A relação entre indústria farmacêutica e a assistência farmacêutica no âmbito do Sistema Único de Saúde (SUS): a compra estadual e municipal de medicamentos no Rio de Janeiro

Esta dissertação tem como objeto o estudo da relação estabelecida entre a indústria farmacêutica e a assistência farmacêutica no âmbito do SUS. O objetivo é avaliar como estão sendo feitas as compras de medicamentos para os programas de assistência farmacêutica básica para hipertensão, diabetes e asma e rinite. A captura de dados foi realizada nas Secretarias de Saúde do estado e do município do Rio de Janeiro. Realizou-se comparação dos preços unitários dos medicamentos adquiridos no estado, no município do Rio de Janeiro e no Banco de Preços em Saúde (BPS), no período de janeiro de 2000 a dezembro de 2006. Em alguns momentos foram utilizados dados da Revista ABCFARMA, sobre preços unitários do mercado varejista. A pesquisa tornou possível registrar que o Estado do Rio de Janeiro compra medicamentos a um preço unitário mais alto do que aqueles praticados pela prefeitura e pelo Banco de Preços em Saúde. A hipótese apresentada é que o preço unitário mais alto se deve às inúmeras compras emergenciais realizadas, que estimulam os fornecedores a compensar o risco com preços maiores. Como a maioria dos fornecedores é distribuidora de medicamentos, elas estariam onerando os preços unitários, pois tiveram problemas no passado com o cumprimento da dívida pelo estado. Segundo autoridades estaduais da Secretaria de Estado de Saúde, esta situação indesejável está sendo superada através de uma nova forma de aquisição de medicamentos. A prefeitura do Rio de Janeiro, por outro lado, tem realizado as compras de medicamentos por licitações na modalidade concorrência. Esta forma possibilitou a aquisição de medicamentos a preços inferiores aos outros entes pesquisados. A maioria dos fornecedores da prefeitura é a própria indústria de medicamentos, o que, em princípio, torna o preço mais baixo. Conclui-se, então: que o Estado do Rio de Janeiro passou por crises de desabastecimento ou abastecimento irregular dos programa de assistência farmacêutica básica, o que contribuiu para a elevação dos preços praticados; e que a prefeitura do Rio de Janeiro tem conseguido comprar medicamentos em condições mais favoráveis que o governo de estado.

Avaliação microbiológica, detecção e susceptibilidade a antimicrobianos de potenciais enteropatógenos das famílias Enterobacteriaceae e Vibrionaceae em mexilhões Perna perna da praia de Itaipu, Niterói-RJ

Por serem organismos filtradores, os mexilhões devem ser extraídos para consumo somente de águas com padrões microbiológicos regulamentados pelo Conselho Nacional do Meio Ambiente, uma vez que intoxicações alimentares de origem bacteriana são as consequências mais comuns relacionadas ao consumo destes moluscos. Após a retirada dos costões, estes organismos passam por processos de fervura, lavagem, acondicionamento em sacos plásticos e transporte até a chegada ao mercado onde são comercializados; etapas estas, realizadas sem cuidados assépticos. Objetivando avaliar a qualidade microbiológica de mexilhões Perna perna coletados na praia de Itaipu, Niterói, RJ; após a sua fervura; e comercializados no Mercado São Pedro, foram realizadas contagens de coliformes totais e termotolerantes e pesquisa de Escherichia coli, Salmonella spp. e Vibrio spp. por metodologia convencional e molecular em amostras obtidas destes locais. Pelo teste de disco-difusão foi observado o perfil de resistência das cepas isoladas. Do total de amostras analisadas (27) apenas 3 dos mexilhões que sofreram processo de aferventação, 1 do comercializado e 3 do in natura, se encontravam dentro dos padrões aceitáveis pela legislação. Não houve diferença significativa entre as contagens de coliformes termotolerantes dos diferentes mexilhões analisados, mas sim entre os períodos seco e chuvoso. Somente uma das nove coletas de água mostrou-se própria para o cultivo de mexilhões (até 14 CF/mL). Foram isoladas e caracterizadas fisiológicamente, 77 estirpes da espécie E. coli, sendo confirmadas molecularmente por PCR os sorotipos EPEC, STEC e EAEC; 4 cepas Salmonella spp. sendo apenas uma confirmada por PCR; e das 57 cepas caracterizadas como Vibrio spp., 51 foram confirmadas por PCR, sendo 46 Vibrio spp., 2 V. cholerae, 1 V. vulnificus, 1 V. parahaemolyticus e 1 V. mimicus. Entre as estirpes de E. coli, 13% apresentaram multirresistência e 15,6% apresentaram resistência múltipla. A estirpe de Salmonella spp. se mostrou sensível a todos os antimicrobiados testados. Das estirpes de Vibrio spp. testadas, 68,6% apresentaram multirresistência e 72,5% apresentaram resistência múltipla. A partir da pesquisa de genes direto do caldo de enriquecimento foi possível detectar todos os genes pesquisados, com exceção para os sorotipos de Salmonella e V. cholerae. Baseado nos resultados do presente trabalho pode-se inferir que os mexilhões, amplamente comercializados no município de Itaipú, podem se constituir em risco para a saúde pública dos consumidores no Rio de Janeiro, necessitando dos órgãos competentes uma eficiente fiscalização nos pontos de venda e cultivo destes moluscos.

The Ancillary Harvest of Atlantic Menhaden, Brevoortia tyrannus, Roe on the North Carolina Coast

Gravid Atlantic menhaden, Brevoortia tyrannus, are available along the central coast of North Carolina during the fall and are harvested by the purse-seine fleet from the port of Beaufort. Virtually all of the catch, sexually immature fish included, is reduces to fish meal, fish oil, and fish solubles; however, minor quantities of roe from ripening female menhaden are extracted for local consupmtion. Routine and selective port sampling information was used to characterize the seasonal and biostatistical nautre of the roe menhaden catches at Beaufort. Fishermen recognize two size classes of roe Atlantic menhaden: "forerunners," which are usually the smallest and earliest adult menhaden encountered in the Fall Fishery, and "mammy shad," which are the largest menhaden harvested and produce the greatest roe yields. Roe is extracted from femal fish at various points along the reduction process stream and by several techniques. Vessel cremen and factory personnel extract menhaden roe for personal and local consumption. Undetermined quantities of menhaden roe are channeled into local retail seafood markets. Wholesale prices are about $20 per gallon of roe, while retail prices are about $5 per pound. Carteret County, North Carolina, is probably the only area on the U.S. Atlantic and Gulf coasts where menhaden roe is sold in retail seafood markets. The potential of extracting menhaden roe for foreign markets is discussed

Precious Coral Fisheries of Hawaii and the U.S. Pacific Islands

The precious coral fishery in Hawaii and the Western Pacific consists of one industry but two distinct and separate fisheries. The first is the harvest of black coral by scuba divers from depths of 30-100 m. The second is a fishery for pink and gold coral at depths between 400 and 1500 m and employs either a human-operated submersible that permits selective harvest or tangle net dredges which are nonselective. The modern history of these fisheries date from 1958 until the present. In this paper the ecology, life history. and management of the dominant species that make up these fisheries are reviewed. Research needs of the fisheries and the economic and future prospects of the precious coral industry are also described. At the present, the precious coral jewelry industry in Hawaii (all species) is valued at about $25 million at the retail level.

U. S. Trade in Tuna for Canning, 1987

U.S. tuna fleet activity, canned tuna processing, ex-vessel, wholesale and retail prices and imports in 1987 are described and compared to their counterparts in previous years. Industry statistics gathered from government agencies and industry contacts are presented in 14 figures and 8 tables. In 1987, U.S. tuna fisheries delivered 253,136 short tons (tons) of tuna to U.S. canneries. Domestic deliveries of albacore (white-meat) tuna were 2,836 tons, down 20 percent from 1986 levels. Domestic deliveries of tropical (light-meat) tuna (bigeye, blackfin, bluefin, skipjack, and yellowfin) were 251,000 tons, up 12 percent. Contract prices for tuna delivered by U. S. vessels to U. S. canneries increased dramatically in 1987. Depending on the size of fish in the delivery, ex-vessel prices of white-meat tuna increased as much as 27 percent, and prices of light-meat tuna increased as much as 47 percent. U. S. cannery receipts of imported and domestically caught raw frozen tuna for canning totaled 532,704 tons in 1987, up 2 percent from 1986 levels. U.S. cannery receipts of white-meat tuna were 104,197 tons, down 10 percent from 1986. Imports made up 97 percent of the total cannery supply. Total 1987 U. S. cannery receipts of raw, frozen light meat tuna were 428,507 tons, up 5 percent from 1986 levels. Imports made up 41 percent of the total cannery supply. The 1987 U.S. pack of canned tuna was 33.6 million standard cases, up 3 percent from 1986. The pack of white-meat tuna was 7.2 million standard cases, down 11 percent from 1986; the pack of light-meat tuna was 26.4 million standard cases, up 7 percent. U. S. imports of canned tuna in 1987 were 10.8 million standard cases, down 11 percent from 1986 levels, the first time in recent years that imports have declined. Per capita consumption of canned tuna in the United States was 3.5 pounds in 1987, down slightly from 1986. The retail composite price was $2.26 per pound, unchanged from 1986.

Regional Fisheries Advisory Committee 21st July, 1975

This is the report from the Regional Fisheries Advisory Committee meeting, which was held on the 21st July 1975. The report contains information on the appointment of the Regional Fisheries Advisory Committee (1975-1976), the appointment of the Local Fisheries Advisory Committee (1975-1976), and the land drainage representation on Local Fisheries Committees. Also included in the report is information on fishery byelaws, fishing at Jumble Reservoir and a progress report on a proposed Coarse Fish Unit and coarse fish stock pools. Licence duties, long term angling leases on Authority Waters and radio equipment for Bailiffting Staff are also covered. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Regional Fisheries Advisory Committee 12th May, 1975

This is the report from the Regional Fisheries Advisory Committee meeting, which was held on the 12th May, 1975. The report covers the minutes from the previous meetings of the Local Fisheries Advisory Committees, licence duties, fishery byelaws, and regional fish hatchery requirements. Also included is information on the long term angling leases on Authority waters. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Regional Fisheries Advisory Committee 6th February, 1978

This is the report from the Regional Fisheries Advisory Committee meeting, which was held on the 6th February 1978. The report contains the minutes of the previous meetings of the Local Fisheries Advisory Comittees, information on fisheries income and expenditure and terminated angling leases. Also included is the update on the fishery regulations on Worthing Reservoirs. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

South & West Cumberland Fisheries Advisory Committee 3rd April, 1978

This is the report from the South and West Cumberland Fisheries Advisory Committee meeting, which was held on the 3rd April, 1978. It covers information on Eskett Quarries, fisheries income and expenditure, British Steel Corporation's works at Workington effluent disposal and terminated angling leases. It also includes the report by the area fisheries officer on river conditions and fishing, migratory fish movements and Holmwrangle hatchery. Included in this report is also pollution incidents, fish disease and Yearl Weir fish counter. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Lune, Wyre & Furness Fisheries Advisory Committee 10th April, 1978

This is the report from the Lune, Wyre and Furness Fisheries Advisory Committee meeting, which was held on the 10th April, 1978. It covers information on fisheries income and expenditure, investigations for future water supplies to South West Cumbria, the Morecambe-Heysham sewage scheme crossing of the River Lune, and terminated angling leases. It also includes the report by the area fisheries officer on river conditions and fishing, and migratory fish movement and spawning on the River Wyre. Included in this report is also Langcliffe and Middleton Hatcheries, the stocking of brown trout by the Angling Associations, the concern of predators and fish disease. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Mersey & Weaver Fisheries Advisory Committee 12th April, 1978

This is the report from the Mersey and Weaver Fisheries Advisory Committee meeting, which was held on the 12th April, 1978. It covers information on fisheries income and expenditure, the pilot warm-water coarse fish hatching and rearing installation at Great Sankey, annual fishing permits on reservoirs and terminated angling leases. It also includes the report by the area fisheries officer on river conditions and fishing, and an update on Tintwistle hatchery and Worthington Stock Pools. Included in this report is also the stocking numbers of coarse fish, brown trout and rainbow trout by the Angling Associations, pollution incidents and fish mortalities and fisheries management. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Lune, Wyre & Furness Fisheries Advisory Committee 10th January, 1980.

This is the report from the Lune, Wyre and Furness Fisheries Advisory Committee meeting, which was held on the 10th January 1980. The report contains sections on the minutes of the Special Meeting held on 13th December 1979, net and fixed engine licence duties, the EEC Directive on the quality of freshwaters and terminated angling leases. It also includes the report by the area fisheries officer which looks at river conditions and fishing, fish monitoring at Broadraine, Skerton, Haverthwaite and Duddon Hall stations, and an update on Middleton hatchery. Also covered in the report is an update on the cage rearing of salmon smolts for the River Leven, stockings carried out by the Water Authority, and information on fish disease, fish spawning and net catch figures for 1979. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Mersey & Weaver Fisheries Advisory Committee 16th January, 1980.

This is the report from the Mersey and Weaver Fisheries Advisory Committee meeting, which was held on the 16th January 1980. The report contains sections on the minutes of the meeting held on the 24th October 1979, the EEC Directive on the quality of freshwaters and terminated angling leases. It also covers the report by the area fisheries officer which looks at river conditions and fishing, Hollingworth and Pilot hatcheries, stocking carried out by Angling Associations and the Authority and mortalities. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Wassergehalte tiefgefrorener Kammmuscheln

Kurzfassung Der Handel mit tiefgefrorenen Kammmuscheln (Pectinidae) hat in den letzten Jahren deutlich zugenommen und ist von der Jakobsmuschel (Pecten maximus) auf eine Reihe weiterer Spezies erweitert worden. Neben nicht zutreffender Handelsbezeichnung fällt diese Erzeugnisgruppe immer wieder durch einen erhöhten Wasserzusatz negativ auf. Es wurde die Zusammensetzung des Muskelfleisches von Produkten aus dem deutschen Handel bestimmt und das Wasser zu Protein- Verhältnis (W/P) berechnet. Eine erhebliche Zahl von Proben hatte hohe Wassergehalte und ein W/P Verhältnis > 5. Dies betraf insbesondere die Tiefseescallop (Placopecten magellanicus) und die Japanische Kammmuschel (Mizuhopecten yessoensis). In den meisten Fällen wurden Zusatzstoffe nachgewiesen, obwohl die gesetzlich vorgeschriebene Deklaration fehlte. Abstract The market share of quick-frozen scallops (Pectinidae) has increased significantly in recent years and has been extended besides the king scallop (Pecten maximus) to a variety of other species. Apart from an incorrect labeling this product group stands out for often excessively high water addition. The composition of the muscle meat and the water to protein ratio (W/P) was determined in samples from the German retail. The results showed that a considerable number of samples had very high moisture contents and W/P ratios > 5. These facts were mainly true for Placopecten magellanicus and Mizuhopecten yessoensis. There was no conformity with the prescribed declaration of food additives.

Otimização do problema de localização de instalações aplicado ao comércio e distribuição de combustíveis

Um dos problemas mais relevantes em organizações de grande porte é a escolha de locais para instalação de plantas industriais, centros de distribuição ou mesmo pontos comerciais. Esse problema logístico é uma decisão estratégica que pode causar um impacto significativo no custo total do produto comercializado. Existem na literatura diversos trabalhos que abordam esse problema. Assim, o objetivo desse trabalho é analisar o problema da localização de instalações proposto por diferentes autores e definir um modelo que seja o mais adequado possível ao mercado de distribuição de combustíveis no Brasil. Para isso, foi realizada uma análise do fluxo de refino e distribuição praticado neste segmento e da formação do respectivo custo de transporte. Foram consideradas restrições como capacidade de estoque, gama de produtos ofertados e níveis da hierarquia de distribuição. A partir dessa análise, foi definido um modelo matemático aplicado à redução dos custos de frete considerando-se a carga tributária. O modelo matemático foi implementado, em linguagem C, e permite simular o problema. Foram aplicadas técnicas de computação paralela visando reduzir o tempo de execução do algoritmo. Os resultados obtidos com o modelo Single Uncapacited Facility Location Problem (SUFLP) simulado nas duas versões do programa, sequencial e paralela, demonstram ganhos de até 5% em economia de custos e redução do tempo de execução em mais de 50%.