Estimativa do risco de carcinogénese associado à radiação X no cateterismo ureteral "duplo J"

Introdução: Porque o cateterismo ureteral “duplo J” implica a exposição do doente a radiação X, com tempos de exposição consideráveis, incidentes numa região anatómica constituída por diversos órgãos, existem dúvidas em relação aos riscos associados à dose de radiação acumulada pelos doentes. O objectivo deste trabalho centrou-se em clarificar estas dúvidas através da estimação quantitativa do risco de carcinogénese associado à dose de radiação. Método: Foram estudados dados relativos a 146 doentes submetidos a procedimentos de cateterismo ureteral “duplo J” no Serviço de Urologia do Hospital de Santa Maria (HSM). As doses eficazes foram determinadas através de métodos Monte Carlo. O risco de carcinogénese foi estimado com base na relação linear dose/efeito, sem limiar de dose, por coeficientes de probabilidade. Resultados: Como resultados mais relevantes, estimou-se que 1 colocação seguida de 1 extracção do cateter “duplo J” proporciona ao doente um risco acrescido de carcinogénese de 0,012%, ou seja, cerca de 1 doente em 8330 desenvolve cancro radio-induzido. Estima-se também, por exemplo, que um doente submetido a 1 colocação, 1 substituição e 1 extracção é, em média, submetido a uma dose eficaz de 4,47mSv, valor de dose semelhante ao proporcionado por uma TC abdominal. Conclusão: Quando comparamos os riscos associados à radiação com o benefício clínico de “poupar” a função renal, concluímos que os benefícios são inestimavelmente mais importantes que os riscos. De qualquer forma, verificamos que existe sempre, ainda que relativamente baixo, algum risco associado aos níveis de dose. Assim, os princípios da Justificação e da Optimização deverão ser sempre equacionados neste tipo de procedimentos.

Interacções comunicativas numa criança com síndrome de Costello

As limitações apresentadas pela criança com Síndrome de Costello impossibilitam-na de aceder à linguagem oral como principal forma de comunicação. As pessoas que interagem com esta criança devem conhecer as formas de comunicação usadas nas interacções comunicativas e as respectivas intenções para que a comunicação se estabeleça. Este estudo procurou identificar como se processam as interacções comunicativas criança/adulto e criança/objecto em contexto de Jardim de infância. Procurou ainda saber qual o papel de uma intervenção programada na melhoria das capacidades comunicativas da criança. Para a realização deste estudo, devido às suas características de “estudo de caso único”, optou-se por utilizar uma metodologia mista, ou seja: qualitativa (comentários) e quantitativa (turnos, iniciativas). A observação directa através de vídeos e a análise dos documentos existentes no processo do participante permitiram a recolha de dados para se alcançarem os objectivos propostos. A interpretação dos resultados revelou-nos que as interacções criança/adulto/objecto se estabeleceram a um nível não simbólico e que os adultos desempenharam um papel fundamental no reconhecimento das interacções comunicativas, na interpretação das suas intenções e na resposta que dão às mesmas, condicionando assim a aprendizagem desta criança. Este estudo revelou-nos também que o programa de intervenção foi benéfico na medida em que se registou um aumento significativo, após a implementação do mesmo, do número e tempo de interacções assim como dos turnos e sua extensão máxima. Finalmente podemos dizer que é de extrema importância que o adulto saiba interpretar as intenções comunicativas da criança de modo a lhe poder proporcionar uma resposta assertiva, permitindo-lhe assim o acesso à aprendizagem.

Blue-enhanced thin-film photodiode for dual-screen x-ray imaging

This article reports on a-Si:H-based low-leakage blue-enhanced photodiodes for dual-screen x-ray imaging detectors. Doped nanocrystalline silicon was incorporated in both the n- and p-type regions to reduce absorption losses for light incoming from the top and bottom screens. The photodiode exhibits a dark current density of 900 pA/cm(2) and an external quantum efficiency up to 90% at a reverse bias of 5 V. In the case of illumination through the tailored p-layer, the quantum efficiency of 60% at a 400 nm wavelength is almost double that for the conventional a-Si:H n-i-p photodiode.

O síndrome do silêncio: síndrome de Waardenbrug

Síndrome de Waardenburg - Perda de audição: neurossensorial, uni ou bilateral; possibilidade de existir micrótia ou apêndices pré-auriculares; nariz achatado – alargamento da pirâmide nasal; alterações na pigmentação de pele, cabelo e olhos.

SU(5) x SU(5) unification revisited

The idea of grand unification in a minimal supersymmetric SU(5) x SU(5) framework is revisited. It is shown that the unification of gauge couplings into a unique coupling constant can be achieved at a high-energy scale compatible with proton decay constraints. This requires the addition of minimal particle content at intermediate energy scales. In particular, the introduction of the SU(2)(L) triplets belonging to the (15, 1)+((15) over bar, 1) representations, as well as of the scalar triplet Sigma(3) and octet Sigma(8) in the (24, 1) representation, turns out to be crucial for unification. The masses of these intermediate particles can vary over a wide range, and even lie in the TeV region. In contrast, the exotic vector-like fermions must be heavy enough and have masses above 10(10) GeV. We also show that, if the SU(5) x SU(5) theory is embedded into a heterotic string scenario, it is not possible to achieve gauge coupling unification with gravity at the perturbative string scale.

Phase diagrams of particles with dissimilar patches: X-junctions and Y-junctions

We use Wertheim's first-order perturbation theory to investigate the phase behaviour and the structure of coexisting fluid phases for a model of patchy particles with dissimilar patches (two patches of type A and f(B) patches of type B). A patch of type alpha = {A, B} can bond to a patch of type beta = {A, B} in a volume nu(alpha beta), thereby decreasing the internal energy by epsilon(alpha beta). We analyse the range of model parameters where AB bonds, or Y-junctions, are energetically disfavoured (epsilon(AB) < epsilon(AA)/2) but entropically favoured (nu(AB) >> nu(alpha alpha)), and BB bonds, or X-junctions, are energetically favoured (epsilon(BB) > 0). We show that, for low values of epsilon(BB)/epsilon(AA), the phase diagram has three different regions: (i) close to the critical temperature a low-density liquid composed of long chains and rich in Y-junctions coexists with a vapour of chains; (ii) at intermediate temperatures there is coexistence between a vapour of short chains and a liquid of very long chains with X-and Y-junctions; (iii) at low temperatures an ideal gas coexists with a high-density liquid with all possible AA and BB bonds formed. It is also shown that in region (i) the liquid binodal is reentrant (its density decreases with decreasing temperature) for the lower values of epsilon(BB)/epsilon(AA). The existence of these three regions is a consequence of the competition between the formation of X- and Y-junctions: X-junctions are energetically favoured and thus dominate at low temperatures, whereas Y-junctions are entropically favoured and dominate at higher temperatures.

Ruthenium(II) Arene Complexes Bearing Tris(pyrazolyl)methanesulfonate Capping Ligands.Electrochemistry, Spectroscopic, and X-ray Structural Characterization

Novel [Ru(L)(Tpms)]Cl and [Ru(L)(Tpms(Ph))]Cl complexes (L = p-cymene, benzene, or hexamethylbenzene, Tpms = tris(pyrazolyl)-methanesulfonate, Tpms(Ph) = tris(3-phenylpyrazoly)methanesulfonate) have been prepared by reaction of [Ru(L)(mu-Cl)(2)](2) with Li[Tpms] and Li[Tpms(Ph)], respectively. [Ru(p-cymene)(Tpms)]BF4 has been synthesized through a metathetic reaction of [Ru(p-cymene)(Tpms)]Cl with AgBF4. [RuCl(cod)(Tpms)] (cod = 1,5-cyclooctadiene) and [RuCl(cod)(Tpms(Ph))] are also reported, being obtained by reaction of [RuCl2(cod)(MeCN)(2)] with Li[Tpms] and Li[Tpms(Ph)], respectively. The structures of the complexes and the coordination modes of the ligands have been established by IR, NMR, and single-crystal X-ray diffraction (for [RuL(Tpms)]X (L = p-cymene or HMB, X = Cl; L = p-cymene, X = BF4)) studies. Electrochemical studies showed that each complex undergoes a single-electron R-II -> R-III oxidation at a potential measured by cyclic voltammetry, allowing to compare the electron-donor characters of the tris(pyrazolyl)methanesulfonate and arene ligands, and to estimate, for the first time, the values of the Lever E-L ligand parameter for Tmps(Ph), HMB, and cod.

Os desafios da inclusão de alunos com síndrome de down

Dissertação apresentada à Escola Superior de Educação de Lisboa para a obtenção do Grau de Mestre em Ciências da Educação - Especialidade Educação especial

Optoelectronic properties of a-Si(1-x)C(x)H films grown in hydrogen diluted silane-methane plasma

This work reports on the optoelectronic properties and device application of hydrogenated amorphous silicon carbide (a-Si(1-x)C(x):H) films grown by plasma-enhanced chemical vapour deposition (PECVD). The films with an optical bandgap ranging from about 1.8 to 2.0 eV were deposited in hydrogen diluted silane-methane plasma by varying the radio frequency power. Several n-i-p structures with an intrinsic a-Si(1-x)C(x):H layer of different optical gaps were also fabricated. The optimized devices exhibited a diode ideality factor of 1.4-1.8, and a leakage current of 190-470 pA/cm(2) at -5 V. The density of deep defect states in a-Si(1-x)C(x):H was estimated from the transient dark current measurements and correlated with the optical bandgap and carbon content. Urbach energies for the valence band tail were also determined by analyzing the spectral response within sub-bandgap energy range. (C) 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

Aplicação da abordagem socioeconómica na Empresa X: corrigir disfunções e potenciar resultados – estudo de caso

Mestrado em Contabilidade

Image quality and dose analysis for a PA chest X-ray: comparison between AEC mode acquisition and manual mode using the 10 kVp ‘rule’

Purpose - To compare the image quality and effective dose applying the 10 kVp rule with manual mode acquisition and AEC mode in PA chest X-ray. Method - 68 images (with and without lesions) were acquired using an anthropomorphic chest phantom using a Wolverson Arcoma X-ray unit. These images were compared against a reference image using the 2 alternative forced choice (2AFC) method. The effective dose (E) was calculated using PCXMC software using the exposure parameters and the DAP. The exposure index (lgM provided by Agfa systems) was recorded. Results - Exposure time decreases more when applying the 10 kVp rule with manual mode (50%–28%) when compared with automatic mode (36%–23%). Statistical differences for E between several ionization chambers' combinations for AEC mode were found (p = 0.002). E is lower when using only the right AEC ionization chamber. Considering the image quality there are no statistical differences (p = 0.348) between the different ionization chambers' combinations for AEC mode for images with no lesions. Considering lgM values, it was demonstrated that they were higher when the AEC mode was used compared to the manual mode. It was also observed that lgM values obtained with AEC mode increased as kVp value went up. The image quality scores did not demonstrate statistical significant differences (p = 0.343) for the images with lesions comparing manual with AEC mode. Conclusion - In general the E is lower when manual mode is used. By using the right AEC ionising chamber under the lung the E will be the lowest in comparison to other ionising chambers. The use of the 10 kVp rule did not affect the visibility of the lesions or image quality.

Cholesterol 24S-Hydroxylase overexpression inhibits the liver X receptor (LXR) pathway by activating small guanosine triphosphate-binding proteins (sGTPases) in neuronal cells

The neuronal-specific cholesterol 24S-hydroxylase (CYP46A1) is important for brain cholesterol elimination. Cyp46a1 null mice exhibit severe deficiencies in learning and hippocampal long-term potentiation, suggested to be caused by a decrease in isoprenoid intermediates of the mevalonate pathway. Conversely, transgenic mice overexpressing CYP46A1 show an improved cognitive function. These results raised the question of whether CYP46A1 expression can modulate the activity of proteins that are crucial for neuronal function, namely of isoprenylated small guanosine triphosphate-binding proteins (sGTPases). Our results show that CYP46A1 overexpression in SH-SY5Y neuroblastoma cells and in primary cultures of rat cortical neurons leads to an increase in 3-hydroxy-3-methyl-glutaryl-CoA reductase activity and to an overall increase in membrane levels of RhoA, Rac1, Cdc42 and Rab8. This increase is accompanied by a specific increase in RhoA activation. Interestingly, treatment with lovastatin or a geranylgeranyltransferase-I inhibitor abolished the CYP46A1 effect. The CYP46A1-mediated increase in sGTPases membrane abundance was confirmed in vivo, in membrane fractions obtained from transgenic mice overexpressing this enzyme. Moreover, CYP46A1 overexpression leads to a decrease in the liver X receptor (LXR) transcriptional activity and in the mRNA levels of ATP-binding cassette transporter 1, sub-family A, member 1 and apolipoprotein E. This effect was abolished by inhibition of prenylation or by co-transfection of a RhoA dominant-negative mutant. Our results suggest a novel regulatory axis in neurons; under conditions of membrane cholesterol reduction by increased CYP46A1 expression, neurons increase isoprenoid synthesis and sGTPase prenylation. This leads to a reduction in LXR activity, and consequently to a decrease in the expression of LXR target genes.

Estratégias pedagógicas para jovens com a síndrome de Asperger na aprendizagem do trompete: relatório de estágio

Resumo I - O Relatório de estágio foi idealizado no âmbito da Unidade Curricular de Estágio do Ensino Especializado, Mestrado em Ensino da Música pela Escola Superior de Música de Lisboa. O documento incide sobre a prática pedagógica desenvolvida no Conservatório Regional de Palmela no ano letivo 2013/2014, abrangendo três alunos dos diferentes graus de ensino. No conteúdo do relatório, para além da caracterização do estabelecimento de ensino onde o estágio foi desenvolvido, foram caracterizados os diferentes alunos realçando as linhas pedagógicas seguidas com cada um dos intervenientes, salientando os aspetos de competências motora, auditiva e expressiva desenvolvidas durante o processo. Os objetivos do trabalho desenvolvido com os alunos é descrito, tendo como base a organização dos materiais a utilizar de acordo com as características de cada aluno, e consequentemente de acordo com a análise crítica da atividade docente. O professor tem a responsabilidade de conduzir o ensino dos alunos para que estes saibam apreciar e compreender as execuções musicais, independentemente da aptidão musical que já possuem.

O percurso escolar de adolescentes com síndrome de asperger

Dissertação apresentada à Escola Superior de Educação de Lisboa Para obtenção de grau de mestre em Ciências da Educação, Especialidade em Educação Especial – Problemas de Cognição e Multideficiência

A survey in Portuguese X-ray fluoroscopy equipment: dose rates and image quality

X-ray fluoroscopy is essential in both diagnosis and medical intervention, although it may contribute to significant radiation doses to patients that have to be optimised and justified. Therefore, it is crucial to the patient to be exposed to the lowest achievable dose without compromising the image quality. The purpose of this study was to perform an analysis of the quality control measurements, particularly dose rates, contrast and spatial resolution of Portuguese fluoroscopy equipment and also to provide a contribution to the establishment of reference levels for the equipment performance parameters. Measurements carried out between 2007 and 2013 on 143 fluoroscopy equipment distributed by 34 nationwide health units were analysed. The measurements suggest that image quality and dose rates of Portuguese equipment are congruent with other studies, and in general, they are as per the Portuguese law. However, there is still a possibility of improvements intending optimisation at a national level.