Caracterização tecnológica da mamografia digital em Portugal: progresso de um projeto em implementação

Introdução – A mamografia é o principal método de diagnóstico por imagem utilizado no rastreio e diagnóstico do cancro da mama, sendo a modalidade de imagem recomendada em vários países da Europa e Estados Unidos para utilização em programas de rastreio. A implementação da tecnologia digital causou alterações na prática da mamografia, nomeadamente a necessidade de adaptar os programas de controlo de qualidade. Objetivos – Caracterizar a tecnologia instalada para mamografia em Portugal e as práticas adotadas na sua utilização pelos profissionais de saúde envolvidos. Concluir sobre o nível de harmonização das práticas em mamografia em Portugal e a conformidade com as recomendações internacionais. Identificar oportunidades para otimização que permitam assegurar a utilização eficaz e segura da tecnologia. Metodologia – Pesquisa e recolha de dados sobre a tecnologia instalada, fornecidos por fontes governamentais, prestadores de serviços de mamografia e indústria. Construção de três questionários, orientados ao perfil do médico radiologista, técnico de radiologia com atividade em mamografia digital e técnico de radiologia coordenador. Os questionários foram aplicados em 65 prestadores de serviços de mamografia selecionados com base em critérios de localização geográfica, tipo de tecnologia instalada e perfil da instituição. Resultados – Foram identificados 441 sistemas para mamografia em Portugal. A tecnologia mais frequente (62%) e vulgarmente conhecida por radiografia computorizada (computed radiography) é constituída por um detector (image plate) de material fotoestimulável inserido numa cassete de suporte e por um sistema de processamento ótico. A maioria destes sistemas (78%) está instalada em prestadores privados. Aproximadamente 12% dos equipamentos instalados são sistemas para radiografia digital direta (Direct Digital Radiography – DDR). Os critérios para seleção dos parâmetros técnicos de exposição variam, observando-se que em 65% das instituições são adotadas as recomendações dos fabricantes do equipamento. As ferramentas de pós-processamento mais usadas pelos médicos radiologistas são o ajuste do contraste e brilho e magnificação total e/ou localizada da imagem. Quinze instituições (em 19) têm implementado um programa de controlo de qualidade. Conclusões – Portugal apresenta um parque de equipamentos heterogéneo que inclui tecnologia obsoleta e tecnologia “topo de gama”. As recomendações/guidelines (europeias ou americanas) não são adotadas formalmente na maioria das instituições como guia para fundamentação das práticas em mamografia, dominando as recomendações dos fabricantes do equipamento. Foram identificadas, pelos técnicos de radiologia e médicos radiologistas, carências de formação especializada, nomeadamente nas temáticas da intervenção mamária, otimização da dose e controlo da qualidade. A maioria dos inquiridos concorda com a necessidade de certificação da prática da mamografia em Portugal e participaria num programa voluntário. ABSTRACT - Introduction – Mammography is the gold standard for screening and imaging diagnosis of breast disease. It is the imaging modality recommended by screening programs in various countries in Europe and the United States. The implementation of the digital technology promoted changes in mammography practice and triggered the need to adjust quality control programs. Aims –Characterize the technology for mammography installed in Portugal. Assess practice in use in mammography and its harmonization and compliance to international guidelines. Identify optimization needs to promote an effective and efficient use of digital mammography to full potential. Methodology – Literature review was performed. Data was collected from official sources (governmental bodies, mammography healthcare providers and medical imaging industry) regarding the number and specifications of mammography equipment installed in Portugal. Three questionnaires targeted at radiologists, breast radiographers and the chief-radiographer were designed for data collection on the technical and clinical practices in mammography. The questionnaires were delivered in a sample of 65 mammography providers selected according to geographical criteria, type of technology and institution profile. Results – Results revealed 441 mammography systems installed in Portugal. The most frequent (62%) technology type are computerized systems (CR) mostly installed in the private sector (78%). 12% are direct radiography systems (DDR). The criteria for selection of the exposure parameters differ between the institutions with the majority (65%) following the recommendations from the manufacturers. The use of available tools for post-processing is limited being the most frequently reported tools used the contrast/ brightness and Zoom or Pan Magnification tools. Fifteen participant institutions (out of 19) have implemented a quality control programme. Conclusions – The technology for mammography in Portugal is heterogeneous and includes both obsolete and state of the art equipment. International guidelines (European or American) are not formally implemented and the manufacturer recommendations are the most frequently used guidance. Education and training needs were identified amongst the healthcare professionals (radiologists and radiographers) with focus in the areas of mammography intervention, patient dose optimization and quality control. The majority of the participants agree with the certification of mammography in Portugal.

IGRT com CBCT: o impacto na precisão em radioterapia

Mestrado em Radiações Aplicadas às Tecnologias da Saúde.

Arte d’escrita desenvolvimento da escrita em alunos de língua materna e alunos de língua não materna

Projeto de Intervenção apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de Mestre em Didática da Língua Portuguesa no 1.º e 2.º Ciclos do Ensino Básico

Do fatigue, physical activity, handgrip strength and quality of life change between pre and post liver transplant?

Analisar: níveis de fadiga, força de preensão, HRQoL, níveis de actividade física. Será que se alteram em doentes PAF após o transplante de fígado? Dado que os níveis de actividade física se encontram abaixo dos valores mínimos recomendados deveria ser encontrada uma estratégia de aumento do tempo dispendido na actividade física leve a moderada idealmente no PRÉ TRANSPLANTE.

Weaving encounters: towards an art of participation

In the early 21st Century, with the phenomenon of digital convergence, the consecration of Web 2.0, the decrease of the cost of cameras and video recorders, the proliferation of mobile phones, laptops and wireless technologies, we witness the arising of a new wave of media, of an informal, personal and at times “minority” nature, facilitating social networks, a culture of fans, of sharing and remix. As digital networks become fully and deeply intricate in our experience, the idea of “participation” arises as one of the most complex and controversial themes of the contemporary critical discourse, namely in what concerns contemporary art and new media art. However, the idea of “participation” as a practice or postulate traverses the 20th century art playing an essential role in its auto-critic, in questioning the concept of author, and in the dilution of the frontiers between art, “life” and society, emphasizing the process, the everyday and a community sense. As such, questioning the new media art in light of a “participatory art” (Frieling, 2008) invokes a double gaze simultaneously attentive to the emerging figures of a “participatory aesthetics” in digital arts and of the genealogy in which it is included. In fact, relating the new media art with the complex and paradoxical phenomenon of “participation” allows us to, on the one hand, avoid “digital formalism” (Lovink, 2008) and analyse the relations between digital art and contemporary social movements; on the other hand, this angle of analysis contributes to reinforce the dialogue and the links between digital art and contemporary art, questioning the alleged frontiers that separate them.

Contribuição para a definição de procedimentos de inspeção de edifícios correntes após um sismo

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Civil

Optimising protocol of acquisition and post-processing procedures in the assessment of coronary artery disease by computed tomography

Coronary artery disease (CAD) is currently one of the most prevalent diseases in the world population and calcium deposits in coronary arteries are one direct risk factor. These can be assessed by the calcium score (CS) application, available via a computed tomography (CT) scan, which gives an accurate indication of the development of the disease. However, the ionising radiation applied to patients is high. This study aimed to optimise the protocol acquisition in order to reduce the radiation dose and explain the flow of procedures to quantify CAD. The main differences in the clinical results, when automated or semiautomated post-processing is used, will be shown, and the epidemiology, imaging, risk factors and prognosis of the disease described. The software steps and the values that allow the risk of developingCADto be predicted will be presented. A64-row multidetector CT scan with dual source and two phantoms (pig hearts) were used to demonstrate the advantages and disadvantages of the Agatston method. The tube energy was balanced. Two measurements were obtained in each of the three experimental protocols (64, 128, 256 mAs). Considerable changes appeared between the values of CS relating to the protocol variation. The predefined standard protocol provided the lowest dose of radiation (0.43 mGy). This study found that the variation in the radiation dose between protocols, taking into consideration the dose control systems attached to the CT equipment and image quality, was not sufficient to justify changing the default protocol provided by the manufacturer.

Modifications of MCM-22 zeolite through sequential post-synthesis treatments. Implications on the acidic and catalytic behaviour

Desilication and a combination of alkaline followed by acid treatment were applied to MCM-22 zeolite using two different base concentrations. The samples were characterised by powder X-ray diffraction, Al-27 and Si-29 MAS-NMR spectroscopy, SEM, TEM and low temperature N-2 adsorption. The acidity of the samples was study through pyridine adsorption followed by FTIR spectroscopy and by the analyses of the hydroxyl region. The catalytic behaviour, anticipated by the effect of post-synthesis treatments on the acidity and space available inside the two internal pore systems was evaluated by using the model reaction of m-xylene transformation. The generation of mesoporosity was achieved upon alkaline treatment with 0.05 M NaOH solution and practically no additional gain was obtained when the more concentrate solution, 0.1 M, was used. Instead, Al extraction takes place along with Si, as shown by Si-29 and Al-27 MAS-NMR data, followed by Al deposition as extraframework species. Samples submitted to alkaline plus acid treatments present distinct behaviour. When the lowest NaOH solution was used no relevant effect was observed on the textural characteristics. Additionally, when the acid treatment was performed on an already fragilized MCM-22 structure, due to previous desilication with 0.1 M NaOH solution, the extraction of Al from both internal pore systems promotes their interconnection, evolving from a 2-D to a 3-D porous structure. This transformation has a marked effect in the catalytic behaviour, allowing an increase of m-xylene conversion as a consequence of an easier and faster molecular traffic in the 3-D structure. On the other hand, the continuous deposition of extraframework Al species inside the pores leads to a shape selective effect that privileges the formation of the more valuable isomer p-xylene.

Somewhere near reality: artistic portrayal of violence in post WWII British realistic drama

ABSTRACT - I will explore and present the portrayal of violence in some British plays that were staged between 1951 and 1965, in order to discuss the role, impact and aim of its representation. Thus, I will consider John Whiting’s Saint’s Day (1951), Ann Jelicoe’s The Sport of my Mad Mother (1956), Arnold Wesker (Chicken Soup with Barley (1958), Harold Pinter’s Birthday Party (1958), David Rudkin’s Afore Night Come (1962) and Edward Bond’s Saved (1965). My aim is to discuss the way how theatre in the post WWII changed the traditional ways of representing violence. On one hand, violence and reality became more and more familiar and domestic, permitting a representation of multiple and non-agonic violence; and, on the other hand, the violence that was depicted often changed the way one perceived reality itself, being part of a socially engaged artistic attitude.

Pós-brutalismo das paixões ao povoado refractário: dissertação

Dissertação submetida à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro - especialização em Encenação,

A director’s approach to art and religion : o quadro, um musical da Paixão segundo o sr. João (The masterpiece, a musical of The passion according to John): trabalho de projecto

Trabalho de Projecto submetido à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro - especialização em Encenação.

Formación de profesores post Bolonia: los desafíos de un proceso en dos etapas

En los últimos años, las políticas de formación de profesores se han convertido en un foco de interés para gobernantes, investigadores y profesionales de la educación. En Portugal, como en otros países europeos, la reestructuración de la formación de profesores estuvo marcada por las políticas, directrices y tendencias de la Comisión Europea, adecuándolas a las especificidades propias de la cultura e historia nacionales. Actualmente, la formación de profesores para los primeros años (0-12) se realiza en instituciones de enseñanza superior, bajo una estructura de dos etapas, constituida por el primer ciclo (licenciatura en Educación Básica) y el segundo ciclo (maestros en educación de infancia y/o ciclo de Enseñanza Básica), con una duración de 4,5 a 5 años. Esta organización en dos etapas ha traído nuevos desafíos a la coherencia y consistencia de los cursos de formación, sobre todo, por lo que respecta a la articulación de la formación académica con la formación práctica. Los problemas generados se vuelven especialmente relevantes en el 6º semestre de la licenciatura en Educación Básica, periodo de transición entre la conclusión de una etapa y el inicio de otra. En este artículo, relatamos el recorrido realizado en la organización de la formación en Educación Básica en una escuela superior de educación en Portugal. El proyecto duró 4 años e incidió en la orientación, organización y procesos de apoyo a la iniciación a la práctica profesional en el 6º semestre del curso. En este proceso, la participación e implicación de los estudiantes, a través de la evaluación de la formación, fue el rasgo fundamental y distintivo.