Two national mammography quality certification programs in Brazil: Framework and main outcomes between 2017 and 2021.

BACKGROUND: This study aims to provide an academic medical overview of the framework and key outcomes of two mammography quality certification programs in Brazil. METHODS: These programs assess radiation dose and phantom image quality in mammography units through a postal system. Each unit that passes this initial assessment is required to submit a sample of copies of five complete examinations. The quality of the patient images and reports is then reviewed by radiologists and medical physicist experts. Additionally, the number of mammography units and mammography coverage in the target population, were assessed. RESULTS: During the study period, 1007 units applied to the certification programs, and 934 (92.8%) successfully passed the assessment of radiation dose and phantom image quality. Out of these, 556 (59.5%) also passed the review of clinical image quality and reports, earning certification. The main issues related to mammogram and report quality were associated with the performance of radiographers (in terms of positioning) and radiologists (in terms of interpretation). On average, there are more than two mammography units/10,000 women in the target group. The screening mammography coverage in this group is 26.3% for women relying exclusively on the public healthcare and 58.1% for women with private healthcare plans. CONCLUSION: This study demonstrates the suitability of the framework adopted by national mammography quality certification programs in a middle-income country. These programs are carried out by relatively small workforce and at reasonable costs, utilizing postal resources to cover the large number of existing mammographic units and the vast distances within the country. POLICY STATEMENT: All mammography services in Brazil must adhere to the quality requirements for examinations and reference values for radiation dose to women established by the Ministry of Health. This ensures standardized conditions for early detection of breast cancer and minimizes the risk associated with x-rays.

Differential NMR and chromatography for the detection and analysis of adulteration of vetiver essential oils.

Adulteration of essential oils is a common and serious problem. Adequate and fast methods are required to establish the authenticity and purity. GC-MS, 1H and 13C NMR were compared in combination with similarity calculations as well as differential spectroscopy and chromatography for the authentication and determination of purity of vetiver essential oils. In the investigation of eight commercial oils 1H and 13C NMR adequately detected all six adulterants encountered in four of the commercial samples, while GC-MS was not able to detect adulteration with vegetable oils. A great advantage of the combined use of similarity calculation and NMR is that the authenticity can be verified without the need of concomitant measurement of a standard sample. The calculation can be carried out with a registered reference spectrum, in the case of 1H NMR acquired using the same magnetic field, but in the case of 13C NMR the spectrum can be obtained with another magnetic field. 1H NMR has the advantage of high speed, and the results can be obtained within minutes. 13C NMR was found to be superior in its ability to provide unequivocal identification of eventual adulterants, with differential spectroscopy revealing all signals of the adulterants.

Indirect evaluation of estrogenic activity post heterotopic ovarian autograft in rats.

PURPOSE: To morphologically evaluate the estrogenic effect on the uterus and vagina of rats submitted to ovarian autografts. METHODS: Twenty Wistar EPM-1 adult rats were bilaterally ovariectomized, followed by ovarian transplants in retroperitoneal regions. The animals were divided in four groups of five animals, according to the day of euthanasia: G4, G7, G14 and G21, corresponding to the 4th, 7th, 14th and 21st day after surgery, respectively. Vaginal smears were collected from the first day of surgery until euthanasia day. After that, the vagina and uterus were removed, fixed in 10% formaldehyde and submitted to histological analysis and stained with hematoxiline and eosine. RESULTS: All animals showed estrous cycle changes during the experiment. In 4th day, the uterus showed low action of estrogen with small number of mitosis and eosinophils as well as poor development. On the 7th day, the endometrium was atrophic without mitotic signals and presented a small number of eosinophils. On the 14th and 21th days the histological findings were similar, with the presence of mitosis in the endometrial glands and intense leucocyte infiltration with a large number of eosinophils. Morphometric results showed that the endometrial and myometrial thickness as well as the number of eosinophils presented the highest values during the 14th and 21th days of the evaluation. The 7th day group also presented the lowest eosinophil numbers. Vaginal epithelium features were: 4th and 7th day groups presented non-keratinized stratified epithelium with 5 and 2 cell layers, respectively. The 14th and 21st day groups presented non-keratinized stratified epithelium with 14 and 15 cell layers. CONCLUSION: Experimental ovarian autografts in the evaluated organs presented maximum estrogen activity after the 21st day of surgery, according to morphological and morphometric data.