Jana Stojanova

• PhD
• Senior Scientist at St. Vincent's Hospital Sydney

Background There is increasing interest in the potential benefit of therapeutic drug monitoring (TDM) in oncology. However, uptake in Australian hospitals is limited. Aim This study sought to explore hospital pharmacists' experiences with TDM in oncology, seeking to determine if they could provide insights into barriers and facilitators to its imp...

Objective The aim of this study was to examine the distribution of country, region, language, and gender diversity in the authorship of Cochrane reviews and compare it to non-Cochrane systematic reviews. Study Design and Setting We retrieved all published articles from the Cochrane Library (until November 6, 2023) using a web crawling technique th...

Aims Advanced chronic liver disease and advanced chronic liver disease‐related ascites have a high mortality. The pharmacological treatment of ascites and fluid overload has changed little over time. Empagliflozin, a sodium‐glucose cotransporter type 2 inhibitor is an untested potential novel treatment in cirrhosis, as it has survival benefits in h...

Background: Cochrane is a recognized source of quality evidence that informs health-related decisions. As an organization, it represents a global network of diverse stakeholders. Cochrane's key organizational values include diversity and inclusion, to enable wide participation and promote access. However, the diversity of Cochrane review authorship...

Background: Cochrane is a recognized source of quality evidence that informs health-related decisions. As an organization, it represents a global network of diverse stakeholders. Cochrane’s key organizational values include diversity and inclusion, to enable wide participation and promote access. However, the diversity of Cochrane review authorship...

Background: Cochrane is a recognized source of quality evidence that informs health-related decisions. As an organization, it represents a global network of diverse stakeholders. Cochrane’s key organizational values include diversity and inclusion, to enable wide participation and promote access. However, the diversity of Cochrane review authorship...

Currently, more than 100,000 papers had been published studying the placenta in both physiological and pathological contexts. However, relevant health conditions affecting placental function, mostly found in low-income countries, should be evaluated deeper. This review will raise some - of what we think necessary - points of discussion regarding ch...

Ceftazidime-avibactam (CTZ-AVM) is a novel cephalosporin/beta-lactamase inhibitor with broad-spectrum activity against multidrug-resistant Pseudomonas aeruginosa. Ceftazidime-induced neurotoxicity is a well-described adverse effect, particularly in patients with renal insufficiency. However, appropriate dosing of ceftazidime-avibactam in patients u...

Aim: Tacrolimus, a CYP3A4 substrate with a narrow therapeutic index, requires dose adjustment when used with voriconazole, a recognised CYP3A4 inhibitor. Recent reports separately describe interactions involving flucloxacillin and tacrolimus or voriconazole, resulting in decreased concentrations of both drugs individually. It has been reported tha...

Pharmacological therapy is the mainstay of treatment for cancer patients. Despite wide interpatient variability in systemic drug concentrations for numerous antineoplastics, dosing based on body size remains the predominant approach. Therapeutic drug monitoring (TDM) is used for few antineoplastics in specific scenarios. We conducted a rapid biblio...

Objectives: The current practice of therapeutic drug monitoring (TDM) in Asia is poorly documented. Our aim was to capture and describe TDM services delivered in hospitals across Asia, including aspects such as assay availability, interpretation of results and clinical decision-making. Methods: An online survey about anti-infective TDM practices, a...

Estrogen produces several beneficial effects in healthy neurological tissues and exhibits cardioprotective effects. Hormone therapy has been widely used to treat menopausal estrogen deficiency for more than 80 years. Despite high initial expectations of cardioprotective effects, there has been substantial distrust following important randomized cli...

Background: Both perfectionism and social anxiety have been described in patients with eating disorders (ED) and medical students. Academic stress also can increase the risk of developing ED. Aim: To analyze the dimensions of perfectionism, social anxiety, and academic stress associated with the risk of developing ED in female medical students. Mat...

Rigorous evidence is vital in all disciplines to ensure efficient, appropriate, and fit-for-purpose decision-making with minimised risk of unintended harm. To date, however, disciplines have been slow to share evidence synthesis frameworks, best practices, and tools amongst one another. Recent progress in collaborative digital and programmatic fram...

Rigorous evidence is vital in all disciplines to ensure efficient, appropriate, and fit-for-purpose decision-making with minimised risk of unintended harm. To date, however, disciplines have been slow to share evidence synthesis frameworks, best practices, and tools amongst one another. Recent progress in collaborative digital and programmatic fram...

INTRODUCTION: In a pandemic, stakeholders such as policy makers, clinicians, patients, and the public need access to high-quality, timely, relevant research evidence in a format that is understandable and applicable. OBJECTIVES: An online survey was used to determine where a global audience finds research evidence about COVID-19 and how they prefer...

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of cannabis‐based medicines, compared to placebo or an alternative treatment strategy, for preventing nausea and vomiting during the postoperative period among adults undergoing elective surgery.

Purpose: Antibiotics are commonly used during pregnancy. However, physiological changes during pregnancy can affect the pharmacokinetics of drugs, including antibiotics, used during this period. Pharmacokinetic evaluations have shed light on how antibiotics are affected during pregnancy and have influenced dosing recommendations in this context. M...

Cyclosporine (CsA) and tacrolimus (TAC) are immunosuppressant drugs characterized by a narrow therapeutic range and high pharmacokinetic variability. The effect of polymorphisms in genes related to the metabolism and transport of these drugs, namely CYP3A4, CYP3A5, MDR1 and POR genes, has been evaluated in diverse populations. However, the impact o...

Resumen El envejecimiento del sistema inmune o «inmunosenescencia» afecta a la respuesta inmune viral en el adulto mayor, sobre todo si existe fragilidad. Algunos hallazgos destacan un desbalance en los mecanismos pro- y antiinflamatorios, una menor producción y diversificación de linfocitos T, alteración de la inmunovigilancia y en la síntesis de...

Background: The importance of foods or food constituents in mental health is increasingly recognized, and “nutritional psychiatry” is a growing discipline. Objective: This narrative review aims to present work supporting associations between food or food constituents and mental health, specifically depressive disorders. Methods: The data presented...

Background Postoperative pain management contributes to reducing postoperative morbidity and unscheduled readmission. Compared to other opioids that manage postopera- tive pain like morphine, few randomized trials have tested the efficacy of intraoper- atively administered methadone to provide evidence for its regular use or be in- cluded in clinic...

Introduction: Chile has an incipient policy regarding humanized birth practices. Obstetric violence is becoming an issue in the public discussion, as brought up by women. Despite this advancement, no initiatives were observed to overcome the conflict. Questions arise from the different points of view of the main stakeholders involved. These questi...

Appendix 1: Summary of documents included.

Appendix 2: Other actors' expressions.

Introducción. Chile tiene una política incipiente en relación con prácticas de parto humanizado y la violencia obstétrica es una materia de creciente discusión pública levantada por las mujeres. A pesar de este avance, no se han observado iniciativas para superar el conflicto. Surge la pregunta acerca de los diferentes puntos de vista de los princi...

Anexo 1: Síntesis de documentos incluidos.

Anexo 2: Expresión de otros actores.

Anexo 2: Expresión de otros actores.

Background: Attentional deficit hyperactivity disorder (ADHD) in adults is associated with borderline personality characteristics or cluster B (emotional instability), but in certain populations, such as medical students, it might be associated with cluster C traits (perfectionism, dependency, anxiety). This may be compensatory to ADHD. Aim: To an...

Introduction: The use of psychotropic drugs in children and adolescents is widespread but associated with suboptimal treatment effects. Therapeutic drug monitoring (TDM) can improve safety of psychotropic drugs in children and adolescents, but is not routinely performed. A major reason is that the relationship between drug concentrations and effect...

Background Post‐transplantation lymphoproliferative disorder (PTLD) is a severe complication in organ transplant recipients. The use of T lymphocyte‐depleting antibodies (TLDAb), especially rabbit TLDAb contributes to PTLD and the V158F polymorphism of Fc gamma receptor IIIA (FcγRIIIA) also named CD16A could affect the concentration–effect relation...

En los estudios experimentales, el investigador aplica una intervención sobre los participantes, por lo que su eje temporal es prospectivo. Estas características permiten probar relaciones causales, pero implican una rigurosa evaluación bioética y una inscripción previa del protocolo de estudio. Entre las investigaciones experimentales se encuentra...

In experimental studies, researchers apply an intervention to a group of study participants and analyze the effects over a future or "prospective" timeline. The prospective nature of these types of studies allows for the determination of causal relationships , but the interventions they are based on require rigorous bioethical evaluation, approval...

Introducción: Las infecciones por levaduras del género Cryptococcus afectan principalmente a pacientes con déficit de la inmunidad mediada por células. Han sido escasos los estudios de sensibilidad realizados para este género en Chile. Objetivos: Determinar la sensibilidad in vitro de Cryptococcus sp a antifúngicos de uso habitual y evaluar la con...

Medicines are an economic good and a fundamental component of public and private health spending and decision-making. Assurance of their quality, efficiency, and safety is essential. In Chile, the wide variety of available drugs, including innovator products, and generics-some of which are certified as bioequivalent, while others are not-creates a...

Introduction: Patients of the Short-stay Child and Adolescent Unit of the Del Salvador Psychiatric Hospital (Valparaíso, Chile) exhibit different clinical and social characteristics compared to literature reports of other national centers, although published data are scarce. Objectives: To describe the operation of the Unit, the socio-familial and...

Introduction: Patients of the Short-stay Child and Adolescent Unit of the Del Salvador Psychiatric Hospital (Valparaíso, Chile) exhibit different clinical and social characteristics compared to literature reports of other national centers, although published data are scarce. Objective: To describe the operation of the Unit, the socio-familial and c...

Background Therapeutic drug monitoring (TDM) is a tool to personalize and optimise dosing by measuring the drug concentration and subsequently adjusting the dose to reach a target concentration or exposure. The evidence to support TDM is however often ranked as expert opinion. Limitations in study design and sample size have hampered definitive con...

Medicines are an economic good and a fundamental component of public and private spending and health decision-making. Assurance of their quality, efficiency and safety is essential. However, the variety of products on the Chilean market, including innovative and generic products—the latter accounted for by many products that are certified as bioequ...

Case-control studies have been essential to the field of epidemiology and in public health research. In this design, data analysis is carried out from the outcome to the exposure, that is, retrospectively, as the association between exposure and outcome is studied between people who present a condition (cases) and those who do not (controls). They...

Los estudios de casos y controles han sido esenciales en el desarrollo de la epidemiología y de la salud pública. En este diseño, el análisis de los datos se realiza desde el desenlace hacia la exposición, es decir, retrospectivamente, ya que se estudia la asociación entre factores de exposición y un desenlace conocido entre personas que ya present...

Resumen Los estudios observacionales analizan las variables de interés en la muestra o en la población, sin intervenir en ellas. Pueden ser meramente descriptivos si se focalizan en la descripción de las variables, o analíticos, en el caso de presentar grupos de comparación para establecer asociaciones mediante la inferencia estadística. Los estudi...

Observational studies evaluate variables of interest in a sample or a population , without intervening in them. They can be descriptive if they focus on the description of variables, or analytical when comparison between groups is made to establish associations through statistical inference. Cross-sectional studies and ecological-also called correl...

The placenta is a transitory organ, located between the mother and the foetus, which supports intrauterine life. This organ has nutritional, endocrine and immunologic functions to support foetal development. Several factors are related to the correct functioning of the placenta including foetal and maternal blood flow, appropriate nutrients, expres...

Resumen Las revisiones sistemáticas de literatura constituyen una de las principales metodologías utilizadas en la validación de las propiedades saludables de los alimentos, o factores alimentarios, que afectan la fisiología humana. Esta herramienta, basada en la evidencia obtenida a través de ensayos clínicos aleatorizados realizados con un diseño...

Systematic literature reviews are one of the main methodologies used to substantiate the health properties of foods and food constituents purported to affect human physiology. This tool is based on scientific evidence obtained from correctly performed randomized controlled trials. Systematic reviews make it possible to conclude whether there is a c...

Aging is a physiological process accompanied by cognitive decline, principally in memory and executive functions. Alterations in the connectivity of the default mode network (DMN) have been found to participate in cognitive decline, as well as in several neurocognitive disorders. The DMN has antisynchronic activity with attentional networks (task-p...

Introduction: Phacoeresis is the procedure through which the lens is surgically removed to treat cataracts. A corneal endothelial loss is a recognized sequel. Although several factors associated with this harm have been described, the surgeon’s prior experience has been scarcely evaluated. Objectives: To assess the association between the surgeo...

Therapeutic drug monitoring (TDM) is a clinical science centered around the quantification of drug concentrations in body fluids. To be considered candidates for TDM drugs must possess certain characteristics, including a narrow therapeutic index; in other words, to avoid toxicity at clinical doses. The relationship between dose and systemic concen...

Aim: To investigate the potential influence of variants in genes involved in the calcineurin pathway on the efficacy and toxicity of calcineurin inhibitors in renal transplantation. Materials & methods: Twenty-three polymorphisms in thirteen genes were tested in 381 renal transplant recipients receiving ciclosporin (n = 221) or tacrolimus (n = 1...

Interindividual variability in immunosuppressive drug responses might be partly explained by genetic variants in proteins involved in the immune response or associated with IS pharmacodynamics. On a general basis, the pharmacogenetics of drug target proteins is less known and understood than that of proteins involved in drug disposition pathways. T...

Voriconazole (VCZ) use is limited by its narrow therapeutic range and significant interpatient variability in exposure. This study aimed to assess (i) the impact of CYP2C19 genotype on VCZ exposure and (ii) the doses required to achieve the therapeutic range in adult patients with invasive fungal infections (IFIs). Therapeutic drug monitoring (TDM)...

We tested the influence of four polymorphisms and gene duplication in CYP2D6 on in vivo enzyme activity in a Chilean mestizo population in order to identify the most relevant genetic profiles that account for observed phenotypes in this ethnic group. CYP2D6*2 (2850C>T), *3 (2549A>del), *4 (1846G>A), *17 (1023C>T) and gene duplication were determine...

The modulation of the immune system following solid organ transplantation has made considerable progress with new immunosuppressive regimens and has considerably improved rejections rates. The improvement in long-term allograft survival is, however, modest. A complex network of cytokines, chemokines, adhesion, activation and co-stimulatory molecule...

Several recent pharmacogenetic studies have investigated the variability in both outcome and toxicity in cisplatin-based therapies. These studies have focused on the genetic variability of therapeutic targets that could affect cisplatin response and toxicity in diverse type of cancer including lung, gastric, ovarian, testicular, and esophageal canc...

Luc Delannoy, director del Instituto de Neuroartes. Luc Delannoy nació en Bélgica, es filósofo de formación y actual director del Instituto de Neuroartes, una red internacional de artistas, filósofos, científicos y profesionales de la salud mental con sede en México, cuyo pro-pósito es desarrollar programas formativos y preventivos de salud mental....

Thèse soutenue à l'UMR-S850 Directeur de thèse : Pr Pierre Marquet

Post-transplant lymphoproliferative disorders (PTLDs) represent a serious complication in solid organ transplantation and are the first cause of cancer related mortality in this population. Pre-transplant Epstein Barr Virus seronegativity and receipt of T cell depleting agents for induction or severe/refractory rejection are known risk factors, but...