O medicamento, quando adequadamente utilizado, é um recurso terapêuti-co essencial para as políticas de saúde. Por outro lado, o seu uso inadequado é um grave problema de saúde pública. Em todo o mundo, as estimativas mostram que mais da metade de todos os medicamentos são prescritos, dispensados ou vendidos de forma inadequada, e que aproximadamente 50% dos usuários não utilizam os medicamentos corretamente (1 assistência (31,3%). Nenhum dos cenários relatados nos estudos atendeu plenamente as recomendações da OMS. As intervenções mais sugeridas para resolver os problemas de uso racional de medicamentos incluíram educação continuada para prescrição racional (56,3%), uso da lista de medicamentos essenciais atualizada, incluindo o nome genérico dos medicamentos e atendendo as necessidades da população (31,3%), e implementação de protocolos clínicos para padronizar condutas terapêuticas (31,3%). Conclusões. Os indicadores da OMS revelaram práticas irracionais de uso de medicamentos na APS em diversos países.Palavras-chave Uso de medicamentos; atenção primária à saúde; indicadores; revisão sistemática. Este é um artigo de acesso aberto distribuído sob os termos da Licença Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO, que permite o uso, distribuição e reprodução em qualquer meio, desde que o trabalho original seja devidamente citado. Não são permitidas modificações ou uso comercial dos artigos. Em qualquer reprodução do artigo, não deve haver nenhuma sugestão de que a OPAS ou o artigo avaliem qualquer organização ou produtos específicos. Não é permitido o uso do logotipo da OPAS. Este aviso deve ser preservado juntamente com o URL original do artigo.

Conflict of interest: noneObjective: assessing health-related quality of life (HRQL) in patients with rheumatoid arthritis (RA), before and after treatment with biological therapy. Methods: a longitudinal study, conducted from November 2010 to September 2011, with implementation of the instruments HAQ II (health assessment questionnaire) and SF-36 (medical outcomes short-from health survey). Barlett test, Anova, Friedman and paired t-test were performed for multiple extracts.Results: 30 patients were evaluated, mean age of 47.6 (SD: 12.25) years and prevalence of females (90%). The mean score of HAQ II before treatment was 1.97, with significant reduction of up to 1.23 after six months of biological therapy (p<0.01). Most of the SF-36 domains showed significant improvement after six months of treatment (p<0.01), highlighting the social aspects, pain, physical functioning, emotional issues, vitality and physical aspects. Conclusion: the use of biologic therapy in patients with RA refractory to standard therapies proved to be an important pharmacological strategy for improving HRQL.

New sensors have been developed for measuring in-situ fluid density that are based on the natural vibration of a structural member in contact with fluids being sampled using a wireline pumpout formation tester. Typically, a fluid-conveying tube is driven to its natural frequency and the frequency changes with fluid density. This design has the potential to greatly enhance the downhole fluid density measurement capability. However, the physical characterization and subsequent calibration of the sensor had to be proven for the harsher downhole environment. Although the principle for the vibrating density sensor is simple, a long list of factors, such as temperature, pressure, and tension, directly or indirectly affect the response of the sensor. Experimental correlations are typically used to calibrate this type of sensor. However, in this paper, we systemically study all of these factors and derive a differential equation that fully describes the physics of the vibrating tube densitometer based entirely on first principles. This is followed by the solution of the equation and its subsequent application to laboratory test results as part of the sensor calibration process. Comparisons between theoretically predicted density values for various fluids and their known fluid density values show this method to be more robust than previous correlations methods. An accuracy of better than +/- 0.002 gm/cm3 over the pressure range of 0 to 20,000 psi and a temperature range of 75 to 350° F under controlled conditions is achievable. The resolution of the sensor can also be better than 0.001 gm/cm3. Experimental results and field examples are presented to demonstrate the accuracy and resolution of the sensor. Introduction A pumpout wireline formation tester (PWFT) is a tool routinely used by operators to collect pressure, volume, and temperature (PVT) reservoir fluid samples. Among the long list of sensors included in the PWFT, the in-situ fluid density sensor plays crucial roles because an accurate determination of the formation fluid density under reservoir conditions is one of the fundamental objectives of formation evaluation. The importance of accurate density is reflected in the number of applications in which in-situ density is essential, such as pressure gradient analysis, fluid contacts, zonal compartmentalization analysis, delineation of oil-water transition zones, contamination analysis during sampling, and fluid identification analysis for immiscible fluids. Pressure gradient analysis based on PWFT pressure surveys has long been a fundamental method of determining fluid types because the in-situ moveable fluid density is directly related to the fluid type. However, there are well-known inherent uncertainties associated with errors in the gradient as a result of inaccuracy in the depth and pressure measurement (Collins et al. 2007). Furthermore, complications in the wellbore environment, such as invasion, supercharging, depletion, formation wettability, and capillary pressure effects (Desbrandes et al. 1988 and Carneigie 2007) combine to introduce additional errors. Therefore, although the practice of using pressure gradient has been one of the primary methods of determining fluid density since its introduction in the 1970s (Pelisser-Combescure et al. 1979), a direct in-situ measurement of fluid density that can overcome these complications is still highly desirable. Various methods have been adapted for density measurement (Godefroy et al. 2008). There are currently two types of sensors for in-situ downhole fluid density measurement; both are based on the principle of measuring the resonance frequency of a vibrating member in contact with fluid. One type has one or more vibrating elements submerged in the flow line (O'Keefe et al. 2007). The disadvantage of this type of sensor is its limited volume of investigation. Although the sensor is fully immersed in the fluid stream, it is sensitive only to a boundary layer in the immediate vicinity of the vibrating sensing element. Thus, it may inherently have problems in measuring multiphase liquids (Webster 1999).

Analisou-se o impacto nos custos da aquisição centralizada de medicamentos de alta complexidade para o tratamento da artrite reumatoide (AR) na Secretaria de Saúde de Pernambuco. Realizou-se um estudo transversal, comparativo de custo, com medicamentos adquiridos em licitações de 2010 (compra descentralizada) e 2012 (compra centralizada). O custo anual atualizado, com a compra descentralizada dos inibidores de Fator de Necrose Tumoral-Alfa (TNF-α) chegaria ao estimado de R$ 29.640.229,68, frente a R$ 15.339.978,00 da compra centralizada, perfazendo uma economia de 48,2%. Este resultado demonstrou que a compra centralizada pelo Ministério da Saúde possibilitou economia de recursos, sugerindo uma importante ferramenta para a melhoria da gestão da Assistência Farmacêutica nos estados.