On the influence of faulting on small-scale soil-gas radon variability: a case study in the Iberian Uranium Province

In order to evaluate the influence of faulting on the variability of geogenic radon at detailed scale (1:2000), data on gamma ray fluxes, U and Th concentrations in rocks, radon in soil-gas and radon in groundwater were collected in three target areas on the Oliveira do Hospital region (Central Portugal). This region stands on the Iberian Uranium Province, and is dominantly composed of Hercynian granites and metasedimentary rocks of pre-Ordovician age, crosscut by faults with dominant strike N35 degrees E, N55 degrees E and N75 degrees E. Radiometric anomalies are frequent, associated with faults of the referred systems and metasedimentary enclaves; the analytical data confirms that these anomalies are produced by local high uranium contents in rocks and fault-filling materials (n=34, range 13-724 ppm), while other radiogenic elements are relatively constant (e.g. Th 4-30 ppm). Radon concentration in soil can be extremely high, up to 12,850 kBq m(-3) (n=215), with a large proportion of results above 100 kBq m(-3). Unsurprisingly, groundwater also shows high radon concentrations, with observed values in the range 150-4850 Bq.L(-1) (n=17). From the results it is concluded that metasedimentary enclaves, as well as faults, can accumulate uranium from circulating fluids, and as a consequence, strongly locally enhance geogenic radon potential. Due to this fact, for the purpose of land use planning in such uranium-enriched regions, very detailed geological mapping is needed to precisely recognize radon high risk areas. A correlation between radon concentration in soil or in groundwater and gamma ray fluxes was established pointing to the possible use of these fluxes as a first step in assessing geogenic radon potential, at least to geological setting similar to the study area.

Iodine intake in Portuguese pregnant women: results of a countrywide study

BACKGROUND

Iodine is the key element for thyroid hormone synthesis, and its deficiency, even moderate, is harmful in pregnancy, when needs are increased, because of its potential deleterious effects on fetal brain development. In Portugal, no recent data on iodine intake exists. The objective of this countrywide study was to analyze iodine status in pregnant Portuguese women in order to propose adequate measures to the health authorities.

SUBJECTS AND METHODS

Using a fast colorimetric method, urine iodine concentration (UIC) was evaluated in 3631 pregnant women followed in 17 maternity hospitals from hinterland and coastal areas in Continental Portugal and the Portuguese islands of Açores and Madeira.

RESULTS

Median UIC value was 84.9 μg/l (range 67.6-124.1) in Continental Portugal, 69.5 μg/l in Madeira, and 50.0 μg/l in Açores. The percentage of satisfactory values (>150 μg/l) was 16.8, ranging from 8.8 to 34.1 in the Continent, and being 8.2 in Madeira and 2.3 in Açores. The percentage of values below 50 μg/l was 23.7, ranging from 14.0 to 37.4 in the Continent, 33.7 in Madeira, and 50.0 in Açores.

CONCLUSIONS

Our results point to an inadequate iodine intake in pregnant women assisted in most Portuguese maternity hospitals. Considering the potential deleterious effects of inadequate iodine supply in pregnancy, iodine supplementation is strongly recommended in this period of life.

[Prevalence of analgesic consumption in the northern of Portugal]

INTRODUCTION

Analgesic drugs are frequently used in developed countries and their in take seems to be rising, despite the associated risks. Counselling about the appropriate and safe use of this medication should be based on the characterization of their consumption. The goal of this study was to evaluate the prevalence and to characterize analgesic consumption patterns in northern Portugal, analysing related socio demographic factors.

METHODS

This multicentric, observational, transversal and analytic study took place between May 2005 and May 2007, based on the lists of 45 family doctors in northern Portugal. The authors used a simple randomised sample of 4500 patients who answered a personal questionnaire. The chi-square test was used to compare proportions and the T student test and ANOVA were used to compare distributions. A significance level of 0.05 was adopted. In order to control possible confounders, a multivariate analysis was made.

RESULTS

The questionnaire was answered by 3492 adults; 30,8% (n=1077, IC 95% 29,3-32,4) of them had taken analgesics in the last fifteen days. Non steroidal anti-inflammatory drugs (NSAID) and salicilates were the most frequently consumed (66%), followed by non opioids (46,6%). Opioids were consumed by 2,7% of the analgesic users, of which the most prevalent pattern of use was the "frequent consumption" (more than three ti mes per week). Most of the patients with a "frequent consumption" pattern used them for more than three months. Age and gender were in dependent risk factors for analgesic in take; women took three times more analgesics than men and consumption rose 1,02 ti mes per year.

DISCUSSION

The methodological variability found between this and other studies limited the comparison of our results with theirs. The only study with similar methods was performed in Sweden and found a higher prevalence (35%) of analgesic intake. In studies that only evaluated NSAID consumption, the results were similar to those of this study. Most of the stu dies were concordant about the higher analgesic in take by women, but not with its rise with age.

DNA damage and metal accumulation in four tissues of feral Octopus vulgaris from two coastal areas in Portugal

The alkaline comet assay has been employed for the first time to estimate the basal DNA damage in the digestive gland, gills, kidney and gonads of Octopus vulgaris. Octopuses were captured in two coastal areas adjacent to the cities of Matosinhos (N) and Olhão (S), Portugal. The area of Matosinhos is influenced by discharges of the Douro River, city of Porto, industries and intensive agriculture, while Olhão is an important fisheries port. Previous works point to contrasting metal availability in the two coastal areas. Among the analysed tissues digestive gland presented the highest levels of Zn, Cu, Cd and Pb. Tissues of specimens from Matosinhos exhibited high levels of Cd and from Olhão enhanced Pb concentrations. The DNA damages in digestive gland, gills and kidney were more accentuated in specimens from Matosinhos than from Olhão, suggesting a stronger effect of contaminants. Elevated strand breakages were registered in digestive gland, recognised for its ability to store and detoxify accumulated metals. The DNA damages in kidney, gills and gonads were lower, reflecting reduced metal accumulation or efficient detoxification. The broad variability of damages in the three tissues may also mirror tissue function, specific defences to genotoxicants and cell-cycle turnover.

A case-control study of cardiovascular risk factors and cardiovascular risk among patients with schizophrenia in a country in the low cardiovascular risk region of Europe

INTRODUCTION

Patients with serious mental illness have increased cardiovascular risk factors and excess mortality from cardiovascular disease that are in part favored by adverse effects of treatment. Given the wide geographical variation of vascular atherosclerotic disease there is a recognized need for national studies.

METHODS

The prevalence of risk factors and estimated absolute and relative cardiovascular risk by means of SCORE risk charts were ascertained in 125 schizophrenia outpatients and 1721 age- and gender-matched primary care center users.

RESULTS

Patients with schizophrenia have a very high prevalence of cardiovascular risk factors. Higher values were observed for smoking (65.0%), clinical or laboratory dyslipidemia (59.1% and 52.0%), careless diet (78.4%), sedentary lifestyle (64.2%), overweight or obesity (64.2%) and abdominal obesity (50.9%). Lower values were observed for hypertension (25.0%), metabolic syndrome (21.9%), diabetes (9.6%) and alcohol abuse (4.0%). An association risk factor exposure and disease was documented (odds ratio, [95% confidence limits]) for smoking (2.47 [1.68-3.64]), laboratory dyslipidemia (1.92 [1.33-2.77]), low HDL-C (2.12 [1.31-3.42]), careless diet (4.46 [2.88-6.90]) and sedentary lifestyle (1.79 [1.22-2.62]). A significant association between antipsychotics that are more likely to induce weight gain and overweight or obesity could not be demonstrated in this study. Hypertension was 46% lower in cases (n = 26/125) than in controls (0.54 [0.34-0.84]). This rather surprising result could be explained by our finding of a negative association (p = 0.01) between blood pressure levels and rate of benzodiazepine prescription among schizophrenia patients. The negative association documented in these patients by multivariate regression analysis (p = 0.005) between hypertension and benzodiazepine prescription reinforces this explanation. Untreated hypertension, untreated dyslipidemia and untreated diabetes are strongly associated with schizophrenia (3.79 [1.63-8.81]), (3.79 [2.06-7.35]), (6.38 [1.725-23.59]), respectively. A significant difference in 10-year absolute risk of fatal cardiovascular disease between cases and controls aged 40 years or more could not be demonstrated in our study (p = 0.054). Nonetheless, in younger individuals, higher levels of relative risk multiples in the 2-12 range were found in schizophrenia patients compared to controls (p < 0.050).

CONCLUSIONS

In schizophrenia patients, a high prevalence of cardiovascular risk factors and of neglected treatment was found. The great majority of cases and controls aged 40 years or more have low and comparable levels of absolute cardiovascular risk mortality. For those aged under 40 years, schizophrenia patients show higher relative cardiovascular risk than controls. These findings call for closer collaboration between psychiatrists and primary care providers. The finding of a lower prevalence of hypertension among cases seems to be associated with an apparent protective effect of benzodiazepines, which are frequently prescribed to patients with schizophrenia in Portugal.

Molecular characterization of antimicrobial resistance in enterococci and Escherichia coli isolates from European wild rabbit (Oryctolagus cuniculus)

A total of 44 Escherichia coli and 64 enterococci recovered from 77 intestinal samples of wild European rabbits in Portugal were analyzed for resistance to antimicrobial agents. Resistance in E. coli isolates was observed for ampicillin, tetracycline, sulfamethoxazole/trimethoprim, streptomycin, gentamicin, tobramycin, nalidixic acid, ciprofloxacin and chloramphenicol. None of the E. coli isolates produced extended-spectrum beta-lactamases (ESBLs). The bla(TEM), aadA, aac(3)-II, tet(A) and/or tet(B), and the catA genes were demonstrated in all ampicillin, streptomycin, gentamicin, tetracycline, and chloramphenicol-resistant isolates respectively, and the sul1 and/or sul2 and/or sul3 genes in 4 of 5 sulfamethoxazole/trimethoprim resistant isolates. Of the enterococcal isolates, Enterococcus faecalis was the most prevalent detected species (39 isolates), followed by E. faecium (21 isolates) and E. hirae (4 isolates). More than one-fourth (29.7%) of the isolates were resistant to tetracycline; 20.3% were resistant to erythromycin, 14.1% were resistant to ciprofloxacin and 10.9% were resistant to high-level-kanamycin. Lower level of resistance (<10%) was detected for ampicillin, quinupristin/dalfopristin and high-level-gentamicin, -streptomycin. No vancomycin-resistance was detected in the enterococci isolates. Resistance genes detected included aac(6')-aph(2''), ant(6)-Ia, tet(M) and/or tet(L) in all gentamicin, streptomycin and tetracycline-resistant isolates respectively. The aph(3')-IIIa gene was detected in 6 of 7 kanamycin-resistant isolates, the erm(B) gene in 11 of 13 erythromycin-resistant isolates and the vat(D) gene in the quinupristin/dalfopristin-resistant E. faecium isolate. This survey showed that faecal bacteria such as E. coli and enterococci of wild rabbits could be a reservoir of antimicrobial resistance genes.

Double health insurance coverage and health care utilisation: evidence from quantile regression

Double health insurance coverage exists when an individual benefits from more than one health insurance plan at the same time. We examine the impact of such supplementary insurance on the utilisation of doctor consultations in Portugal, taking advantage of institutional features which make double coverage plausibly exogenous. The novelty is that the analysis is carried out for different points of the conditional distribution, not only for its mean location, within the context of count data modelling and without imposing restrictive parametric assumptions.Results indicate that double coverage creates additional utilisation of health care across the whole outcome distribution for both public and private second layers of health insurance coverage but with greater magnitude in the latter group. We unveil that this additional consumption effect is relatively smaller for more frequent users.

Spondyloarthritis: analysis of a Brazilian series compared with a large Ibero-American registry (RESPONDIA group)

Recent studies have outlined the clinical and epidemiological profile of the spondyloarthritides in Ibero-American countries. The objective of this study was to compare the data collected in a Brazilian epidemiological study with the data obtained from other Ibero-American countries that used the same protocol of investigation. The Brazilian series presented a higher frequency of patients with ankylosing spondylitis (72.3% Brazilian vs. 57.7% Ibero-American), being associated with the male gender (73.6% vs. 66.0%) and histocompatibility antigen positive HLA-B27 (65.9% vs. 51.8%). Regarding the treatment, hormonal anti-inflammatory drugs - NSAIDS were more frequently prescribed to Brazilian patients (77.0% vs. 71.2%) and less often, corticosteroids (7.5% vs. 18.5%).

Assessment of new application system in Portuguese patients with relapsing-remitting multiple sclerosis

OBJECTIVE

To evaluate the satisfaction level of multiple sclerosis (MS) patients treated with interferon beta-1b (IFNbeta-1b, Betaferon*) using a newly developed application system compared to their currently used application system.

METHODS

A survey was conducted in Portugal in patients treated with IFNbeta-1b for relapsing-remitting MS with the Betaject or Betaject Lite autoinjector. Nurses demonstrated the new application system and supervised the first injection. Patients rated their overall satisfaction retrospectively with their current application system and prospectively after the first, the seventh and the 15th injection with the newly developed application system. Additionally, the ease of use was evaluated for both application systems using a questionnaire consisting of 13 questions. Responses were compiled and descriptive analyses performed.

RESULTS

A total of 249 patients evaluated the current and the new system after the first, 235 after the seventh and 174 after the 15th injection. The satisfaction level was high with the current system (70.3%, 'satisfied' or 'very satisfied'). However, compared with the current system, more patients were either 'satisfied' or 'very satisfied' (98%) with the new system after first injection. Only a minority of patients rated 'somewhat satisfied': 2.0% after the first, 8.6% after the seventh, and 4.4% after the 15th injection. Increased overall satisfaction level ('satisfied' or 'very satisfied') with the newly developed system was maintained over time (98% - first, 90.5% - seventh, 93.8% - 15th injection). The thinner, pre-attached 30-gauge needle and the visual signalling of injection completion were among the changes considered as strong improvements to the new system by up to 80.3% of patients.

LIMITATION

Retrospective analysis of current system.

CONCLUSIONS

This survey documented patient satisfaction with different application systems of IFNbeta-1b. The increased satisfaction with the new application system indicates an improvement to the currently used injection system, which may contribute to further advancement in adherence and consequently higher clinical efficacy of treatment.

Organic speciation of atmospheric particles in Alvão Natural Park (Portugal)

PM(10) continental rural background aerosols were collected during a summer field campaign (August-September 2006) at Lamas de Olo in the upper zone of the Alvão Natural Park, a mountain region of northern Portugal. In addition to the determination of the carbonaceous content by a thermal-optical method, the organic speciation of aerosols was performed by gas chromatography-mass spectrometry in an effort to evaluate photo-oxidation products of biogenic volatile organic compounds and other markers for source characterization. The detailed analysis revealed relatively high concentrations of polyols and short-chain dicarboxylic, tricarboxylic, hydroxycarboxylic, and oxocarboxylic acids, many of which are thought to be indicators of secondary aerosol formation, accounting for about 70% of global chromatographically resolved mass. Major photo-oxidation products of alpha- and beta-pinene have been detected. The tracers for the photo-oxidation of isoprene comprise two diastereoisomeric 2-methyltetrols, C(5)-alkene triols, and 2-methylglyceric acid, which have only recently been elucidated. In addition, the occurrence of levoglucosan and other biomass combustion tracers indicates that the site was affected by wildfires. This source contributed to more than 80% of the organic carbon mass during a period of strong forest fire influence.

[Patient's relationship with the medical prescription - an observational study in urban populations in the ambulatory setting of General Practice/Family Medicine in the centre of Portugal]

INTRODUCTION

The vast majority of General Practice/Family Medicine appointments end with a pharmacological prescription. It is therefore important to study the expectations facing the reasons to treat and the value attributed to the prescribed medicines, by patients.

OBJECTIVES

To know the expectations of patients facing the decision to treat and the therapeutic value attributed to prescribed medicines, by gender, academic grading, profession and age groups.

MATERIAL AND METHODS

In an observational study using a validated questionnaire, a non probabilistic convenience population representing, by gender and age groups, the universe of the urban attendants of a Primary Care facility in central Portugal, was studied. The questionnaire was applied, after informed consent, in an interview with a psychologist, for anonymous self-fulfillment. Descriptive and inferential statistics were performed.

RESULTS

A population of 180 individuals was studied, mean age 47,3 ± 17,0 years (ns by gender) median 45 years, mode 29, being 85 males (47,2%). No differences were found by gender, profession and age groups. There is a clear preference for the treatment of the diseases the doctor has diagnosed. A frequency of 2,8% would prefer to define the medical prescription. Patients think that prescribed medicines aim to increase health (79,5%) and to treat the diagnosed diseases (67,6%). Older and non actives agree that prescribed medicines are targeted to the problems they presented, while younger ones medicines are targeted for their diseases. For the active ones prescribed medicines are to improve health.

DISCUSSION

Patient's expectations about the decision of treating are technically oriented and medicines are thought of as a tool for healing and also as a mean to increase health. These two perspectives urge general practitioners/family doctors to make good patients medicines information and to define therapeutical objectives with patients.

CONCLUSIONS

The knowledge of the patients' expectation on pharmacological therapy can help increase its results, once patients wish to be treated of the diseases doctors diagnose and think that medicines cure diseases and increase health.

[Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region]

Patients and health staff frequently need to stay in health care facilities for quite a long time. Therefore, it's necessary to create the conditions that allow the ingestion of food during those periods, namely through the existence of automatic food dispensers. However, the available food and beverages might not always be compatible with a healthy diet. The aim of this work was to evaluate if the food and beverages available in automatic food dispensers in public Ambulatory Care Facilities (ACF) and Hospitals of the Portugal North Health Region were contributing to a healthy diet, during the year of 2007. A questionnaire was elaborated and sent to the Coordinators of the Health Sub-Regions and to the Hospital Administrators. The questionnaire requested information about the existence of automatic food dispensers in the several departments of each health care facility, as well as which food and beverages were available and most sold. Afterwards, the pre-processing of the results involved the classification of the food and beverages in three categories: recommended, sometimes recommended and not recommended. The questionnaire reply ratio was 71% in ACF and 83% in Hospitals. Automatic food dispensers were available in all the Hospitals and 86.5% of ACF. It wasn't possible to acquire food in 37% of the health facility departments. These departments were all located in ACF. The more frequently available beverages in departments with automatic food dispensers were coffee, still water, tea, juices and nectars and soft drinks. Still water, coffee, yogurt, juices and nectars and soft drinks were reported as the most sold. The more frequently avaliable food items were chocolate, recommended cookies, not recommended cakes, recommended sandwiches and sometimes recommended croissants. The food items reported as being the most sold were recommended sandwiches, chocolate, recommended cookies, sometimes recommended croissants and not recommended cookies. The beverages in the recommended and sometimes recommended groups were the most frequently available and sold. The not recommended food items were reported as being the most available, while both the recommended and not recommended food items were equally reported as being the most sold. Results show that unhealthy food and beverages are widely available in public health care facilities of the Portugal North Health Region.

Proanthocyanidin content, antioxidant capacity and scavenger activity of Portuguese sparkling wines (Bairrada Appellation of Origin)

BACKGROUND

The main object of the present study was to investigate the different proanthocyanidin fraction (monomeric, oligomeric and polymeric fraction) contents, antioxidant capacity and scavenger activity of the most important and representative commercial sparkling wines available in Bairrada Portuguese Appellation of Origin.

RESULTS

The white commercial sparkling wines tested had much less total phenolic, proanthocyanidin content, antioxidant capacity and scavenger activity than the sparkling red wines. For all white and red sparkling wines the polymeric fraction of proanthocyanidins was the most abundant fraction quantified. The antioxidant capacity was positively correlated with the different proanthocyanidin fractions studied. However, in general, higher correlations between total polyphenols, different proanthocyanidin fractions and antioxidant capacity were found only for red sparkling wines.

CONCLUSION

The results confirm that Portuguese sparkling wines from Bairrada Appellation of Origin are good sources of antioxidants when compared with other wines elaborated from other grapes varieties and from other regions. At same time, good linear correlations between the levels of each different proanthocyanidin fractions and total polyphenols with antioxidant capacity were found for the commercial sparkling wines analysed.

On the differential advantages of evergreenness and deciduousness in mediterranean oak woodlands: a flux perspective

We assessed the differential advantages of deciduousness and evergreenness by examining 26 site-years of carbon dioxide, water vapor, and energy flux measurements from five comparable oak woodlands in France, Italy, Portugal, and California (USA). On average, the evergreen and deciduous oak woodlands assimilated and respired similar amounts of carbon while using similar amounts of water. These results suggest that evergreen and deciduous woodlands have specific, and similar, ecological costs in mediterranean climates, and that both leaf habits are able to meet these costs. What are the mechanisms behind these findings? Deciduous oaks compensated for having a shorter growing season by attaining a greater capacity to assimilate carbon for a given amount of intercepted solar radiation during the well-watered spring period; at saturating light levels, deciduous oaks gained carbon at six times the rate of evergreen oaks. Otherwise, the two leaf habits experienced similar efficiencies in carbon use (the change in carbon respired per change in carbon assimilated), water use (the change in carbon assimilation per change in water evaporated), and rainfall use (the change in evaporation per change in rainfall). Overall, leaf area index, rather than leaf habit, was the significant factor in determining the absolute magnitude of carbon gained and water lost by each evergreen and deciduous oak woodland over an annual interval; the closed canopies assimilated and respired more carbon and transpired more water than the open canopies. Both deciduous and evergreen mediterranean oaks survive in their seasonally hot/dry, wet/ cool native range by ensuring that actual evaporation is less than the supply of water. This feat is accomplished by adjusting the leaf area index to reduce total water loss at the landscape scale, by down-regulating photosynthesis, respiration, and stomatal conductance with progressive seasonal soil water deficits, and by extending their root systems to tap groundwater.

[The use of herbal medicine therapies by cancer patients]

The use of herbal complementary and alternative medicines is growing among Portuguese cancer patients, contributing to a higher risk for unwanted interactions, especially due to the narrow therapeutic index of most oncolytic drugs. A literature review was carried out in order to determine which medicinal plants are most commonly used by cancer patients, in Europe and USA, and their risk of interaction with the multiple medications taken by those patients. The collected information reveals a high degree of herb-drug interaction suggesting that patients under antineoplastic treatments should avoid the concomitant use of herbal medicines. These findings show that it is extremely important to have a clear knowledge of the herbal complementary and alternative medicines used by Portuguese cancer patients and to assess healthcare professionals' familiarity and attitude towards its use by cancer patients.

Diptera of forensic importance in the Iberian Peninsula: larval identification key

A revision of the species and families of sarcosaprophagous flies (Diptera: Calliphoridae, Sarcophagidae, Muscidae, Fanniidae, Drosophilidae, Phoridae, Piophilidae and Stratiomyidae) suitable for forensic purposes in the Iberian Peninsula is presented. Morphological characteristics that allow the accurate identification of third instars of the species present in the Iberian Peninsula are described and presented in the form of a diagnostic key. For larval Calliphoridae, characteristics such as the spines of the body segments were useful for the genus Calliphora whereas features of the anal segment and the cephalopharyngeal skeleton were useful for larvae of Lucilia. Identification of three Chrysominae species present in the Iberian Peninsula is included. For larval Sarcophagidae, characters such as the arrangement and shape of spiracular openings, structures of the anal segment and the cephalopharyngeal skeleton were used for the first time. A new record of Sarcophaga cultellata Pandellé, from a human corpse, is also included as well as recent incursions into the European cadaveric entomofauna such as Synthesiomyia nudiseta (van der Wulp) and Hermetia illucens (Linnaeus). This work provides useful new information that could be applied to forensic investigations in the Iberian Peninsula and in southern Europe.

Volatiles from Thymbra and Thymus species of the western Mediterranean basin, Portugal and Macaronesia

Thyme is the common name of many taxa belonging to the Thymbra and Thymus genera. Given the economic importance of thyme oils, many thyme species have been studied and their essential oils and other volatile-containing extracts chemically characterized. Thymbra and Thymus species are frequent in the west Mediterranean region, considered to be the centre of origin of the genus Thymus, and extend further westwards in the Iberian Peninsula and northwest Africa, to the Macaronesian region in the Atlantic Ocean. The present work gives an overview of the chemical composition of the volatiles from the taxa of these two genera occurring in the above geographic area.

Exploring pharmacists' communication with customers through screening services

OBJECTIVE

To describe pharmacist-customer communication, during blood pressure and capillary cholesterol services, in a community pharmacy setting.

METHODS

Participants were purposively selected and data collected by audio-recording. The encounters' verbal content was transcribed verbatim, utterances identified, time stamped, and classified according to a coding scheme of 15 categories. Four dialogue structures were analyzed: speaker turn, interactivity, turn density and turn duration.

RESULTS

Eighty-three episodes were registered (51 blood pressure, 32 cholesterol). The average blood pressure episode lasted 5:35 min, with 81.2 utterances (55.3% customers), and an interactivity rate of 7 turns/min. The average cholesterol episode took 7:05 min, with 135.3 utterances (52.7% pharmacists), and an interactivity rate of 13.3 turns/min. In both cases, pharmacists asked more questions (mainly closed ones), while customers gave more information. An increased number of speaker turns and closed questions were associated to higher systolic pressure. No correlations were identified with cholesterol values.

CONCLUSION

It would seem that pharmacists tend to control the exchange and its content through closed questioning. Although talk dominance is balanced, hypertensive episodes induce a higher information search.

PRACTICE IMPLICATIONS

Educational interventions, focusing on pharmacists' communication competencies, should be available to favor interaction skills resulting in a customer's augment of proactive information seeking behaviour.

Essential oils from Distichoselinum tenuifolium: chemical composition, cytotoxicity, antifungal and anti-inflammatory properties

ETHNOPHARMACOLOGICAL RELEVANCE

Several aromatic plants and their essential oils are known to possess antimicrobial and anti-inflammatory properties. Distichoselinum tenuifolium (Lag.) Garcia Martin & Silvestre, an Iberian endemism, is traditionally used in the treatment of contact dermatitis and skin infections. However, the cellular mechanisms through which this plant exerts their beneficial effects are not known.

AIM OF THE STUDY

The aims of this study were to examine the chemical composition of the essential oil isolated from Distichoselinum tenuifolium, and to test the efficacy of the essential oil as an antifungal and anti-inflammatory potential.

MATERIALS AND METHODS

The oils were investigated by gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) and the antifungal activity (minimal inhibitory concentrations: MIC and minimal lethal concentrations: MLC) were evaluated against yeasts, dermatophyte and Aspergillus strains. Assessment of cell viability was made by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and the in vitro anti-inflammatory potential of Distichoselinum tenuifolium oil was evaluated by measuring nitric oxide (NO) production induced by LPS, in the absence or in the presence of the oil, in a mouse macrophage cell line.

RESULTS

The oils are predominantly composed of monoterpene hydrocarbons, being myrcene the main compound (47.7-84.6%). The oils revealed significant antifungal activity against Cryptococcus neoformans and dermatophyte strains and significantly inhibited NO production stimulated by LPS in macrophages, without affecting cell viability at concentrations ranging from 0.64 microL/mL to 1.25 microL/mL.

CONCLUSION

These findings add significant information to the pharmacological activity of Distichoselinum tenuifolium essential oils, specifically to its antifungal and anti-inflammatory properties, thus justifying and reinforcing the use of this plant on traditional medicine. Therefore, their beneficial effects and use in disease prevention, especially those related to fungal infections and inflammation, should be explored in more depth.

Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

BACKGROUND

Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option.

METHODS

Two self-report questionnaires were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests.

RESULTS

153 students (60.8% female) filled in both questionnaires (no dropouts). After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry.However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students.

CONCLUSIONS

The results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment.