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MAIN CONCLUSION: Open-Top Chambers should be more used in tropical ecosystems to study climate change effects in plants as they are still insufficient to extract plant response patterns in these ecosystems. Understanding flora response to climate change (CC) is critical for predicting future ecosystem dynamics. Open-Top Chambers (OTCs) have been widely used to study the effects of CC on plants and are very popular in temperate ecosystems but are still underused in tropical regions. In this systematic review, we aimed to discuss the use of OTCs in the study of the effects of different agents of climate change on tropical flora by presenting scientometric data, discussing the technical aspects of its use and enumerating some observations on plant response patterns to climatic alterations in the tropics. Our analysis indicated that the bottleneck in choosing an OTC shape is not strictly related to its purpose or the type of parameter modulated; instead, passive or active approaches seem to be a more sensitive point. The common critical point in using this technique in warmer regions is overheating and decoupling, but it can be overcome with simple adaptations and extra features. The most frequently parameter modulated was CO2, followed by O3 and temperature. The plant families with more representatives in the studies analyzed were Fabaceae, Myrtaceae, and Poaceae, and the most represented biome was tropical and subtropical moist broadleaf forests. In conclusion, OTCs are a valuable and feasible tool to study CC effects on various tropical ecosystems, regardless of structure, active/passive approach, or other technical features. One of the primary advantages of this methodology is its applicability for in situ use, eliminating the need for plant transplantation. We encourage studies using OTC experimental design for plant conservation in the tropics.
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Mudança Climática , Fabaceae , Ecossistema , Poaceae , TemperaturaRESUMO
Global warming and changes in land use are some of the main threats to high mountain species. Both can interact in ways not yet assessed. In this study, we evaluated the photosynthetic responses of six common páramo species within a warming experiment using open-top chambers (OTC) in conserved páramo areas with different land use histories. We did not find significant differences in the photochemical performance of the species as measured through Fv/Fm, ETR, and NPQ in response to passive warming, indicating that warmed plants are not stressed. However, NPQ values were higher in recovering areas, especially in the driest and warmest months. Leaf transpiration, stomatal conductance, and Ci were not affected by the OTC or the land use history. The photosynthetic capacity, maximum photosynthetic capacity, and carboxylation rate of RuBisCO increased in response to warming but only in the area with no anthropogenic intervention. These results suggest that species will respond differently to warming depending on the history of páramo use, and therefore not all páramo communities will respond equally to climate change. In disturbed sites with altered soil conditions, plants could have a lower breadth of physiological response to warming.
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Warmer temperatures predicted as a result of climate change will have an impact on milpa. An experiment was carried out with induced passive heat with the objective of simulating the increase in temperature on the physiological, morphological, and yield parameters of milpa from different climates of San Luis Potosí, Mexico. Two different environments, Open-top chambers (OTC) and control, and three milpas, from warm-dry, temperate, and hot and humid climates, were studied. A total of 12 experimental units of 13.13 m2 were used in the random design, with a factorial arrangement of 2 × 3 and two replications. Abiotic variables (minimum, maximum, and mean daily temperatures and accumulated heat units) were determined and compared between the two environments and confirmed that the OTC increased the abiotic variables. The growth and development parameters increased under the warming effect. Furthermore, the milpa from hot and humid climate was the least affected. In contrast, the warming considerably delayed yield parameters. The squash suffered the most, while the bean benefited the most. The warming affected the chlorophyll fluorescence and gas exchange differently for each crop. However, at an early stage, the maximum photochemical efficiency (Fv/Fm) and non-photochemical quenching (qN) for bean and maize were reduced, while at a late stage, they were Fv/Fm, photochemical quenching (qP), and qN for maize; stomatal conductance and transpiration rate of the squash were improved under the warming treatments. In conclusion, the warming delayed the yield and photosynthetic parameters, while growth and development benefited. The milpa systems were differently affected by warming.
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Resumen La automedicación y la autoprescripción son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violación a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicación en realidad lo son de la autoprescripción.
Abstract Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription.
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Humanos , Autocuidado/métodos , Automedicação , Autoadministração , Medicamentos sob Prescrição/administração & dosagem , Atitude do Pessoal de SaúdeRESUMO
Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription.La automedicación y la autoprescripción son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violación a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicación en realidad lo son de la autoprescripción.
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Medicamentos sob Prescrição/administração & dosagem , Autoadministração , Autocuidado/métodos , Automedicação , Atitude do Pessoal de Saúde , HumanosRESUMO
BACKGROUND: The consumption of psychotropic drugs without a medical prescription is a growing public health problem worldwide. Misuse or indiscriminate use involves several risks. OBJECTIVE: To determine sociodemographic factors and behaviors associated with the consumption of psychotropic drugs without prescription in Chile. METHODS: This is a descriptive study based on the data of the XI National Study of Drugs in the General Population in Chile, carried out in the population between 12 and 64 years old (n = 19 512) during 2014. Prevalence was estimated, and a multivariate logistic regression model was adjusted. Also, a multiple correspondence analysis was performed. RESULTS: The prevalence of psychotropic drug use was 2.3%. In the studied population, associated risk factors are female sex (odds ratio: 1.4; 95% confidence interval: 1.16 to 1.77); ages between 20-29 (odds ratio: 1.4; 95% confidence interval: 0.98 to 2.26) and 40-49 (odds ratio: 1.8; 95% confidence interval: 1.19 to 2.75); consumption of marijuana (odds ratio: 3.0; 95% confidence interval: 3.32 to 3.97), cocaine or crack (odds ratio: 3.7; 95% confidence interval: 2.45 to 5.70); tobacco (odds ratio: 1.4; 95% confidence interval: 1.17 to 1.78); alcohol (odds ratio: 1.3; 95% confidence interval: 1.11 to 1.73); and poor health perception (odds ratio: 1.8; 95% confidence interval: 1.51 to 2.28). Military personnel used more pain and cough medication; young women between 19 to 25 years old used stimulants; the population between 45 to 64 years had a bad perception of health associated with the use of tranquilizers; and men between 12 and 18 years used illicit drugs. CONCLUSIONS: The prevalence found in the different groups is consistent with data reported in Latin America, showing the relationship between the use of non-prescription psychotropic drugs with sociodemographic factors, risk behaviors, and the identification of consumption profiles.
ANTECEDENTES: El consumo de psicofármacos sin receta médica es un problema creciente de salud pública en todo el mundo, su uso indebido implica una serie de riesgos. OBJETIVO: Determinar factores sociodemográficos y conductas asociadas al consumo de psicofármacos sin receta en Chile. MÉTODOS: Estudio descriptivo a partir de los datos del XI Estudio Nacional de Drogas en Población General en Chile, año 2014, realizado en población entre 12 y 64 años (n = 19 512). Se estimó la prevalencia y se ajustó un modelo multivariado de regresión logística. Además, se realizó análisis de correspondencia múltiple. RESULTADOS: La prevalencia de consumo de psicofármacos fue 2,3%. En población estudiada, los factores asociados son sexo femenino (Odds ratio: 1,4; intervalo de confianza 95%: 1,16 a 1,77), edades entre 20 y 29 (Odds ratio: 1,4; intervalo de confianza 95%: 0,98 a 2,26) y 40 y 49 años (Odds ratio: 1,8; intervalo de confianza 95%: 1,19 a 2,75), consumo de: marihuana (Odds ratio: 3,0; intervalo de confianza 95%: 3,32 a 3,97), cocaína o pasta base (Odds ratio: 3,7; intervalo de confianza 95%: 2,45 a 5,70), tabaco (Odds ratio: 1,4; intervalo de confianza 95%: 1,17 a 1,78), alcohol (Odds ratio: 1,3; intervalo de confianza 95%: 1,11 a 1,73) y mala percepción de salud (Odds ratio: 1,8; intervalo de confianza 95%: 1,51 a 2,28). De los perfiles, se vinculó a población de fuerzas armadas con consumo de analgésicos y antitusivos, a jóvenes de 19 a 25 años con consumo de estimulantes, a población de 45 a 64 años con mala percepción de salud asociada al consumo de tranquilizantes y a hombres de 12 a 18 años con uso de sustancias psicoactivas. CONCLUSIÓN: Las prevalencias halladas concuerdan con datos en Latinoamérica, permitiendo evidenciar la relación que existe entre el consumo de psicofármacos con factores sociodemográficos, conductas de riesgo e identificación de perfiles de consumo.
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Consumo de Bebidas Alcoólicas/epidemiologia , Drogas Ilícitas , Psicotrópicos/administração & dosagem , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Chile/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Assunção de Riscos , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
Abstract X-linked ornithine transcarbamylase deficiency (OTCD) is the most common urea cycle disorder. Hemizygous males with complete deficiency manifest neonatal acute hyperammonemia, while those with partial deficiency have a late presentation. The symptomatology of heterozygotes depends on the inactivation pattern of X chromosome. Hyperammonemic episodes can cause neurological damage and are potentially fatal. Here, we match clinical, biochemical, and molecular findings with bioinformatics analyses to report genotype-phenotype correlations in 14 Argentine patients with OTCD from 11 unrelated families: 4 hemizygotes with neonatal onset (complete OTC gene deletion, 533C > T, c.540+1G > A, c.697delG); 4 hemizygotes with late onset (c.216+1G > A, c.386G > A, c.622G > A, c.829C > T); and 6 symptomatic heterozygotes (complete OTC gene deletion, c.533C > T, c.452T > G, c.540+1G > A, dupE1-9/delE10). Three of these mutations were previously unreported: c.540+1G > A, c.697delG, and dup1-9/del10. Our data highlight the relevance of combining molecular and bioinformatics analyses for accurate diagnosis and outcome prediction in suspected patients with OTCD and the importance of carrier testing for effective genetic counseling.
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Objetivo: Entender o impacto econômico que os medicamentos isentos de prescrição (MIPs) exercem nos sistemas de saúde e populações da Europa e Américas, em especial no Brasil. Métodos: Revisão bibliográfica cobrindo um período de 20 anos, com artigos identificados pelos serviços PubMed e Lilacs, contendo os termos "automedicação", "medicamentos isentos de prescrição" e "economias", e seus equivalentes na língua inglesa. Resultados: Existe carência na literatura de estudos sobre os impactos econômicos que os MIPs trazem aos países e à sociedade. Os estudos e estatísticas mais abrangentes estão compilados pelas três maiores associações de produtores de MIPs no mundo e demonstram uma aceleração das reclassificações e geração de economias relevantes. No Brasil, um estudo de 2015 utilizando hipóteses conservadoras estimou um impacto orçamentário positivo dos MIPs no Sistema Único de Saúde (SUS) de R$ 364 milhões, aproximadamente US$ 117 milhões. Esse é o único estudo identificado cujo objetivo foi fazer uma quantificação econômica no país. Conclusão: Neste momento em que a RDC nº 98/2016 dá a possibilidade para a reclassificação como MIP de um grande número de substâncias farmacêuticas, é imperativo que sejam feitos estudos robustos que estimem todos os impactos econômicos a serem esperados, que poderão servir como elementos para as análises técnicas a serem conduzidas e até mesmo para atribuir graus de prioridade a elas.
Objective: To understand the economic impact of over-the-counter medicines (OTC) medications on healthcare systems and the population in Europe and the Americas, with special focus in Brazil. Methods: Bibliographic review covering a 20-year timeframe. The articles were identified through the PubMed and Lilacs services, containing the terms "self-medication", "over-the-counter" and "savings", and their equivalents in Portuguese. Results: There is lack of publications focused on the economic impact that medicines can bring to the countries and the society. The most complete studies and statistics have been compiled by the three most important OTC manufacturers associations in the world and show an acceleration in switches and significant savings generated. In Brazil, a 2015 paper using conservative assumptions estimated a positive economic impact of OTC to the Brazilian Healthcare System (SUS) of R$ 364 million, about US$ 117 million. This is the only study that had the goal of an economic impact quantification conducted in the country. Conclusion: The new regulation RDC nº 98/2016 gives the possibility for the switch of many substances from prescription to OTC and it is imperative that robust studies are conducted to uncover all the impacts that can be expected, providing inputs for technical evaluations and even to attribute priority levels to them.
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Humanos , Economia e Organizações de Saúde , Medicamentos sem Prescrição , AutomedicaçãoRESUMO
Antibiotics are widely used in poultry production for the treatment of bacterial diseases. However, residues may remain in products and by-products destined for human consumption or animal feeding. The claws of chickens, which are a by-product of the poultry industry, can directly or indirectly enter the food chain as meals destined to feed other productive animals. Thus, it becomes necessary to determine and quantify antimicrobial residues present in this matrix. The objective of the study was to assess the depletion of oxytetracycline (OTC) and its metabolite 4-epi-OTC in broiler chicken's claws. Claws of 32 broilers treated with a therapeutic dosage of 10% OTC during 7 days were analysed. Samples were taken at days 3, 9, 15 and 19 post-treatment. As for the control group, eight broiler chickens were raised under the same conditions. Extraction was carried out through EDTA-McIlvaine buffer, and clean-up employed a SPE C-18 Sep-Pak®. Instrumental analysis was performed through LC-MS/MS. The concentrations of both analytes were determined in claw samples until day 19 post-treatment. Average concentrations were within the LOD (20 µg kg-1) and LOQ (22 µg kg-1) for OTC and 84 µg kg-1 for 4-epi-OTC. Withdrawal times (WDTs) of 39 days for OTC and 54 days for 4-epi-OTC were established in claws based on 95% confidence. These findings demonstrate that claws can be a source of antimicrobial residue entry into the food chain, since the results showed that OTC and its metabolite can be found in chicken's claws for long periods, even exceeding the average lifespan of a broiler chicken.
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Antibacterianos/análise , Resíduos de Drogas/análise , Casco e Garras/química , Oxitetraciclina/análise , Ração Animal/análise , Animais , Antibacterianos/administração & dosagem , Antibacterianos/metabolismo , Biotransformação , Galinhas , Chile , Cromatografia Líquida , Resíduos de Drogas/metabolismo , Cadeia Alimentar , Humanos , Limite de Detecção , Oxitetraciclina/administração & dosagem , Oxitetraciclina/análogos & derivados , Oxitetraciclina/metabolismo , Extração em Fase Sólida , Espectrometria de Massas em TandemRESUMO
BACKGROUND: Urticarial Vasculitis (UV) is in most of the cases idiopathic; however it has been associated with several conditions and drugs. Over the counter (OTC) diet pills are widely available, even on-line, but they are rarely regulated by pharmaceutical control. CASE PRESENTATION: We present the case of a 35-year-old female patient suffering of pruriginous and painful wheals more than 1 cm in diameter, with a burning sensation. The eruption lasted more than 24 hours and was accompanied by angioedema, headache and myalgia. No remarkable medical history was found, except for previous intake of OTC diet pills. UV diagnosis was confirmed by the skin biopsy of a lesion. CONCLUSION: OTC diet pills are widely available worldwide, and due to its widespread use, allergologists and dermatologist should be able to recognize symptoms and lesions of cutaneous vasculitis, which may be under reported.
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OBJECTIVE: To prospectively characterize acute hyperammonemic episodes in patients with urea cycle disorders (UCDs) in terms of precipitating factors, treatments, and use of medical resources. STUDY DESIGN: This was a prospective, longitudinal observational study of hyperammonemic episodes in patients with UCD enrolled in the National Institutes of Health-sponsored Urea Cycle Disorders Consortium Longitudinal Study. An acute hyperammonemic event was defined as plasma ammonia level >100 µmol/L. Physician-reported data regarding the precipitating event and laboratory and clinical variables were recorded in a central database. RESULTS: In our study population, 128 patients with UCD experienced a total of 413 hyperammonemia events. Most patients experienced between 1 and 3 (65%) or between 4 and 6 (23%) hyperammonemia events since study inception, averaging fewer than 1 event/year. The most common identifiable precipitant was infection (33%), 24% of which were upper/lower respiratory tract infections. Indicators of increased morbidity were seen with infection, including increased hospitalization rates (P = .02), longer hospital stays (+2.0 days; P = .003), and increased use of intravenous ammonia scavengers (+45%-52%; P = .003-.03). CONCLUSION: Infection is the most common precipitant of acute hyperammonemia in patients with UCD and is associated with indicators of increased morbidity (ie, hospitalization rate, length of stay, and use of intravenous ammonia scavengers). These findings suggest that the catabolic and immune effects of infection may be a target for clinical intervention in inborn errors of metabolism.
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Hiperamonemia/etiologia , Infecções/complicações , Distúrbios Congênitos do Ciclo da Ureia/complicações , Doença Aguda , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Hiperamonemia/epidemiologia , Masculino , Fatores Desencadeantes , Estudos Prospectivos , Taxa de SobrevidaRESUMO
OBJECTIVE: To assess whether adding flow restrictors (FRs) to liquid medicine bottles can provide additional protection against unsupervised medication ingestions by young children, even when the child-resistant closure is not fully secured. STUDY DESIGN: In April and May 2012, we conducted a block randomized trial with a convenience sample of 110 3- and 4-year-old children from 5 local preschools. Participants attempted to remove test liquid from an uncapped bottle with an FR and a control bottle without an FR (with either no cap or an incompletely closed cap). RESULTS: All but 1 (96%; 25 of 26) of the open control bottles and 82% (68 of 83) of the incompletely closed control bottles were emptied within 2 minutes. Only 6% (7 of 110) of the bottles with FRs were emptied during the 10-minute testing period, none before 6 minutes. Overall, children removed less liquid from the bottles with FRs than from the open or incompletely closed control bottles without FRs (both P < .001). All children assigned open control bottles and 90% of those assigned incompletely closed control bottles removed ≥ 25 mL of liquid. In contrast, 11% of children removed ≥ 25 mL of liquid from uncapped bottles with FRs. Older children (aged 54-59 months) were more successful than younger children at removing ≥ 25 mL of liquid (P = .002) from bottles with FRs. CONCLUSION: Our findings suggest that adding FRs to liquid medicine bottles limits the accessibility of their contents to young children and could complement the safety provided by current child-resistant packaging.
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Embalagem de Medicamentos , Segurança do Paciente , Preparações Farmacêuticas/administração & dosagem , Intoxicação/prevenção & controle , Criança , Pré-Escolar , Qualidade de Produtos para o Consumidor , Desenho de Equipamento , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: To determine the impact of industry and Food and Drug Administration initiatives implemented to limit the use of over-the-counter (OTC) cough and cold medications in children younger than 6 years of age. STUDY DESIGN: This is a retrospective database study of OTC cough and cold medication ingestions reported to US poison centers between 2000 and 2010. Data analyzed from the National Poison Data System included the month and year of ingestion, reason for ingestion, health care utilization, and medical outcome. Ingestion frequencies were stratified by age and reason. Data were divided into pre- and postintervention periods for comparative analysis. RESULTS: Unintentional ingestions of OTC cough and cold medications decreased 33.4% and therapeutic errors by 46.0%. Health care facility referral declined for unintentional ingestions (28.9% <2 years of age, 19.9% 2-5 years of age, P < .0001) and therapeutic errors in children younger than 2 years of age (59.2%, P < .0001). Moderate and severe adverse outcomes decreased for unintentional ingestions in children younger than 2 years of age by 32.4% and by 21.3% in 2- to 5-year olds, P < .0001. CONCLUSIONS: The restriction of OTC cough and cold medications has led to a decline in unintentional ingestions, therapeutic errors, health care facility referral, and serious medical outcomes in children younger than 2 years of age. There has also been a decline in ingestions in 2- to 5-year-old children.
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Antitussígenos/intoxicação , Tosse/tratamento farmacológico , Rotulagem de Medicamentos , Medicamentos sem Prescrição/intoxicação , Centros de Controle de Intoxicações , Intoxicação/epidemiologia , Criança , Pré-Escolar , Bases de Dados Factuais , Expectorantes/intoxicação , Antagonistas dos Receptores Histamínicos/intoxicação , Humanos , Lactente , Descongestionantes Nasais/intoxicação , Segurança do Paciente , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos , United States Food and Drug AdministrationRESUMO
O presente artigo apresenta uma análise da qualidade das propagandas de medicamentos isentos de prescrição destinadas à classe médica, baseado na nova RDC no 96, de 17 de dezembro de 2008. Para análise coletou-se 16 fascículos da Revista Brasileira de Medicina (RBM) a partir de agosto 2009 a dezembro de 2010. Para averiguação da qualidade, elaborou-se um questionário dividido em três partes. Ao todo 160 peças publicitárias foram encontradas, em que 27 delas eram referentes aos medicamentos isentos de prescrição, contemplando nove indústrias farmacêuticas. Observou-se que nenhuma das peças publicitárias cumpriu na íntegra as novas regras exigidas na legislação vigente (RDC 96/08), apresentando infrações desde identificação da mesma até as proibições de figuras humanas e mensagens subjetivas. Portanto, concluiu-se que: há necessidade de implantação de um instrumento mais efetivo de fiscalização, a fim de melhorar à qualidade das propagandas para poderem ser usadas como fonte fidedigna de informação e atualização aos prescritores.
This article presents an analysis of the quality of advertisements for over-the-counter (OTC) drugs addressed to the medical profession, based on the new Anvisa resolution RDC 96 (17/12/2008). For this analysis, 16 volumes of the Brazilian Journal of Medicine (RBM) were collected, from August 2009 to December 2010. To investigate the quality of the adverts, we prepared a questionnaire divided into three parts. In total, 160 advertisements were found, of which 27 were related to drugs exempt from prescription, from 9 laboratories. It was observed that none of the advertisements complied fully with the new rules, as required by legislation (RDC 96/08), with violations ranging from identification of the advert to prohibitions of human figures and subjective messages. Therefore, it was concluded that there is a need to implement more effective monitoring, so as to improve the quality of the adverts, so they can be used as a reliable source of information and update by prescribers.
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Publicidade de Medicamentos , Legislação de Medicamentos , Medicamentos sem Prescrição/uso terapêutico , PropagandaRESUMO
OBJETIVO: Se presenta el método para diseñar etiquetas de medicamentos centrados en el usuario, aplicado a un analgésico pediátrico. MATERIAL Y MÉTODOS: El Communication Research Institute (CRI) de Australia desarrolló este método, consistente en seis etapas que cubren todos los aspectos relacionados con el diseño de una etiqueta. Para aplicarlo por primera vez al analgésico pediátrico en México, y en sociedad con el CRI, el Centro de Estudios Avanzados de Diseño realizó diversos ajustes, como la modificación del nivel de desempeño o la inclusión de preguntas al protocolo. RESULTADOS: La aplicación de este método a la etiqueta del analgésico mejoró sustancialmente la localización y comprensión de la información del medicamento en "usuarios en riesgo", lo cual garantiza que el público general obtendrá la información adecuada para automedicarse correctamente. CONCLUSIONES: La aplicación del método llevó a firmar, en 2005, las Guías de etiquetado para medicamentos de libre acceso en México.
OBJECTIVE: This study presents the application of a method to design medicine labels centred in the user and applied to a Mexican children's analgesic. MATERIAL AND METHODS: The method was developed by the Communication Research Institute (CRI) of Australia and consists of six stages that thoroughly consider all aspects related to medicine labels. This method was applied for the first time in Mexico by CRI and by the Centre for Advanced Studies in Design (CEAD), but it required a number of modifications to adjust it, like modifying the label's performance requirements and incorporating different questions to the protocol. RESULTS: The application of this method to the children's analgesic improved significantly the localization and comprehension of the information by "users at risk", which guarantees that the general public will get adequate information for correct self-medication. CONCLUSIONS: The application of this method led to sign the Guides for OTC labels in Mexico in 2006.