Relatório de Estágio

O presente relatório de estágio foi concebido no âmbito da na unidade curricular de Integração Curricular: Prática Educativa e Relatório de Estágio inserida do mestrado profissionalizante em Ensino do 1.º e 2º Ciclo do Ensino Básico. Tem como objetivo dar a conhecer, de forma refletida e fundamentada, a prática realizada pela mestranda no âmbito da sua intervenção educativa em contexto de prática de ensino supervisionada. Como o estágio é de natureza profissional e sendo uma oportunidade de colocar na prática os diversos conhecimentos que foram obtidos ao longo da formação académica, este documento começa com a realização de um enquadramento académico e profissional que destaca os princípios que nortearam a ação da professora estagiária. A nível académico lança-se uma visão sobre os pressupostos legais que alicerçam a formação profissional de professores, em geral, e da prática de ensino supervisionada, em particular. Por outro lado, a nível profissional destacam-se princípios estruturantes da construção e desenvolvimento profissional, que sustentou a prática da professora estagiária ao longo deste percurso. Num segundo momento, descrevem-se as experiências vividas no decorrer da Prática de Ensino Supervisionada desenvolvida no ano letivo 2013/2014 que foi realizada no Agrupamento de Escolas do Cerco, com uma turma do 5.º ano de escolaridade da Escola Básica e Secundária do Cerco e outra do 2.º ano de escolaridade da EB1/JI do Falcão. Este estágio permitiu desenvolver competências pessoais, sociais e profissionais: observação; cooperação; regência; participação e desenvolvimento de atividades e projetos no contexto educativo. Estas experiências de ensino e aprendizagem procuraram a promoção de uma aprendizagem ativa e significativa para os alunos. Este percurso formativo apesar de ser uma base da identidade profissional docente, não é estanque e estará em constante mudança e evolução, para uma formação contínua ao longo da vida.

Pharmacological effects of Sapindus mukorossi

Sapindus mukorossi is an extremely valuable medicinal plant, distributed in tropical and sub-tropical regions of Asia. The aim of present review is to form a short compilation of the phytochemical composition and pharmacological properties of this multipurpose tree. The main phytoconstituents isolated and identified from different parts of this plant are triterpenoidal saponins of oleanane, dammarane and tirucullane type. The structure and chemical names of all the types of triterpenoidal saponins reported in Sapindus mukorossi are included in this review. Many research studies have been conducted to prove the plant's potential as being spermicidal, contraceptive, hepatoprotective, emetic, anti-inflammatory and anti-protozoal. The present review highlights some of the salient pharmacological uses of Sapindus mukorossi.

Frequency of human bocavirus respiratory infections among at-risk patients in São Paulo, Brazil

BACKGROUND AND OBJECTIVES: Human Bocavirus (HBoV) has been described since 2005 as an etiological agent of respiratory virus infections. From 2001 to 2008 we investigated the etiology of HBoV among adults and children in different groups at risk of presenting complications arising from acute respiratory infection, the investigation was carried out in a tertiary hospital health care system in Brazil. METHODS: HBoV DNA was assayed in 598 respiratory samples from community and hospitalized patients by PCR. RESULTS: Of the 598 tested samples, 2.44% (8/328) of children, including five children with heart disease, and 0.4% (1/270) of adult bone-marrow-transplant were HBoV positive. CONCLUSIONS: These data suggested lower HBoV frequency among different at-risk patients and highlights the need to better understand the real role of HBoV among acute respiratory symptomatic patients.

21st century quality: Looking into the “Crystal ball”

The discussion of possible scenarios for the future of Quality is on the priority list of major Quality Practitioners Societies. EOQ – European Organization for Quality (EOQ, 2014) main team for its 58th EOQ-Congress held June 2014 in Göteborg was “Managing Challenges in Quality Leadership” and ASQ - American Society for Quality (ASQ, 2015) appointed “the Future of Quality” for Quality Progress Magazine November 2015 issue. In addition, the ISO 9001:2008 revision process carried by ISO/TC 176 aims to assure that ISO 9001:2015 International Standard remains stable for the next 10 years (ISO, 2014) contributing to an increased discussion on the future of quality. The purpose of this research is to review available Quality Management approaches and outline, adding an academic perspective, expected developments for Quality within the 21st Century. This paper follows a qualitative approach, although data from international organizations is used. A literature review has been undertaken on quality management past and potential future trends. Based on these findings a model is proposed for organization quality management development and propositions for the future of quality management are advanced. Firstly, a state of the art of existing Quality Management approaches is presented, for example, like Total Quality Management (TQM) and Quality Gurus, ISO 9000 International Standards Series (with an outline of the expected changes for ISO 9001:2015), Six Sigma and Business Excellence Models.Secondly, building on theoretical and managerial approaches, a two dimensional matrix – Quality Engineering (QE - technical aspects of quality) and Quality Management (QM: soft aspects of quality) - is presented, outlining five proposed characterizations of Quality maturity levels and giving insights for applications and future developments. Literature review highlights that QM and QE may be addressing similar quality issues but their approaches are different in terms of scope breadth and intensity and they ought to complement and reciprocally reinforce one another. The challenges organizations face within the 21st century have stronger uncertainty, complexity, and differentiation. Two main propositions are advanced as relevant for 21st Century Quality: - QM importance for the sustainable success of organizations will increase and they should be aware of the larger ecosystem to be managed for improvement, possibly leading to the emergence of a new Quality paradigm, The Civilizacional Excellence paradigm. - QE should get more attention from QM and the Quality professionals will have to: a) Master and apply in wider contexts and in additional depth the Quality Tools (basic, intermediate and advanced); b) Have the soft skills needed for its success; c) Be results oriented and better understand and demonstrate the relationships between approaches and results These propositions challenge both scholars and practitioners for a sustained and supported discussion on the future of Quality. “All things are ready, if our mind be so.” (Shakespeare, Henry V, circa 1599).

Emotion-oriented interventions for environment and the facilitation of pro-environmental behavior

Dissertação para obtenção do Grau de Doutor em Ambiente, pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

Delineating environmental groundwater vulnerability and protection zones mapping in fractured rock masses

Hard‐rock watersheds commonly exhibit complex geological bedrock and morphological features. Hydromineral resources have relevant economic value for the thermal spas industry. The present study aims to develop a groundwater vulnerability approach in Caldas da Cavaca hydromineral system (Aguiar da Beira, Central Portugal) which has a thermal tradition that dates back to the late 19th century, and contribute to a better understanding of the hydrogeological conceptual site model. In this work different layers were overlaid, generating several thematic maps to arrive at an integrated framework of several key‐sectors in Caldas da Cavaca site. Thus, to accomplish a comprehensive analysis and conceptualization of the site, a multi‐technical approach was used, such as, field and laboratory techniques, where several data was collected, like geotectonics, hydrology and hydrogeology, hydrogeomorphology, hydrogeophysical and hydrogeomechanical zoning aiming the application of the so‐called DISCO method. All these techniques were successfully performed and a groundwater vulnerability to contamination assessment, based on GOD‐S, DRASTIC‐Fm, SINTACS, SI and DISCO indexes methodology, was delineated. Geographical Information Systems (GIS) technology was on the basis to organise and integrate the geodatabases and to produce all the thematic maps. This multi‐technical approach highlights the importance of groundwater vulnerability to contamination mapping as a tool to support hydrogeological conceptualisation, contributing to better decision‐making of water resources management and sustainability.

EVIDENCE OF Leishmania (Leishmania) infantum INFECTION IN DOGS FROM JUIZ DE FORA, MINAS GERAIS STATE, BRAZIL, BASED ON IMMUNOCHROMATOGRAPHIC DUAL-PATH PLATFORM (DPP®) AND PCR ASSAYS

In Brazil, domestic dogs are branded as the primary reservoir for zoonotic visceral leishmaniasis, due to the clear positive correlation observed between human and canine infection rates. This study aimed to carry out a serological survey of canine visceral leishmaniasis (CVL) in dogs housed at a public kennel in the municipality of Juiz de Fora, Minas Gerais State, Brazil, using the immunochromatographic TR DPP® CVL rapid test. Additionally, conventional and/or real time PCR assay was used to detect and confirm L. infantum infection in the DPP positive dogs only. Of the 400 dogs studied, most did not present clinical signs for CVL (p < 0.05), and fifteen (3.8%) were seropositive in the DPP test. There was no statistically significant difference between the DPP seropositive dogs and the clinical signs of the disease (p > 0.05). Both conventional and real time PCR tests confirmed L. infantum infection in nine (75.0%) of the twelve DPP seropositive dogs that remained alive during the follow-up period. This study is the first seroepidemiologic survey of CVL held in the city of Juiz de Fora, and the results reinforce the idea that this disease is currently in a process of expansion and urbanization in Brazil. Furthermore, this study highlights the use of the DPP test as an alternative for diagnosing CVL in large and mid-sized cities, due to its ease of implementation.

Birt-Hogg-Dubé Syndrome

A 45-year-old woman with a history of renal carcinoma was observed for facial, cervical and truncal flesh-colored papules. Relatives had similar skin findings and a brother had repeated episodes of pneumothorax. The computerized tomography scan revealed multiple cysts on both lungs. A skin biopsy revealed a perifollicular fibroma. The clinical diagnosis of Birt-Hogg-Dubé syndrome (BHDS) was corroborated by identification of a novel frameshift c.573delGAinsT (p.G191fsX31) mutation in heterozygosity on exon 6 of the folliculin gene. The presence of multiple and typical benign hair follicle tumors highlights the role of the dermatologist in the diagnosis of this rare genodermatosis that is associated with an increased risk of renal cell cancer and pulmonary cysts, warranting personal and familial follow-up and counseling.

Breast Cancer Presents With a Paraneoplastic Neurologic Syndrome

BACKGROUND: Paraneoplastic neurologic syndromes (PNS) pose quite an uncommon neurological complication, affecting less than 1% of patients with breast cancer. Nearly one third of these patients lack detectable onconeural antibodies (ONAs), and improvement in neurologic deficits with concomitant cancer treatments is achieved in less than 30% of cases. CASE PRESENTATION: A 42-year-old, premenopausal woman presented with facial paralysis on the central left side accompanied by a left tongue deviation, an upward vertical nystagmus, moderate spastic paraparesis, dystonic posturing of the left foot, lower limb hyperreflexia and bilateral extensor plantar reflex. After ruling out all other potential neurologic causes, PNS was suspected but no ONAs were found. A PET-CT scan detected increased metabolism in the right breast, as well as an ipsilateral thoracic interpectoral adenopathy. Core biopsy confirmed the presence of an infiltrating duct carcinoma. After breast surgery, the neurologic symptoms disappeared. One week later, the patient was readmitted to the hospital with a bilateral fatigable eyelid ptosis, and two weeks later, there was a noticeable improvement in eyelid ptosis, accompanied by a rapid and progressive development of lower spastic paraparesis. She started adjuvant treatment with chemotherapy with marked clinical and neurological improvement, and by the end of radiotherapy, there were no signs of neurologic impairment. CONCLUSION: This case study highlights the importance of a high level of vigilance for the detection of PNS, even when ONAs are not detected, as the rapid identification and treatment of the underlying tumor offers the best chance for a full recovery.

Atypical Case of Mediterranean Spotted Fever

The authors present a case of atypical severe (malignant) Mediterranean spotted fever, with a brief review on the subject. Although not previously described in Brazil, the possibility of imported cases, especially from Portuguese tourists, is real. This case report highlights the severe form of the disease and the possibility of atypical presentation with confounding differential diagnosis. A brief review of classical presentation is also done. The authors believe it is a valid paper and a good contribution to your Journal of Infectious Diseases. The content of the manuscript represents the views of the coauthors, and neither the corresponding author nor the coauthors have submitted duplicate or overlapping manuscripts elsewhere.

Association of Intestinal Malrotation and Bochdalek Hernia in an Adult: a Case Report

Background Late presentations of congenital diaphragmatic hernia are rare and differ from the classic neonatal presentation. The association with other congenital malformations in children, mainly intestinal malrotation, is well documented. The diagnosis of this association in adults is very rare, and depends on a high degree of suspicion. Case presentation We report a case of a 50-year-old female Caucasian patient with a previous history of intestinal malrotation diagnosed in adolescence and treated conservatively. She was referred to the hospital with signs and symptoms of intestinal obstruction. The patient undertook computed tomography that confirmed small bowel obstruction with no obvious cause, and a right subphrenic abscess with right empyema was also present. An exploratory laparotomy was performed that revealed an intestinal malrotation associated with a right gangrenous and perforated Bochdalek hernia. Resection of the affected small bowel, closure of the Bochdalek foramen and the Ladd procedure were carried out. Conclusion This case shows a rare association of two rare conditions in adults, and highlights the challenge in reaching the diagnosis and management options.

IgG4-Related Hashimoto's Thyroiditis - A New Variant of a Well Known Disease

Hashimoto's thyroiditis (HT) has been characterized for many years as a well-defined clinicopathologic entity, but is now considered a heterogeneous disease. IgG4-related HT is a new subtype characterized by thyroid inflammation rich in IgG4-positive plasma cells and marked fibrosis. It may be part of the systemic IgG4-related disease. We report a case of a 56-year-old Portuguese man who presented with a one-month history of progressive neck swelling and dysphagia. Laboratory testing revealed increased inflammatory parameters, subclinical hypothyroidism and very high levels of thyroid autoantibodies. Cervical ultrasound (US) demonstrated an enlarged and heterogeneous thyroid gland and two hypoechoic nodules. US-guided fine needle aspiration cytology was consistent with lymphocytic thyroiditis. The patient was submitted to total thyroidectomy and microscopic examination identified typical findings of HT, marked fibrosis limited within the thyroid capsule and lymphoplasmacytic infiltration, with >50 IgG4-positive plasma cells per high-power field and an IgG4/IgG ratio of >40%. After surgery, serum IgG4 concentration was high-normal. Symptoms relief and reduction in laboratory inflammatory parameters were noticed. Thyroid function is controlled with levothyroxine. To our knowledge we report the first case of IgG4-related HT in a non-Asian patient. We also perform a review of the literature regarding IgG4-related disease and IgG4-related HT. Our case highlights this new variant of the well known HT, and helps physicians in recognizing its main clinical features, allowing for proper diagnosis and treatment.

Onychomycosis in Patients with Chronic Leg Ulcer and Toenail Abnormalities

Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects.

Analysis of the intranuclear life of nonsense transcripts

Dissertação para obtenção do Grau de Doutor em Biologia, Especialidade de Biologia Molecular