760 research outputs found

    Prescribing Nirmatrelvir-Ritonavir: How to Recognize and Manage Drug-Drug Interactions

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    Nirmatrelvir-ritonavir (NMV/r) is now being used to treat high-risk patients with mild to moderate COVID-19. This article provides advice to clinicians regarding recognition of medications likely to interact with NMV/r and suggests approaches to managing such drug-drug interactions. An algorithm is provided to assist in decision making

    The course of specialization in public health in Rio de Janeiro, Brazil, from 1926 to 2006: lessons and challenges

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    <p>Abstract</p> <p>Background</p> <p>Public health, as a field of knowledge, depends on its professionals. Their education and training, therefore, is considered to be an important factor for the quality of health services. In Brazil, the Course of Specialization in Public Health of the National School of Public Health is one of the oldest in the country. The course has existed for over 80 years, during which it has had an eventful history, with modifications in its organization, interruptions in its delivery, threats to its survival and changes in the institutions hosting it, reflecting the wider transformation in Brazilian society and public life over that period.</p> <p>Methods</p> <p>In this article we analyse this course via its history, disciplines, organization and characteristics of the student body.</p> <p>Results</p> <p>Insights were gained into the advancement of public health in Brazil and the progress of education for professionals in this field was highlighted. The course has formed nearly 2000 specialists in public health.</p> <p>Conclusions</p> <p>An analysis of the course's history provides valuable lessons for other schools of public health trying to train professionals in developing countries.</p

    Simulation of long-acting administration of antituberculosis agents using pharmacokinetic modelling

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    Design and qualify a PBPK model for existing oral anti-TB agents. Predict pharmacokinetics of long-acting nanoformulations of anti-TB agents in adults

    In Silico Dose Prediction for Long-Acting Rilpivirine and Cabotegravir Administration to Children and Adolescents.

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    Long-acting injectable antiretrovirals represent a pharmacological alternative to oral formulations and an innovative clinical option to address adherence and reduce drug costs. Clinical studies in children and adolescents are characterised by ethical and logistic barriers complicating the identification of dose optimisation. Physiologically-based pharmacokinetic modelling represents a valuable tool to inform dose finding prior to clinical trials. The objective of this study was to simulate potential dosing strategies for existing long-acting injectable depot formulations of cabotegravir and rilpivirine in children and adolescents (aged 3-18 years) using physiologically-based pharmacokinetic modelling.Whole-body physiologically-based pharmacokinetic models were developed to represent the anatomical, physiological and molecular processes and age-related changes in children and adolescents through allometric equations. Models were validated for long-acting injectable intramuscular cabotegravir and rilpivirine in adults. Subsequently, the anatomy and physiology of children and adolescents were validated against available literature. The optimal doses of monthly administration of cabotegravir and rilpivirine were identified in children and adolescents, to achieve trough concentrations over the target concentrations derived in a recent efficacy trial of the same formulations.Pharmacokinetic data generated through the physiologically-based pharmacokinetic simulations were similar to observed clinical data in adults. Optimal doses of long-acting injectable antiretrovirals cabotegravir and rilpivirine were predicted using the release rate observed for existing clinical formulations, for different weight groups of children and adolescents. The intramuscular loading dose and maintenance dose of cabotegravir ranged from 200 to 600 mg and from 100 to 250 mg, respectively, and for rilpivirine it ranged from 250 to 550 mg and from 150 to 500 mg, respectively, across various weight groups of children ranging from 15 to 70 kg.The reported findings represent a rational platform for the identification of suitable dosing strategies and can inform prospective clinical investigation of long-acting injectable formulations in children and adolescents

    Long-acting injectable formulations for children and adolescents using PBPK modelling

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    Dose prediction of long-acting cabotegravir and rilpivirine in children and adolescents according to weight categorie

    Academic freedom: in justification of a universal ideal

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    This paper examines the justification for, and benefits of, academic freedom to academics, students, universities and the world at large. The paper surveys the development of the concept of academic freedom within Europe, more especially the impact of the reforms at the University of Berlin instigated by Wilhelm von Humboldt. Following from this, the paper examines the reasons why the various facets of academic freedom are important and why the principle should continue to be supported
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