This article contributes to the clozapine literature by describing a possible interaction between taking valproic acid and smoking, which modifies plasma clozapine concentrations, by estimating the effect sizes of other compounds on plasma clozapine concentrations after correcting for confounders, and by providing dose-correction factors for clinicians.
This article investigates drug dosage individualization when the patient population can be described with a random-effects linear model of a continuous pharmacokinetic or pharmacodynamic response. Specifically, we show through both decision-theoretic arguments and simulations that a published clinical algorithm may produce better individualized dosages than some traditional methods of therapeutic drug monitoring. Since empirical evidence suggests that the linear model may adequately describe drugs and patient populations, and linear models are easier to handle than the nonlinear models traditionally used in population pharmacokinetics, our results highlight the potential applicability of linear mixed models to dosage computations and personalized medicine.
Vaccination against the coronavirus disease 2019 (COVID-19) started in early December of 2020 in the USA. The efficacy of the vaccines vary depending on the SARS-CoV-2 variant. Some countries have been able to deploy strong vaccination programs, and large proportions of their populations have been fully vaccinated. In other countries, low proportions of their populations have been vaccinated, due to different factors. For instance, countries such as Afghanistan, Cameroon, Ghana, Haiti and Syria have less than 10% of their populations fully vaccinated at this time. Implementing an optimal vaccination program is a very complex process due to a variety of variables that affect the programs. Besides, science, policy and ethics are all involved in the determination of the main objectives of the vaccination program. We present two nonlinear mathematical models that allow us to gain insight into the optimal vaccination strategy under different situations, taking into account the case fatality rate and age-structure of the population. We study scenarios with different availabilities and efficacies of the vaccines. The results of this study show that for most scenarios, the optimal allocation of vaccines is to first give the doses to people in the 55+ age group. However, in some situations the optimal strategy is to first allocate vaccines to the 15–54 age group. This situation occurs whenever the SARS-CoV-2 transmission rate is relatively high and the people in the 55+ age group have a transmission rate 50% or less that of those in the 15–54 age group. This study and similar ones can provide scientific recommendations for countries where the proportion of vaccinated individuals is relatively small or for future pandemics.
We propose a mathematical model based on a set of delay differential equations that describe intracellular HIV infection. The model includes three different subpopulations of cells and the HIV virus. The mathematical model is formulated in such a way that takes into account the time between viral entry into a target cell and the production of new virions. We study the local stability of the infection-free and endemic equilibrium states. Moreover, by using a suitable Lyapunov functional and the LaSalle invariant principle, it is proved that if the basic reproduction ratio is less than unity, the infection-free equilibrium is globally asymptotically stable. In addition, we designed a non-standard difference scheme that preserves some relevant properties of the continuous mathematical model.
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