O problema de falsificação de medicamentos aumenta a cada dia, acentuado pela globalização e vantagem financeira inerente a essa atividade. Diversos tipos de medicamentos têm sido alvo de falsificações, tornando-se um grave problema de saúde e segurança pública. O estudo avaliou o panorama do problema no Brasil, bem como as ações de fiscalização sanitária realizadas pela Agência Nacional de Vigilância Sanitária em conjunto com o Departamento de Polícia Federal, de 2007 a março de 2011. Foram realizadas análises das apreensões, tipos de apreensões, quantitativos de prisões, entre outros fatores. Observou-se que em 90% dos estabelecimentos onde ocorreram algum tipo de crime (venda de medicamento falsificado e falta de controle de medicamentos e entorpecentes), não havia a efetiva presença do profissional farmacêutico. Dentre os produtos apreendidos, a maior parte foi de medicamentos para combate da disfunção erétil. Mostrou-se também que a integração entre os órgãos torna-se uma ferramenta de grande valia no combate a esse tipo de venda de medicamento.

ObjectiveTo evaluate COS and oocyte retrieval results in ART treatment cycles initiated at any stage of the menstrual cycle (random start) in cancer patients, who could not postpone the onset of cancer treatment.MethodsProspective observational study of 26 women with cancer, with an indication to start cancer treatment within the next 20 days and wishing to preserve their fertility. Ovarian stimulation started immediately with FSH followed by GnRH antagonist for pituitary suppression and GnRH agonist for oocyte maturation. Treatment started from day 1 to day 14 of the menstrual cycle was considered to be in the follicular phase, and that started from day 15 to day 28 was considered to be in the luteal phase. Oocyte retrieval was performed 34 h after GnRH agonist administration. After identification and maturity classification, metaphase II oocytes were cryopreserved using vitrification.ResultsA total of 13 women had breast cancer, 4 ovarian cancer, 3 Central Nervous System cancer, 3 endometrial cancer, 2 cervical cancer and one bowel cancer. Thirteen patients started treatment during follicular phase and 13 during luteal phase. We found similar results for the duration of treatment, total dose of follicle stimulating hormone, number of ampoules of gonadotropin releasing hormone antagonist, mean number of follicles identified at ultrasound on the day of trigger and retrieval, number of aspirated oocytes and Metaphase II oocytes.ConclusionRandom-start controlled ovarian stimulation for emergency fertility preservation for minimizing delay in oncologic treatment for cancer patients does not interfere with the number of metaphase II oocytes, and therefore can be routinely used for stimulation followed by cryopreservation.

NCT01482416.

Selecting the most suitable drug for the treatment of depression has clinical and economic implications, since both safety and cost of antidepressants (AD) vary among therapeutic subgroups. This study aimed to evaluate the prescription of antidepressants for users of the pharmacy for civil servants of PBH (FARMASERV) in 2005. Univariate, bivariate and multivariate analyzes using logistic regression were performed. Of the total prescriptions analyzed (652), the majority were for women (81.7%) and individuals aged between 19 and 59 years (81.7%). The variables independently associated with the selection of AD were gender, age and the specialty of the prescriber. Women and young adults were more likely to be prescribed an SSRI compared to their congeners, with statistically significant differences. Psychiatrists were more likely to prescribe an SSRI than neurologists or general physicians. The determinant factors for selecting antidepressants may aid the planning of interventions aimed at patients and prescribers which can enable rationalization of the use of antidepressants.Uniterms: Antidepressants/rational use. Depression/ treatment . Medicines/rational use.A seleção adequada do medicamento para o tratamento da depressão tem implicações clínicas e econômicas, visto que a segurança e o custo dos antidepressivos (AD) variam entre as subclasses terapêuticas. Esse estudo avaliou prescrições de AD dispensadas em 2005 para usuários da Farmácia da Clínica dos Servidores da PBH (FARMASERV). Foram realizadas análises univariada, bivariada e multivariada dos dados, utilizando-se regressão logística. Do total de prescrições (652), a maioria era para mulheres (81,7%) e para indivíduos com idade entre 19 e 59 anos (81,7%). As variáveis independentemente associadas à seleção de AD foram gênero, faixa etária e especialidade do prescritor. Mulheres e adultos jovens têm maior chance de receber prescrição de ISRS, em comparação aos seus congêneres, sendo as diferenças estatisticamente significativas. A chance dos psiquiatras prescreverem ISRS é maior do que neurologistas e clínicos gerais. Os fatores determinantes da seleção do antidepressivo podem subsidiar o planejamento de intervenções dirigidas aos pacientes e prescritores de forma a permitir a racionalização de sua utilização.Unitermos: Antidepressivos/uso racional. Depressão/terapia. Medicamentos/uso racional.

These results were presented at the 35 th annual meeting of the European Society of Human Reproduction and Embryology ABSTRACT Objective: Lyophilization is potentially more practical and cost-effective alternative for sperm preservation. However, there are no studies that evaluate the ultrastructure of human spermatozoa after lyophilization. Therefore, the aim of our study was to evaluate the ultrasctructure of lyophilized spermatozoa using Transmission Electron Microscopy.Methods: From a total of 21 donated seminal samples, 30 aliquots were originated and divided into two aliquots so that one could have been submitted to cryopreservation/thaw and the other for lyophilization/rehydration. The liquefied aliquots were homogenized at room temperature. Samples assigned for cryopreservation were placed in straws and samples assigned for lyophilization were placed in the appropriate vials. Cryopreservation samples were placed at -30oC for 30 minutes subsequently for 30 minutes at vapour phase and then plunged into liquid nitrogen. Lately, were warmed in water bath at 37oC for 10 minutes followed by 10 minutes centrifugation. The pellet was resuspended and analysed in a Makler chamber. The semen vials assigned for lyophilization were loaded into a pre-fixed freeze-drying chamber. Following lyophilization, vials were removed from the freeze-drying chamber and kept at 4oC until rehydration. TEM was performed after rehydration and thawing. Sperm samples were fixed, rinsed in buffer, post fixed and dehydration was carried out in escalating concentrations of alcohol solution, acetone and then, embedding in Epon resin. Ultrathin sections were stained and examined in a Transmission Electron Microscope.Results: Analysis of sperm after freezing/thawing using Transmission Electron Microscopy showed lesions to the midpiece, with some mitochondria degeneration and random rupture of plasma membrane. In the head, we identified intact plasma membrane, nucleus and acrosome, as in the flagellum all main structures remained intact including the plasma membrane, the longitudinal columns of dense fibers and the semicircular fibers. Analysis by Transmission Electron Microscopy showed that spermatozoa heads had ruptured plasma membranes, absence of acrosomes, nuclei with heterogeneous and decompressed chromatin. Mitochondria were deteriorated in the midpiece. Longitudinal columns of dense fibers were absent in the flagellum. Axonemes, in cross-sections, were disrupted with disorganized structures.Conclusions: To our knowledge, our study demonstrated, for the first time, the structure of the human spermatozoa after lyophilization using Transmission Electron Microscopy. The use of a fixed lyophilization protocol with media containing cryoprotectants might explain the damage to the structures. More studies are necessary to improve the results of sperm lyophilization. In the future, the use of lyophilization of spermatozoa might reduce the costs of fertility preservation, since there will be no need for storage space and transportation is simpler.

Purpose Laparoscopy is a very accurate diagnostic tool for endometriosis. However, diagnostic accuracy has been questioned, as there is no reliable link between the visual status of the peritoneal cavity reported by laparoscopy and the patient's clinical condition. In addition, there is no actual association between the presence of typical peritoneal lesions and its confirmation by means of pathologic examination. The aim of our study was to determine whether histologic microscopic assessment is a reliable method for the diagnosis of endometriosis. Methods We performed a prospective transversal study with 68 women with suggestive history of endometriosis who underwent laparoscopy. After biopsy, an intra-observer and inter-observer variability of the histologic study was analyzed by the Kappa integrity test to reveal whether microscopic examination is an accurate exam for the diagnosis of endometriosis. Results In 38 of the 68 slides, all examiners confirmed the presence of endometriosis (55.9%). The intra-observer analysis showed an individual agreement degree over 92 (kappa=0.85; P<.001), and the inter-observer analysis showed an overall agreement of 76.5 (k=0.78; P<.001). Conclusions The results showed a high level of integrity of the histologic exam for the diagnosis of endometriosis and confirmed that microscopic histology is a reliable and reproducible diagnostic tool for endometriosis.

Objective To evaluate the effect of short-term hormone replacement therapy with tibolone 2.5 mg daily on endothelial function of healthy postmenopausal women, using flow-mediated dilation (FMD) of the brachial artery. Methods We performed a randomized, double-blinded, placebo-controlled study. A total of 100 healthy postmenopausal women were randomly allocated to receive tibolone (n = 50) or placebo (n = 50) for 28 days. Measurement of the FMD of the brachial artery was performed before and after the use of tibolone and placebo. Results A total of 31 women completed the study in the tibolone group, and 32 women completed the study in the control group. The results of the FMD measurements obtained from the women in the two groups before treatment were similar (0.018 and 0.091, for tibolone and placebo, p = 0.57). The values of the FMD in women who used tibolone and placebo, before and after the treatment, were similar in both groups. The numbers of women who presented an increase in the values of the FMD in both groups were also similar. Conclusion Our results demonstrate that the administration of 2.5 mg tibolone to healthy postmenopausal women for 28 days does not promote endothelial-dependent vasodilation, measured by FMD of the brachial artery.

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