Controlo da tuberculose em Portugal : papel e qualidade da detecção de casos

RESUMO - A impressionante evolução da incidência notificada desde 1950 evidencia o quanto o sistema de informação é sensível ao esforço de notificação, reflectindo ainda o impacte das medidas de controlo que foram sendo introduzidas, bem como alguma melhoria nas condições sociais com efeito favorável sobre a doença (Briz, 2005). Sendo a tuberculose uma doença de notificação obrigatória, nos termos da Portaria n.º 766/86, de 26 de Dezembro, os casos deverão ser sempre comunicados à Autoridade de Saúde, em impresso aprovado. O facto de a tuberculose ter um sistema de informação próprio tem permitido um conhecimento relativamente completo da situação epidemiológica. (DGS, 1995) Pretende-se caracterizar o perfil de distribuição da incidência notificada da tuberculose pulmonar, em Portugal Continental, nomeadamente a nível distrital, no período compreendido entre 2000 e 2008, inclusive, partindo-se depois para um estudo mais pormenorizado, relacionado com a sensibilidade do sistema de notificação da tuberculose, no sentido de se quantificarem os problemas de subnotificação. Para validação da notificação, serão utilizados os dados de 2007 e 2008. Procurar-se-á depois obter o perfil da incidência ajustada para a detecção em cada um desses anos, avançando-se de seguida para a identificação e caracterização de parâmetros complementares e de acesso fácil que contribuam para interpretar a distribuição geográfica da incidência notificada, em função da sua provável validade. Perante o eventual confronto com o problema da subnotificação, a identificação das razões da menor adesão à notificação de casos de tuberculose pulmonar apresenta-se quase como inevitável, sendo feita através do recurso a entrevistas a informadores-chave. --------------------------------------ABSTRACT - The impressive development of the incidence reported since 1950 shows how the system is sensitive to the effort of notification, still reflects the impact of control measures have been introduced, and some improvement in social conditions with favorable effect on the disease ( Briz, 2005). As tuberculosis a notifiable disease, according to Ordinance No. 766/86, December 26, cases should be reported to the Health Authority, approved in print. The fact that tuberculosis have an information system itself has allowed a relatively complete knowledge of the epidemiological situation. (DGS, 1995) The aim is to characterize the distribution profile of the reported incidence of pulmonary tuberculosis, in Portugal, particularly at district level in the period between 2000 and 2008, starting from then to a more detailed study, related to the sensitivity of the system notification of tuberculosis, in order to quantify the problems of underreporting. For validation of the notification, we used the data from 2007 and 2008. Search will then obtain the profile of the adjusted incidence for detection in each of those years, advancing is then for the identification and characterization of additional parameters and easy access to contribute to interpret the geographical distribution of reported incidence in according to their likely validity. Given the eventual confrontation with the problem of underreporting, the identification of reasons for the lower adherence to reporting cases of pulmonary tuberculosis has become almost as inevitable, being made through the use of interviews with key informants.

Restos de Anchitherium de Lisboa, Portugal

The Anchitherium remains from several Portuguese localities placed on IVb and Vb (Lisbon area) levels are studied. They are compared with the French and Spanish remains, and particularly with those from the Madrid basin. They are identified as Anchitherium cf. A. ezquerrae from the Vb level remains, because the remains are very scarce.

Sélaciens du Miocène terminal du bassin d'Alvalade (Portugal). Essai de synthèse

A rich uppermost Miocene selachian fauna from the Alvalade Basin (represented by more than 10.000 teeth) is accounted for. It is the most modern miocene fauna of neritic habit under warm-temperate to subtropical conditions, known in the european Miocene.

Veiga Ferreira e a Paleontologia em Portugal

This communication deals with the less known research activities on Palconlology by Octávio da Veiga Ferreira, since just after he became a member of the staff of the Serviços Geológicos de Portugal. These activities lasted for about 25 years (1951-1975, eventually up to 1987). Besides much field and laboralory work, Veiga Ferreira produced (alone or in collaboration} 38 papers. These concern vertebrates, echinoids, pectens and other molluscs, and malacostraca, as well as some papers of a more general or divulgation character. Studied fossils range from Jurassic to Quaternary, and from continental Portugal to Santa Maria Island (Azores), the Madeira Archipel and Angola. Veiga Ferreira is author of much valid work. He generously helped others as well. A bibliography for his paleontological papers is provided.

Invertebrados y micropaleontología en la evolución de la Cuenca del Guadalquivir (España) y la Plataforma del Algarve (Portugal)

Based upon the depositional sequences in the Guadalquivir basin and the bio-events defined (foraminifera and nanoplancton) we present the synthesis of the paleontological results in correlation with the Neogene of Algarve (Portugal). We present the most representative outcrops for micropaleonlologic results, as well as paleoenvironmental correlations between Algarve and the Guadalquivir basin.

Mineralogia da fracção argilosa da Formação de Vale Álvaro (Bragança, NE Portugal)

The studied materials were sampled from several conglomerate and carbonate sandstone units, overlapped for 23 meters. This formation represents a debris flow dominated alluvial fan alternating with quiet sedimentary conditions. These deposits of probably Paleogene age were placed upon mafic and ultramafic rocks that are the exclusive source of sediments. Optical and SEM identification, microanalysis and XRD studies (with decomposition procedures) of clay fractions obtained after high-speed centrifugation were performed in order to characterise the clay minerals content. The results of the analytical program allowed the establishment of the following remarks: a) Fe-rich montmorillonite dominance over paligorskite, chlorite, chlorite-smectite mixed-layers, serpentine and talc; b) smectites in the 12.4 - 15 A range, expanding to about 17 A after EG treatment; c) serpentine and talc as secondary minerals in the interior of altered clasts; d) chlorite and clorite smectite mixed-layer compositions in the borders of the clasts and in the cement. The composition of sediments results from coarse clasts eroded from mafic and ultramafic rocks and clayey material. Clasts show evidences of post-depositional weathering (coatings of chlorite and smectite). Clayey material has the contributions of i) inherired chlorite, smectite and chlorite-smectite mixed-layers; ii ) authigenic crystallisation of Fe-montmorillonite (due to availability of Fe in the crystallising solutions following previous weathering events); iii) authigenic paligorskite associated to a carbonate cement.

A sedimentação e a gliptogénese no registo cenozóico continental do Minho (NW Portugal)

This study identifies and describes the major Cenozoíc glyptogenesis and sedimentation episodes in the Minho region (NW Portugal). The fluvial processes of exorheic network were mainly the builders of Cenozoic landscape. This paper presents a chronological sequence of the major fluvial events based on geomorphology and sedimentary characteristics obtained in former studies and new ones. The oldest Cenozoic sedimentation (Placencian) remains on local depressions and was generated by fluvial and fluvio-lacustrine processes. Quaternary glyptogenesis begins probably with a major European cooling (Gunz?). So, the Placencian infilling was eroded and a new episode of sedimentation was accumulated in the same early paleovalley. There were three more cycles of quaternary glyptogenesis and sedimentation. The last glyptogenesis episode records the last glacial period. The post-glacial alluvion contains clasts of granites, schists, feldspats, and other alterable lithologies and minerals; on clay dimensions there are abundant illite and interstratified minerals. This composition differs from the older ones, more siliciclastic and kaolinitic. Other minor erosion episodes were identified, controlled manly by eustasy; evidences of tectonic movements were observed only in rio Minho valley.

Paleoambiental reconstruction based on mineralogical data of quaternary littoral deposits occuring at Cortegaça and Maceda beaches (Ovar, Portugal)

The main goal of the present work is the use of mineralogical data corresponding to sediment fine fractions (silt and clay) of Quaternary littoral deposits for the definition of a more detailed vertical zonography and to discriminate the most significant morphoclimatic changes concerned with sediment source areas and sediment deposition areas. The analysis of the available mineralogical data reveals a vertical evolution of the mineral composition. The following aspects deserve particular reference: 1) fine fractions (<38 nm) are composed of quartz and phyllosilicates associated to feldspars, prevailing over other minerals; however in certain sections iron hydroxides and evaporitic minerals occur in significant amounts; 2) clay fractions (<2 nm) show a general prevalence of illite associated with kaolinite and oscillations, in relative terms, of kaolinite and illite contents. Qualitative and quantitative lateral and vertical variations of clay and non clay minerals allow the discrimination of sedimentary sequences and the establishment of the ritmicity and periodicity of the morphoclimatic Quaternary episodes that occurred in the Cortegaça and Maceda beaches. To each one of the sedimentary sequences corresponds, in a first stage, a littoral environment that increasingly became more continental. Climate would be mild to cold, sometimes with humidity - aridity oscillations. Warmer and moister episodes alternated with cooler and dryer ones.

Variação dos parâmetros paleomagnéticos em perfis dos Tufos de Condeixa (Baixo Mondego, Portugal)

Paleomagnetic parameters measured in 4 outcrops of the Tufos de Condeixa are presented. The directional signatures allow the admission of the Reversed Polarity Criptchron C1n-1 in the Condeixa-a-Velha outcrop. It was possible to discuss the magnetic properties, origin of the magnetic grains and paleoclimatic variation relationships. The downward of the initial magnetization and magnetic susceplibility values in the Condeixa-a-Velha outcrop coincide with the Cln-1 (504-493 Ka) occurrence and may represent a paleoclimatic variation. The Tufos de Condeixa were formed during the Ionian-Tarentian(?).

Significado regional dos depósitos neogénicos continentais da área de Vila de Rei (Portugal Central)

In the Vila de Rei area (Central Portugal) the continental deposits of the Lower Tagus Tertiary Basin lay upon the pediment of the Portuguese Central Chain. Three conglomerate units are recorded from the base upwards, separated by regional or basinal unconformities; Conglomerados de Rio de Moinhos (RM); Conglomerados de Serra de Almeirim (SA) and Conglomerados de Vila de Rei (VR). The first two units (RM and SA) have been sites of gold exploitation in huge open pit mines probably during Roman colonisation times. The contact of this units, on the Paleozoic basement or on the Paleogene unit Grés de Monsanto, is unconform, defining in both limits a large nondepositional and/or erosional hiatus. Those conglomerates seal the sedimentation of the Lower Tagus Tertiary Basin along its northern border. Taking into account the significance assigned to their basinal unconformity limits, the uplift of the Portuguese Central Chain, and the fact of this continental units yielded no fossils with chronostratigraphic significance, they have been considered ranging from Upper Miocene to the beginning of the Quaternary. Finally, a lithostraligraphic equivalence with the Neogenic units of the Bierzo and Duerna basins (NW of the Iberian Peninsula), where exploitations from Roman times are also evident, is presented.

Transição do enchimento terciário para o encaixe fluvial quaternário na área de Vila Velha de Ródão (sector NE da Bacia do Baixo Tejo)

The geomorphologic characteristics and lithostratigraphic units of the transition from the Tertiary filling stage to the Quaternary fluvial incision in the Vila Velha de Ródão area (Lower Tagus Basin, NE sector) are presented. Several morphodynamic episodes, which had an important tectonic control, were distinguished. The same main morphosedimentary processes can be identified in other areas of this important river basin. Five periods of Quaternary fluvial incision were characterized.

Meta-analysis of gender and science research - Country report - Portugal

In Portugal, especially starting in the 1970s, women’s studies had implications on the emergency of the concept of gender and the feminist criticism to the prevailing models about differences between sexes. Until then, women had been absent from scientific research both as subject and as object. Feminism brought more reflexivity to the scientific thinking. After the 25th of April 1974, because of the consequent political openness, several innovating themes of research emerged, together with new concepts and fields of study. However, as far as gender and science relationship is concerned, such studies especially concentrate on higher education institutions. The feminist thinking seems to have two main objectives: to give women visibility, on the one hand, and to denunciate men’s domain in the several fields of knowledge. In 1977, the “Feminine Commission” is created and since then it has been publishing studies on women’s condition and contributing to the enhancement of the reflection of female condition at all levels. In the 1980s, the growing feminisation of tertiary education (both of students and academics), favoured the development of women’s studies, especially on their condition within universities with a special focus on the glass ceiling, despite the lack of statistical data by gender, thus making difficult the analysis of women integration in several sectors, namely in educational and scientific research activities. Other agglutinating themes are family, social and legal condition, work, education, and feminine intervention on political and social movements. In the 1990s, Women Studies are institutionalised in the academic context with the creation of the first Master in Women Studies in the Universidade Aberta (Open University), in Lisbon. In 1999, the first Portuguese journal of women studies is created – “Faces de Eva”. Seminars, conferences, thesis, journals, and projects on women’s studies are more and more common. However, results and publications are not so divulgated as they should be, because of lack of comprehensive and coordinated databases. 2. Analysis by topics 2.1. Horizontal and vertical segregation Research questions It is one of the main areas of research in Portugal. Essentially two issues have been considered: - The analysis of vertical gender segregation in educational and professional fields, having reflexes on women professional career progression with special attention to men’s power in control positions and the glass ceiling. - The analysis of horizontal segregation, special in higher education (teaching and research) where women have less visibility than men, and the under-representation of women in technology and technological careers. Research in this area mainly focuses on description, showing the under-representation of women in certain scientific areas and senior positions. Nevertheless, the studies that analyze horizontal segregation in the field of education adopt a more analytical approach which focuses on the analysis of the mechanisms of reproduction of gender stereotypes, especially socialisation, influencing educational and career choices. 1

Contribuição para a análise tectono-sedimentar do Fosso de Aljezur (SW de Portugal)

The Aljezur "graben" is a crucial piece in understanding the Caenozoic evolution of the SW atlantic portuguese edge. Detailed study of the sedimentary filling and bordering accidents allows the identification of several evolution steps since the Miocene. The graben is bordered by accidents that dislocate geomorphologic surfaces (Littoral Platform to the W, Interior Platform to the E), and also Neogene sedimentary units. The sedimentary filling is composed by conglomerates and sands grading into clays and bioclastic limestones (Burdigalian to Serravalian), upon which lie unconformably fine reddish sands, sometimes with abundant micas. Genetic and geometric relationships between these sands, those in higher surfaces outside the "graben" and the main bordering faults, are discussed. As a conclusion, the reconstruction of the tectono-sedimentary evolution is attempted, integrating it in a "pull-apart" context associated with the Messejana-fault system and it's reactivation by the differently orientated alpine compressions.

Tertiary evolution of the São Vicente and Setúbal submarine canyons, Southwest Portugal: insights from seismic stratigraphy

The Setúbal and São Vicente canyons are two major modern submarine canyons located in the southwest Iberian margin of Portugal. Although recognised as Pliocene to Quaternary features, their development during the Tertiary has not been fully understood up to date. A grid of 2D seismic data has been used to characterise the sedimentary deposits of the adjacent flanks to the submarine canyons. The relationship between the geological structure of the margin and the canyon's present location has been investigated. The interpretation of the main seismic units allowed the recognition of three generations of ravinements probably originated after middle Oligocene. Six units grouped in two distinctive seismic sequences have been identified and correlated with offshore stratigraphic data. Seismic Sequence 2 (SS2), the oldest, overlies Mesozoic and upper Eocene deformed units. Seismic Sequence I (SS1) is composed of four different seismic packages separated from SS2 by an erosional surface. The base of the studied sediment ridges is marked by an extensive erosional surface derived from a early/middle Oligocene relative sea-level fall. Deposition in the adjacent area to the actual canyons was reinitiated in late Oligocene in the form of transgressive and channel-fill deposits. A new depositional hiatus is recorded onshore during the Burdigalian, coincident with the unconformity separating SS1 and SS2. This can be correlated with the Arrábida unconformity and with the paroxysmal Burdigalian phase of the Betic domain. Presently, the Setúbal and São Vicente submarine canyons locally cut SS1 and SS2, forming distinctive channels from those recognised on the seismic data. On the upper shelf both dissect highly deformed areas subject to important erosion.

The Neogene of Algarve (Portugal)

A synthesis about the Neogene and Quaternary of Algarve (Southern Portugal) is presented. New isotopic 87Sr/86Sr ages as well as biostratigraphic data about the Miocene deposits allow to present a new stratigraphic frame for the previously characterized units. The Lagos-Portimão Formation corresponds to deposits of temperate carbonate platform sedimentological type, developed during a long time span (Lower Burdigalian to Upper Serravallian). A major change in sedimentation conditions (carbonate to siliciclastic environments) occurred in the Lower Tortonian with the deposition of yellowish sands. Spongoliths rich in microfossils are represented in Algarve inland. Their age is not well established; calcareous nannofossils indicate the CN5a zone (Upper Serravallian) while foraminifera point out at least Nl6 zone (Lower Tortonian). In the Upper Tortonian, the sedimentation is widespread in Eastern Algarve, related with the Guadalquivir Basin infill. The deposits begin with detrital limestones, locally very rich in Heterostegina, passing to fossiliferous conglomerates and siltstones (Cacela Formation). Coarse-grained conglomerates at Galvana (Faro) pose some age problems. K/Ar age on glauconite indicates 6.72±0.17 Ma. However, glauconites may be reworked from older deposits (Cacela Formation). The Galvana Conglomerate could be related to Pliocene deposits are not well characterized. Olhos de Água sands, with a thin marine intercalation rich in marine vertebrates (fishes, a crocodile, cetaceans, sirenians), may be Upper Pliocene; however, the vertebrates point out to a Serravallian to Tortonian age. 87Sr/86Sr ages on oysters from above the level with vertebrates point out to 3.0(+2.5-1.0) Ma. Similar sand deposits occur at Morgadinho (Luz de Tavira). These sands are overlain by marls, lignite clays, lacustrine limestones and a silty calcareous crust. A small mammals association indicate an age span between Upper Pliocene and Lower Middle Pleistocene (MN17-MN20). A Biharian mammal fauna (Lower Pleistocene) was collected at Algoz in similar deposits. In the present state of knowledge, Morgadinho and Algoz deposits may be correlative.