLEP, and 6.5% MEP. The most frequent complication in the early postoperative period was a mild fever (2.76% of the cases). The morcellation was delayed to a separate stage because of intensive hemorrhaging in 1.4% of the cases. Bladder tamponade was found in 1.1% of the cases. We found no correlation between complication rate and either prostate volume or energy source. Stress urinary incontinence was found in 3.9% of patients at 3 months and in only 1.4% of patients at 6 months after the operation. Urethral stricture at 6 months after the surgery was found in 1.4% of patients, whereas bladder neck sclerosis was found in only 0.9% of these cases. No significant difference was observed between these complication frequencies and any preoperative factors or energy source. All EEP types are safe with equal rates of complications intraoperatively, postoperatively, and at 6 months follow-up.
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http://dx.doi.org/10.1089/end.2019.0630DOI Listing
February 2020

Comparison of biphasic insulin aspart 30 given three times daily or twice daily in combination with metformin versus oral antidiabetic drugs alone in patients with poorly controlled type 2 diabetes: a 16-week, randomized, open-label, parallel-group trial conducted in russia.

Clin Ther 2007 Nov;29(11):2374-84

Department of Prophylactic Medicine, Post-graduate Medical Education Institute, Khabarovsk, Russia.

Background: Modern premixed insulins offer a flexible approach to the initiation of insulin therapy in patients with poorly controlled type 2 diabetes. A disadvantage of twice-daily regimens of biphasic insulin aspart 30 (BIAsp 30) is that lunchtime control (when no insulin is administered) can be suboptimal. Therefore, it is possible that administering BIAsp 30 thrice daily might further optimize glycemic control and offer an option for patients in whom metformin (MET) is contraindicated.

Objective: This study evaluated the efficacy and safety profiles of 2 different regimens of BIAsp 30 compared with a regimen consisting of oral antidiabetic drugs (OADs) alone.

Methods: In this multicenter, randomized, open-label, parallel-group trial, insulin-naive patients with poorly controlled type 2 diabetes (baseline glycosylated hemoglobin [HbA(1c) > or =8.0%) who were taking OADs (a sulfonylurea or meglitinide with/without MET or MET only) were randomized to receive BIAsp 30 TID, BIAsp 30 BID + MET, or continuation of their current OAD therapy for 16 weeks. The primary end point was HbA(1c) at the end of the study. Secondary end points included reductions in HbA(1c), mean blood glucose (BG), prandial increment, mean 7-point self-monitored BG profile, weight changes, tolerability (hypoglycemia, adverse events), and satisfaction/quality of life (derived from 2 questionnaires completed at weeks 0, 8, and 16).

Results: The study enrolled 308 insulin-naive patients with type 2 diabetes (78.9% female; mean age, 58.3 years; body mass index, 29.4 kg/m(2); HbA(1c), 10.3%). Both BIAsp 30 TID and BIAsp 30 BID + MET were associated with significantly greater mean (SD) reductions in HbA(1c) relative to OADs alone (absolute percent reduction: 2.9% [1.5%], 3.0% [1.6%], and 2.1% [1.4%], respectively; P < 0.001, both insulin groups vs OAD group) and improved post-prandial glucose control (reduction in mean post-prandial glucose:-6.32 [4.07], -6.44 [4.70], and -3.59 [4.22] mmol/L; P < 0.001, both insulin groups vs OAD group). The mean decrease in the prandial increment was -1.26 mmol/L for BIAsp 30 TID, -2.15 mmol/L for BIAsp 30 BID + MET, and -0.44 mmol/L for OAD. The differences in reduction in the prandial increment were statistically significant for BIAsp 30 TID versus OAD (P = 0.047), BIAsp 30 BID + MET versus OAD (P < 0.001), and BIAsp 30 TID versus BIAsp 30 BID + MET (P = 0.042). Mean body weight increased significantly from baseline with both BIAsp 30 TID and BIAsp 30 BID + MET (+1.71 and +1.50 kg, respectively; both, P < 0.001), and decreased significantly in the OAD group (-0.75 kg; P = 0.003). There were no major hypoglycemic events, and most hypoglycemic events were recorded as symptoms only (144/158 [91.1%]). There were no significant differences in the mean frequency of overall hypoglycemic episodes between BIAsp 30 TID and BIAsp 30 BID + MET (0.73 and 0.69 episodes per patient-year, respectively).

Conclusions: In these patients with type 2 diabetes that was poorly controlled by OADs, BIAsp 30 TID and BIAsp 30 BID plus MET were associated with significantly greater reductions in HbA(1c) and postprandial BG compared with OADs alone. The insulin regimens were associated with significantly more weight gain than OADs alone. There were no differences in rates of hypoglycemia between the insulin regimens.
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http://dx.doi.org/10.1016/j.clinthera.2007.11.017DOI Listing
November 2007
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