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Ana Paula Martins

Publications and source records attributed to Ana Paula Martins.

12 recordsLinked to original sources

Prevalence of self-medication in rural areas of Portugal.

OBJECTIVES: To study the prevalence of self-medication among pharmacy customers in rural areas of Portugal, to assess possible predictors of self-medication and to find out whether there was a seasonal dependence in the purchase of drugs for self-medication. METHOD: A cross-sectional study during four different periods of a year was conducted. Community pharmacies of rural areas of Portugal were invited to participate and pharmacists were asked to recruit one person every hour during the opening hours and administer a questionnaire. Drugs dispensed were classified according to the Anatomical Therapeutic Chemical Classification system up to the second level. MAIN OUTCOME MEASURE: Prevalence of self-medication is defined as the percentage of patients acquiring a medicine that was not prescribed (written) or recommended (orally) by a physician. RESULTS: The prevalence of self-medication was 21.5%. Main therapeutic groups acquired for self-medication were "other alimentary tract and metabolism products" (A16; proportion acquired for self-medication= 75.0%), "throat preparations" (R02; 74.7%), "antiemetics and antinauseants" (A04; 70.0%), "cough and cold preparations" (R05; 56.5%), and "nasal preparations" (R01; 50.0%). Variables found to be predictors of self-medication were age, type of health professional or person consulted when a mild health problem occurred, time elapsed since last visit to the physician and time waited between setting an appointment and the actual visit. Seasonality seemed to occur for only "cough and cold preparations", for "dermatologicals" and for "anti-inflammatory and anti-rheumatic products". CONCLUSION: In rural Portugal about one fifth of the pharmacy customers engaged in self-medication. However, further research should be made to address appropriateness of self-medication.

Adult↗

Comparison of the healing mechanisms of myocardial lesions induced by dry radiofrequency and microwave epicardial ablation.

BACKGROUND: Histological assessment of the evolution of lesions induced on a pig's left atrium by microwave (MW) epicardial applications and comparison with dry radiofrequency (RF) lesions. METHODS: MW (40 W, 40 seconds) and dry RF (80 degrees C, 2 minutes) were epicardially applied on nine pigs' left atrium. Samples were procured following application (n = 2), at day 3 (n = 2), day 7 (n = 2), day 14 (n = 2), and at 1 month (n = 1). They were fixed in formalin, embedded in paraffin, sectioned (2 mu), stained with histochemical dyes, immunomarked, and histologically analyzed. RESULTS: Histological features of acute stage MW lesion are interstitial hemorrhage, adipose, and muscular tissues' coagulation necrosis, thrombosis of myocardial interstitium small vessels at damaged and optically undamaged areas, epicardial coronary branches, and endocardial parietal thrombosis. Day 3-lymphohistiocytic infiltration (lysosyme+) highlights lesion limits. Day 7-lymphohistiocytic infiltration increases, multi-nucleated giant cells appear surrounding/fagocyting necrotic tissue. Neovessels and scarce myofibroblasts appear. Lesion edges are now better defined. Day 14-myofibroblastic proliferation (actin++, vimentin+) creates "young" scar tissue, as in "healing by second intention." Lesions are deeper and wider than appeared at acute stage. One month-dense fibrous tissue scar appears. Endothelial cells covering endocardium are morphologically intact. RF lesions are histologically identical to MW's, although no vessel thrombosis was identified at acute optically undamaged areas and cytomorphologic elements emerge at later stages in the healing process. CONCLUSIONS: (1) Microwave scars are deeper and wider than the lesions observed at the acute stage. (2) Evolution of microwave lesions is faster and induces broader scars than dry radiofrequency. (3) Scar formation (both energies) is "healing by second intention." (4) Endocardial thrombosis may occur despite morphologically intact endothelium.

Animals↗

Noise-induced gastric lesions: a light and scanning electron microscopy study of the alterations of the rat gastric mucosa induced by low frequency noise.

INTRODUCTION: Exposure to low frequency noise (LFN) can lead to vibroacoustic disease (VAD), recognized as a systemic disease with lesions in a broad spectrum of organs. Although gastrointestinal complaints are common among individuals exposed to noise, only few studies tried to evaluate the digestive lesions. The authors performed this study in order to investigate gastric lesions in an animal model of VAD. MATERIAL AND METHODS: Adult Wistar rats were exposed to continuous LFN. After five weeks they were sacrificed. The stomachs were studied by light microscopy and scanning electron microscopy, and compared with stomachs of animals kept in silence. RESULTS: Superficial erosions were present in the noise-exposed animals. Massive cell death of the gastric epithelium was observed, both by light and electron microscopy. DISCUSSION: The erosions, reflecting cellular degeneration and death, occurred without inflammation, similar to what has been observed in other LFN-exposed organs.

Animals↗

Cholesterol pericarditis--relapsing pericardial effusion in a patient with rheumatoid arthritis.

Cholesterol pericarditis is an uncommon form of pericardial disease, of unknown pathophysiology, that is characterized by chronic relapsing, usually large, pericardial effusions that are distinctive due to a high level of cholesterol. Usually it is idiopathic, but it can be associated with various systemic diseases such as hypothyroidism, rheumatoid arthritis and tuberculosis, among others. Its clinical course is usually indolent and complications such as cardiac tamponade and chronic constrictive pericarditis are relatively rare. However, the need for surgery for complete treatment has been reported in at least 10 % of cases. When rheumatoid arthritis is the underlying cause, this outcome is more frequent among those with an acute episode of pericarditis during the course of the disease. We report the case of a 61-year-old female rheumatoid arthritis patient, who presented with heart failure due to a large pericardial effusion and was successfully treated by a surgical approach.

Arthritis, Rheumatoid↗

Dilated cardiomyopathy due to endocrine dysfunction.

Dilated cardiomyopathy can be idiopathic or be caused by many potentially treatable conditions. We report a complex case of peripartum heart failure associated with hypothyroidism and hypoparathyroidism. Myocardial biopsy suggested that hypothyroidism was the main cause for the dilated pattern, but hypocalcemia played a critical role in acute decompensation of heart failure during hospitalization. After a long and clinically complicated hospital stay, correction of hypothyroidism and hypocalcemia resulted in near-normal cardiac function.

Adult↗

Cardiac MICE--tumor or thrombus?

INTRODUCTION: Mesothelial/monocytic incidental cardiac excrescence (cardiac MICE) is a rare intracardiac lesion, which can cause severe disease and lead to misdiagnosis. MATERIAL AND METHODS: A 66-year-old woman with floppy mitral valve and coronary atherosclerosis underwent diagnostic coronary angiography, mitral valve surgery and aortocoronary bypass. During surgery, a thrombus was detected inside the left atrium and sent for pathology analysis. The sample was routinely processed, stained with histochemical dyes and immunomarked for epithelial (keratin) and mesenchymal cells (vimentin), histiocytes (lysozyme) and endothelial cells (Factor VIII). RESULTS: Histologically, the lesion contained mesothelial cells (keratin/vimentin coexpression), histiocytes (lysozyme/vimentin positive) and fibrin, leading to a diagnosis of MICE. DISCUSSION AND CONCLUSIONS: Cardiac MICE is a benign cardiac tumor-like lesion. It may be misdiagnosed as a thrombus or neoplasia, either primary or metastatic. Through embolization, it may cause myocardial or multiorgan infarctions, in some cases fatal. Developments in cardiothoracic surgery and interventional cardiology may increase its incidence; hence the importance of recognizing this entity.

Aged↗

Lymphoma with clinical presentation of a primary pericardial tumor.

Primary malignant cardiac tumors, particularly lymphoma, are rare entities. Cardiac involvement or metastization of the heart from neoplasia located elsewhere are more frequently found. We present the case of a 79-year-old patient admitted with heart failure symptoms with a 3-week evolution. Evaluation led to the identification of a cardiac tumor with unusual clinical presentation and with a rapid and fatal evolution. Pathologic analysis identified a B-cell non-Hodgkin lymphoma.

Aged↗

Antimalarial activity of medicinal plants used in traditional medicine in S. Tomé and Príncipe islands.

The present study investigates the antimalarial activity of 13 medicinal plants used in traditional medicine in S. Tomé and Príncipe (STP) islands in the Gulf of Guinea, aiming at identifying the most effective plants for further research. Fieldwork was carried out with the collaboration of 37 traditional healers from both islands, during an ethnobotanical study, which was conducted from 1993 to 1999. Our results indicate that the traditional healers in STP use several medicinal plants against fever and/or 'malaria' which reveal strong antiparasitic activity in vitro: four of the plant extracts have evident antiplasmodial activity against chloroquine resistant Plasmodium falciparum, with IC(50) values <10 microg/ml, and also revealed hepatic schizontocidal activity (<5-35 microg/ml). In vivo, the extracts caused partial reduction of Plasmodium berghei parasitaemia in mice.

Animals↗

In vitro antiplasmodial activity of Tithonia diversifolia and identification of its main active constituent: tagitinin C.

The antimalarial properties of Tithonia diversifolia, an Asteraceae traditionally used to treat malaria, were investigated in vitro against three strains of Plasmodium falciparum. The ether extract from aerial parts of the plant collected in São Tomé e Príncipe, demonstrated good antiplasmodial activity (IC 50 on FCA strain: 0.75 microg/ml). A bioassay guided fractionation of this extract led to the isolation of the known sesquiterpene lactone tagitinin C as an active component against Plasmodium (IC 50 on FCA strain: 0.33 microg/ml), but also possessing cytotoxic properties (IC 50 on HTC-116 cells: 0.706 microg/ml).

Animals↗

Leiomyosarcoma of the inferior vena cava--a very rare case report.

The authors present a case report of a patient with abdominal pain that began 6 months before hospital admission. Ambulatory abdominal echography and computed tomography (CT) revealed partial thrombosis of the inferior vena cava (IVC) with right atrial extension. During hospitalization, magnetic resonance imaging (MRI) revealed aspects suggesting a tumoral lesion of the right atrium, rather than a thrombus, with tumoral extension to the IVC. The echocardiogram showed images suggesting a right atrial tumor. Transesophageal echocardiography confirmed the diagnosis. During surgery, an IVC tumor was found invading the right atrium, which histopathology confirmed as a leiomyosarcoma. The authors present this case because this type of tumor is rare (21 cases worldwide at this anatomic site), it is difficult to diagnose, and its management has not been adequately described. The authors review the literature relevant to this case.

Heart Neoplasms↗

Self-medication in a Portuguese urban population: a prevalence study.

PURPOSE: To determine the prevalence of self-medication in a Portuguese urban population. To assess the feasibility of performing these studies in community pharmacies. METHODS: A cross-sectional study was chosen to collect information about demography, use of health services and drug utilization in a sample of pharmacy user-purchasers in a pre-determined period of time. RESULTS: The proportion of pharmacies which participated in the study was 18.3% (11 from 60 invited) in Lisbon and 37.5% (15 of 40 invited) in Porto. Among the 3312 selected patients, only 2.6% (n = 114) refused to participate. The prevalence of self-medication was found to be 26.2%. The distribution of self-medication by gender was 28.4% for males and 25.2% for females. Use of self-medication was statistically significantly higher (p < 0.001) among individuals aged between 10 and 49 years. The main therapeutic groups used for self-medication, according to the ATC classification, were throat preparations, cough and cold preparations, stomatological preparations (antiinfectives and corticosteroides for local oral treatment), laxatives, analgesics, dermatological preparations, vitamins, mineral supplements and other alimentary tract and metabolism products. CONCLUSIONS: In the urban areas under study the overall prevalence of self-medication was 26.2%. Predictive factors for self-medication seem to be, a high level of education, professional status and length of waiting times for a medical consultation in cases of a severe health problem. Further research on this subject is needed to confirm the reproducibility of these results, since potential selection bias could have been introduced due to the method used for patient selection. Pharmacoepidemiologic research is feasible in Portuguese community pharmacies.

Adolescent↗