Subsequent Recall Research Articles

Hippocampal-cortical interactions during event boundaries support retention of complex narrative events

According to most memory theories, encoding involves continuous communication between the hippocampus and neocortex, but recent work has shown that key moments at the end of an event, called event boundaries, may be especially critical for memory formation. We sought to determine how communication between the hippocampus and neocortical regions during the encoding of naturalistic events related to subsequent retrieval of those events and whether this was particularly important at event boundaries. Participants encoded and recalled two cartoon movies during fMRI scanning. Higher functional connectivity between the hippocampus and the posterior medial network (PMN) at an event's offset is related to the subsequent successful recall of that event. Furthermore, hippocampal-PMN offset connectivity also predicted the amount of detail retrieved after a 2-day delay. These data demonstrate that the relationship between memory encoding and hippocampal-neocortical interaction is dynamic and biased toward boundaries.

Converging diencephalic and hippocampal supports for episodic memory

To understand the neural basis of episodic memory it is necessary to appreciate the significance of the fornix. This pathway creates a direct link between those temporal lobe and medial diencephalic sites responsible for anterograde amnesia. A collaboration with Andrew Mayes made it possible to recruit and scan 38 patients with colloid cysts in the third ventricle, a condition associated with variable fornix damage. Complete fornix loss was seen in three patients, who suffered chronic long-term memory problems. Volumetric analyses involving all 38 patients then revealed a highly consistent relationship between mammillary body volume and the recall of episodic memory. That relationship was not seen for working memory or tests of recognition memory. Three different methods all supported a dissociation between recollective-based recognition (impaired) and familiarity-based recognition (spared). This dissociation helped to show how the mammillary body-anterior thalamic nuclei axis, as well as the hippocampus, is vital for episodic memory yet is not required for familiarity-based recognition. These findings set the scene for a reformulation of temporal lobe and diencephalic amnesia. In this revised model, these two regions converge on overlapping cortical areas, including retrosplenial cortex. The united actions of the hippocampal formation and the anterior thalamic nuclei on these cortical areas enable episodic memory encoding and consolidation, impacting on subsequent recall.

Reminder-dependent alterations in long-term declarative memory expression

The reminder of a previously-learned memory can render that memory vulnerable to disruption or change in expression. Such memory alterations have been viewed as supportive of the framework of memory reconsolidation. However, alternative interpretations and inconsistencies in the replication of fundamental findings have raised questions particularly in the domain of human declarative memory. Here we present a series of related experiments, all of which involve the learning of a declarative memory, followed 1–2 days later by memory reminder. Post-reminder learning of interfering material did result in modulation of subsequent recall at test, but the precise manifestation of that interference effect differed across experiments. With post-reminder performance of a visuospatial task, a quantitative impairment in test recall performance was observed within a visual list-learning paradigm, but not in a foreign vocabulary learning paradigm. These results support the existence of reminder-induced memory processes that can lead to the alteration of subsequent memory performance by interfering tasks. However, it remains unclear whether these effects are reflective of modulation or impairment of the putative memory reconsolidation process.

Bi-parametric prostate MRI with a recall system for contrast enhanced imaging: Improving accessibility while maintaining quality

PurposeTo review the efficacy of a recall system for bi-parametric non-contrast prostate MRI (bp-MRI). MethodsA bi-parametric protocol was instituted in July 2020 for all patients who had a prostate MRI requested, excluding those after treatment of prostate cancer, patients with hip prosthesis or pacemaker, and those who lived out-of-town. The protocol consisted of tri-planar T2-weighted and diffusion weighted images (DWI) (b = 50, 800 s/mm2 for ADC map; b = 1,500 s/mm2 acquired separately) in accordance with the Prostate Imaging Reporting & Data system (PI-RADS) v2.1 guidelines. After interpretation of bp-MRI exams, patients with equivocal (PI-RADS 3) lesions in peripheral zone (PZ) or any technical limitations were recalled for contrast administration. ResultsOut of 909 bp-MRI scans performed from July 2020 to April 2021, only 52 (5.7 %) were recalled, of which 46 (88.5 %) attended. Amongst these, 41/52 (78.8 %) were recalled for PZ PI-RADS 3 lesions, while the rest of 11 (21.2 %) cases were recalled for technical reasons. Mean time to subsequent recall scan was 11.6 days. On assessment of post-contrast imaging, 29/46 (63 %) cases were upgraded to PI-RADS 4 while 17/46 (37 %) remained PI-RADS 3. This system avoided contrast-agent use in 857 patients, with contrast cost savings of €64,620 (US$68,560) and 214 hours 15 minutes of scanner time was saved. This allowed 255 additional bp-MRI scans to be performed, reducing the waitlist from 1 year to 2–3 weeks. ConclusionA bi-parametric prostate MRI protocol with a robust recall system for contrast administration not only saved time eliminating the marked backlog but was also more cost efficient without compromising the quality of patient care.

Do Judgments of Learning Impair Recall When Uninformative Cues Are Salient?

Judgments of learning (JOL) are one of the most commonly used measures of metamemory. There is mixed evidence that eliciting JOLs while participants are studying word pairs influences their subsequent recall, a phenomenon known as reactivity. The majority of studies have found that positive reactivity occurs when word pairs are related. This finding suggests that when the final test is sensitive to the cues used to make a JOL (e.g., pair relatedness), a benefit to recall is observed. Here, in three experiments, JOL reactivity is examined in the presence of a salient, yet non-diagnostic cue-font size. The results show that when study time is limited and font size is made salient, eliciting JOLs impairs future recall. It is argued that JOLs prompt participants to evaluate salient cues in the learning environment to evaluate whether they will affect future recall. This increased processing of salient cues can impair recall if it comes at the expense of processing less salient but more informative cues. These findings suggest that the relevance to the test of the cues processed when JOLs are performed determines the direction of reactivity effects, with both positive and negative reactivity being possible depending on how diagnostic the salient metacognitive cues are for recall.

A recurrent neural network model of prefrontal brain activity during a working memory task.

When multiple items are held in short-term memory, cues that retrospectively prioritise one item over another (retro-cues) can facilitate subsequent recall. However, the neural and computational underpinnings of this effect are poorly understood. One recent study recorded neural signals in the macaque lateral prefrontal cortex (LPFC) during a retro-cueing task, contrasting delay-period activity before (pre-cue) and after (post-cue) retrocue onset. They reported that in the pre-cue delay, the individual stimuli were maintained in independent subspaces of neural population activity, whereas in the post-cue delay, the prioritised items were rotated into a common subspace, potentially allowing a common readout mechanism. To understand how such representational transitions can be learnt through error minimisation, we trained recurrent neural networks (RNNs) with supervision to perform an equivalent cued-recall task. RNNs were presented with two inputs denoting conjunctive colour-location stimuli, followed by a pre-cue memory delay, a location retrocue, and a post-cue delay. We found that the orthogonal-to-parallel geometry transformation observed in the macaque LPFC emerged naturally in RNNs trained to perform the task. Interestingly, the parallel geometry only developed when the cued information was required to be maintained in short-term memory for several cycles before readout, suggesting that it might confer robustness during maintenance. We extend these findings by analysing the learning dynamics and connectivity patterns of the RNNs, as well as the behaviour of models trained with probabilistic cues, allowing us to make predictions for future studies. Overall, our findings are consistent with recent theoretical accounts which propose that retrocues transform the prioritised memory items into a prospective, action-oriented format.

Previous infection with seasonal coronaviruses does not protect male Syrian hamsters from challenge with SARS-CoV-2

SARS-CoV-2 variants and seasonal coronaviruses continue to cause disease and coronaviruses in the animal reservoir pose a constant spillover threat. Importantly, understanding of how previous infection may influence future exposures, especially in the context of seasonal coronaviruses and SARS-CoV-2 variants, is still limited. Here we adopted a step-wise experimental approach to examine the primary immune response and subsequent immune recall toward antigenically distinct coronaviruses using male Syrian hamsters. Hamsters were initially inoculated with seasonal coronaviruses (HCoV-NL63, HCoV-229E, or HCoV-OC43), or SARS-CoV-2 pango B lineage virus, then challenged with SARS-CoV-2 pango B lineage virus, or SARS-CoV-2 variants Beta or Omicron. Although infection with seasonal coronaviruses offered little protection against SARS-CoV-2 challenge, HCoV-NL63-infected animals had an increase of the previously elicited HCoV-NL63-specific neutralizing antibodies during challenge with SARS-CoV-2. On the other hand, primary infection with HCoV-OC43 induced distinct T cell gene signatures. Gene expression profiling indicated interferon responses and germinal center reactions to be induced during more similar primary infection-challenge combinations while signatures of increased inflammation as well as suppression of the antiviral response were observed following antigenically distant viral challenges. This work characterizes and analyzes seasonal coronaviruses effect on SARS-CoV-2 secondary infection and the findings are important for pan-coronavirus vaccine design.

The Effectiveness of Paracetamol to Reduce the Post-Vaccination SARS-CoV-2 Adverse Effects in an Italian Vaccination Center.

The arrival of specific vaccines was crucial for the eradication of COVID-19. Despite the security of the vaccination, the administration of COVID-19 mRNA vaccines often causes systemic side effects for a short time after the injection, such as headache, fatigue, fever, muscle pain and nausea. These side effects can limit the adherence to COVID-19 vaccines administration, especially in healthcare workers. This study aims to analyze the impact of the prophylactic use of paracetamol to reduce the post-vaccination Comirnaty/Pfizer adverse effects. The study took place at the San Giovanni Battista Hospital in Rome and included all hospital employees who received two doses of Pfizer-BioNTech. The vaccination health personnel recommended the preventive intake of 1 g of paracetamol before the inoculation of the vaccine and then every 6 h in the first 24 h. Information was collected through forms and subsequent telephone recall. A total of 403 volunteers were involved in the study, with 391 of them receiving two doses and twelve individuals only one dose of the vaccine. The main results demonstrated that the prophylactic therapy influenced the lower onset of asthenia in the first and second doses. However, there were no significant differences between the two groups in terms of fever, headache and localized pain. Paracetamol had a good impact on the side effect of COVID-19 vaccination, reducing asthenia in both doses and mitigating the total of symptoms during the second vaccination.

Can you accurately monitor your behaviors while multitasking? The effect of multitasking on metacognition.

With the pace of life accelerating, multitasking has become the norm in daily life. According to research, multiple cognitive processes, including numerical reasoning, comprehension, and writing, are negatively affected by multitasking. However, only a few studies have investigated the relationship between multitasking and metacognition. In this study, the effect of multitasking on metacognition was examined using a prospective monitoring paradigm (prediction of subsequent recall performance). In Experiment 1, the participants simultaneously studied word pairs (primary task) and differentiated between different sound pitches (secondary task) and then predicted their performance in a subsequent memory test for the studied word pairs (prospective metacognitive monitoring). The accuracy of metacognitive evaluation with multitasking was then compared with that without multitasking. In Experiment 2, sounds and icons of real-life applications were used to improve the ecological validity of the experiment in the secondary task. The results indicated that multitasking impaired metacognition in both artificial and real-life simulated scenarios. In addition, the participants who engaged in more media multitasking in their daily lives exhibited poorer metacognitive monitoring abilities in single tasks.

The association between working memory precision and the nonlinear dynamics of frontal and parieto-occipital EEG activity

Electrophysiological working memory (WM) research shows brain areas communicate via macroscopic oscillations across frequency bands, generating nonlinear amplitude modulation (AM) in the signal. Traditionally, AM is expressed as the coupling strength between the signal and a prespecified modulator at a lower frequency. Therefore, the idea of AM and coupling cannot be studied separately. In this study, 33 participants completed a color recall task while their brain activity was recorded through EEG. The AM of the EEG data was extracted using the Holo-Hilbert spectral analysis (HHSA), an adaptive method based on the Hilbert-Huang transforms. The results showed that WM load modulated parieto-occipital alpha/beta power suppression. Furthermore, individuals with higher frontal theta power and lower parieto-occipital alpha/beta power exhibited superior WM precision. In addition, the AM of parieto-occipital alpha/beta power predicted WM precision after presenting a target-defining probe array. The phase-amplitude coupling (PAC) between the frontal theta phase and parieto-occipital alpha/beta AM increased with WM load while processing incoming stimuli, but the PAC itself did not predict the subsequent recall performance. These results suggest frontal and parieto-occipital regions communicate through theta-alpha/beta PAC. However, the overall recall precision depends on the alpha/beta AM following the onset of the retro cue.

Repeated guessing attempts during acquisition can promote subsequent recall performance.

Taking a pretest before to-be-learned material is studied can improve long-term retention of the material relative to material that was initially only studied. Using weakly associated word pairs (Experiments 1 and 3), Swahili-German word pairs (Experiment 2), and prose passages (Experiment 4) as study material, the present study examined whether this pretesting effect is modulated in size when pretests are repeatedly administered during acquisition. All four experiments consistently showed the typical pretesting effect, with enhanced recall after a single guessing attempt relative to the study-only baseline. Critically, the pretesting effect increased in size when multiple guessing attempts were made during acquisition, regardless of whether the duration of the pretesting phase increased with the number of guesses (Experiments 1, 2, and 4) or was held constant (Experiment 3). The results of Experiment 4 also indicate that neither a single guessing attempt nor multiple guessing attempts easily induce the transfer of learning to previously studied but untested information. Together, the findings demonstrate that additional guesses can promote access to the pretested target material on the final test, suggesting that in educational contexts, extensive pretesting during acquisition may serve as an effective learning strategy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Age-related differences in memory when offloading important information.

People can choose to use external memory aids and offload information to help them remember it, but it is unclear how objective and subjective value or importance influence offloading decisions in younger and older adults. We presented younger adults (n = 99; age range: 18-31) and older adults (n = 93; age range: 60-96) with items to remember for a later test and allowed them to offload a subset of the presented items. In Experiment 1, the to-be-remembered information was lists of associated words paired with point values counting toward participants' scores if recalled. In Experiment 2, the to-be-remembered information was lists of items along a theme, such as packing for vacation, which differed in subjective value. Results revealed that when words were paired with objective point values, younger adults were more selective in their offloading decisions and subsequent recall than older adults (i.e., younger adults were more likely to offload and recall high-value items than low-value items relative to older adults). When the to-be-remembered items instead differed in subjective value, older adults were more selective in their offloading decisions than younger adults. Specifically, older adults were more likely to offload words they rated as important relative to items they rated as less important while younger adults displayed the opposite pattern-younger adults were more likely to offload words they rated as less important compared with items they rated as more important. This difference in offloading tendencies when to-be-remembered information varies in subjective value may be indicative of older adults engaging in a form of metacognitive control that can help ensure the use of responsible remembering. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Intermacs quarterly report analysis to monitor longitudinal outcomes in a centrifugal flow assist device

In June 2021, HVAD System distribution ceased due to observational data demonstrating increased mortality and neurological events compared to another commercial device, and a device malfunction with delay or failure to restart, especially in certain subpopulations. To assess ongoing risk for patients on support following subsequent device recalls, the manufacturer's Intermacs HVAD System 2022 Quarterly Reports were queried to identify mortality and adverse events trends in a contemporary cohort of 3110 primary HVAD implantations since October 2017, stratified by year-of-implant. Mean duration of support was 21±16months, with 33% alive on original device, 25% transplanted, 6% undergoing device exchange, 4% recovered, and 32% expired. Kaplan-Meier and event-per-patient-year estimates for survival, freedom from device explant, stroke, and pump thrombus were similar across year-of-implant. Following market withdrawal and recent device recalls, there appears to be no increase in mortality, stroke, pump thrombus, or explant for HVAD-supported patients. Quarterly report monitoring is ongoing.

Read carefully, because this is important! How value-driven strategies impact sentence memory.

Little is understood about how people strategically process and remember important but complex information, such as sentences. In the current study, we asked whether people can effectively prioritize memory for sentences as a function of their relative importance (operationalized as a reward point value) and whether they do so, in part, by changing their sentence processing strategies when value information is available in advance. We adapted the value-directed remembering paradigm (Castel, Psychol Learn Motiv 48:225-270, 2007) for sentences that varied in constraint and predictability. Each sentence was associated with a high or low value for subsequent free recall (whole sentence) and recognition (sentence-final words) tests. Value information appeared after or before each sentence as a between-subject manipulation. Regardless of condition, we observed that high-value sentences were recalled more often than low-value sentences, showing that people can strategically prioritize their encoding of sentences. However, memory patterns differed depending on when value information was available. Recall for high-value sentences that ended unexpectedly (and therefore violated one's predictions) was reduced in the Before compared to the After condition. Before condition participants also showed a greater tendency to false alarm to lures (words that were the predicted - but not obtained - ending) from strongly constraining sentences. These observations suggest that when people try to prioritize sentence-level information that they know is valuable, the reading strategies they employ may paradoxically lead to worse memory.

Suppression-Induced Forgetting as a Model for Repression.

The Think/No-Think (T/NT) task was designed to test whether the deliberate avoidance of retrieving a memory (i.e., suppression) hinders the subsequent recall of that memory. Forgetting effects obtained with the T/NT-task (Suppression-Induced Forgetting) are thought to result from memory inhibition: the deactivation of the representation of the to-be-suppressed memory. Memory inhibition can be specifically inferred from decreased performance on a test using Independent Probes-cues that are unrelated to the initial study phase in the T/NT-procedure. The present contribution explores the evidence for the idea that Suppression-Induced Forgetting obtained with such Independent Probes may provide a viable model for repression. A review of the literature on Suppression-Induced Forgetting with Independent Probes (SIF-IP) suggests that reliable estimates of the overall effect size are unavailable, that the extent to which the literature suffers from publication bias is unknown and that reporting bias may obstruct a clear view of the percentage of studies that find a statistically significant effect. In addition, it is difficult to study SIF-IP in autobiographical memories, due to their complexity and idiosyncrasy. All in all, it seems questionable whether suppression-induced forgetting obtained with independent probes provides a viable model of repression.

Learning new words via feedback-Association between feedback-locked ERPs and recall performance-An exploratory study.

Feedback learning is thought to involve the dopamine system and its projection sites in the basal ganglia and anterior cingulate cortex (ACC), regions associated with procedural learning. Under certain conditions, such as when feedback is delayed, feedback-locked activation is pronounced in the medial temporal lobe (MTL), which is associated with declarative learning. In event-related potential research, the feedback-related negativity (FRN) has been linked to immediate feedback processing, while the N170, possibly reflecting MTL activity, has been related to delayed feedback processing. In the current study, we performed an exploratory investigation on the relation between N170 and FRN amplitude and memory performance in a test for declarative memory (free recall), also exploring the role of feedback delay. To this end, we adapted a paradigm in which participants learned associations between non-objects and non-words with either immediate or delayed feedback, and added a subsequent free recall test. We indeed found that N170, but not FRN amplitudes, depended on later free recall performance, with smaller amplitudes for later remembered non-words. In an additional analysis with memory performance as dependent variable, the N170, but not the FRN amplitude predicted free recall, modulated by feedback timing and valence. This finding shows that the N170 reflects an important process during feedback processing, possibly related to expectations and their violation, but is distinct from the process reflected by the FRN.

Concurrent- and After-Effects of Medial Temporal Lobe Stimulation on Directed Information Flow to and from Prefrontal and Parietal Cortices during Memory Formation.

Electrical stimulation of the medial temporal lobe (MTL) has the potential to uncover causal circuit mechanisms underlying memory function. However, little is known about how MTL stimulation alters information flow with frontoparietal cortical regions implicated in episodic memory. We used intracranial EEG recordings from humans (14 participants, 10 females) to investigate how MTL stimulation alters directed information flow between MTL and PFC and between MTL and posterior parietal cortex (PPC). Participants performed a verbal episodic memory task during which they were presented with words and asked to recall them after a delay of ∼20 s; 50 Hz stimulation was applied to MTL electrodes on selected trials during memory encoding. Directed information flow was examined using phase transfer entropy. Behaviorally, we observed that MTL stimulation reduced memory recall. MTL stimulation decreased top-down PFC→MTL directed information flow during both memory encoding and subsequent memory recall, revealing aftereffects more than 20 s after end of stimulation. Stimulation suppressed top-down PFC→MTL influences to a greater extent than PPC→MTL. Finally, MTL→PFC information flow on stimulation trials was significantly lower for successful, compared with unsuccessful, memory recall; in contrast, MTL→ventral PPC information flow was higher for successful, compared with unsuccessful, memory recall. Together, these results demonstrate that the effects of MTL stimulation are behaviorally, regionally, and directionally specific, that MTL stimulation selectively impairs directional signaling with PFC, and that causal MTL-ventral PPC circuits support successful memory recall. Findings provide new insights into dynamic casual circuits underling episodic memory and their modulation by MTL stimulation.SIGNIFICANCE STATEMENT The medial temporal lobe (MTL) and its interactions with prefrontal and parietal cortices (PFC and PPC) play a critical role in human memory. Dysfunctional MTL-PFC and MTL-PPC circuits are prominent in psychiatric and neurologic disorders, including Alzheimer's disease and schizophrenia. Brain stimulation has emerged as a potential mechanism for enhancing memory and cognitive functions, but the underlying neurophysiological mechanisms and dynamic causal circuitry underlying bottom-up and top-down signaling involving the MTL are unknown. Here, we use intracranial EEG recordings to investigate the effects of MTL stimulation on causal signaling in key episodic memory circuits linking the MTL with PFC and PPC. Our findings have implications for translational applications aimed at realizing the promise of brain stimulation-based treatment of memory disorders.

In sight, out of mind? Disengagement at encoding gradually reduces recall of location.

Disengaging from the external world-a phenomenon referred to as mind wandering-is a common experience that has been shown to be associated with detriments in cognitive performance across a large range of tasks. In the current web-based study, we used a continuous delayed estimation paradigm to investigate the impact of task disengagement at encoding on subsequent recall of location. Task disengagement was assessed with thought probes on a dichotomous (off- vs. on-task) and a continuous response scale (from 0% to 100% on-task). This approach allowed us to consider perceptual decoupling in both a dichotomous and a graded manner. In the first study (n = 54), we found a negative relationship between levels of task disengagement at encoding and subsequent recall of location measured in degrees. This finding supports a graded perceptual decoupling process rather than a decoupling that happens in an all-or-none manner. In the second study (n = 104), we replicated this finding. An analysis of 22 participants showing enough off-task trials to fit the data with the standard mixture model revealed that in this particular subsample, being disengaged from the task at encoding was related to worse long-term memory performance in terms of likelihood to recall but not in terms of precision with which information is recalled. Overall, the findings suggest a graded nature of task disengagement that covaries with fine-grained differences in subsequent recall of location. Going forwards, it will be important to test the validity of continuous measures of mind-wandering.

Can children and adolescents with ADHD use attention to maintain verbal information in working memory?

Children and adolescents with attentional-deficit/hyperactivity disorder (ADHD) present deficits in working memory (WM), but accounts for this phenomenon are still lacking. In this study, we used two variations of a complex-span task to test whether a specific WM mechanism, attentional refreshing, causes these deficits. Attentional refreshing is a maintenance strategy based on the sequential switch of attention between maintaining and processing information in WM. Its use is evidenced by a decrease in recall performance proportional to the distraction of attention away from the memoranda. In this study, we designed two experiments requiring children and adolescents with ADHD symptoms to maintain sequences of letters for subsequent recall, while performing a distracting task. In Experiment 1, the distracting task consisted of reading digits aloud. In Experiment 2, it consisted in making spatial judgements. The pace of the distracting tasks was varied to manipulate the level of attentional distraction. We observed that recall in ADHD participants was higher in the distracting conditions that give attention more opportunity to refresh letters. Moreover, ADHD participants had a similar recall performance to their age-matched typically developing peers. This study shows first evidence that individuals with ADHD can use attention to maintain verbal information in WM and calls for more research to understand their WM development.

Recall of substandard medicines in Brazil during the period 2010–2018

BackgroundEven with all the care taken during the production process, the pharmaceutical industries are still subject to manufacturing medicines with quality deviations, generating commercialized products without the required quality and necessitating their subsequent recall from the market. The objective of this study was to evaluate the reasons that led to the recall of medicines in Brazil in the period evaluated.MethodsThis is a descriptive study (using document analysis), on the recall of substandard medicines registered on the website of the National Health Surveillance Agency (ANVISA), from 2010 to 2018. The variables studied were the type of medicine (reference, generic, similar, specific, biological, herbal, simplified notification, new and radiopharmaceutical), type of pharmaceutical dosage form (solid, liquid, semi-solid and parenteral preparation), and reason for recall (Good manufacturing practices, quality and quality/good manufacturing practices).ResultsA total of n = 3,056 recalls of substandard medicine were recorded. Similar medicines had a higher recall index (30.1%), followed by generics (21.3%), simplified notification (20.7%) and reference (12.2%). Different dosage forms had similar recalls: solids (35.2%), liquids (31.2%) and parenteral preparations (30.0%), with the exception of semi-solids (3.4%). The reasons for the highest occurrences were related to good manufacturing practices (58.4%) and quality (40.4%).ConclusionThe probable cause for this high number of recalls is the fact that, even with all the quality controls and processes in accordance with good manufacturing practices, errors can occur, both human and in automated processes, thus causing the release of batches that should not have been approved. In summary, it is necessary for manufacturers to implement a robust and well structured quality system in order to avoid such deviations, and it is up to ANVISA to apply greater oversight in the post marketing of these products.