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Antecedentes y Objetivo: Los estragos causados por la pandemia COVID-19 alcanzaron también la educación médica perdiéndose la enseñanza tutorial que ejercíamos en nuestro Instituto. Método: Se implementaron estrategias a través de las tecnologías de la información y de la comunicación que se describen en este artículo. Resultados: Con las estrategias llevadas a cabo se pudo continuar con toda la educación teórica de manera virtual a distancia, incluyendo el pase cotidiano de visita a los enfermos, la presentación de casos clínicos, el análisis a distancia de los métodos de laboratorio y gabinete, así como la enseñanza de la exploración física y la adquisición de los métodos de ayuda diagnóstica de los gabinetes. El número de asistentes a la sesión general semanaria del Instituto incremento de 100 asistentes presenciales a 500 virtuales (promedio) con reproducciones de las mismas en un promedio de 5,000. Se discuten las ventajas e inconvenientes de estas nuevas técnicas y cuáles son los desafíos para el futuro. Conclusiones: Sin duda alguna, la pandemia ha causado daño a la enseñanza de dos generaciones de estudiantes de la medicina en los años 2020 y 2021 y aún seguimos temerosos de que en el 2022 persista. A nuestro juicio la educación médica implementada por nosotros no es lo ideal, pero por lo menos constituye un buen paliativo del daño que la pandemia produjo en la educación médica.

Azares y decisiones, um título que resume, com rigor, uma vida, a vida. Senti ao ler estas memórias o fascínio da releitura, do retorno a tantos momentos, lugares e pensamentos, de que é feita uma vida e dos possíveis reencontros que ocorrem com a minha própria vida.

Elogio histórico do académico emérito Ilídio melo Peres do Amaral, feito pelo senhor Jorge Manuel barbosa Gaspar

Ángel Cabo Alonso (1922-2016): um Mestre da Geografia Peninsular

RESUMO – Neste texto procurámos reconstituir os conteúdos que nos pareceram mais relevantes de uma apresentação feita no âmbito das conferências do IGOT. A exposição viveu muito de um conjunto largo de imagens que não é possível, nem operativo, transpor para a versão escrita. Estruturámos a reflexão segundo quatro pontos, que se seguem a uma introdução em que afirmamos a “materialidade” do futuro, na qual podemos projetar as cidades, em coerência com o seu passado. A natureza da cidade tem um passado, um presente e um futuro. O primeiro ponto chama a atenção para a importância da ficção, nomeadamente a ficção científica para o ordenamento do território do futuro, dando-se particular relevância às orientações da ciberfiction. No segundo ponto “O futuro das cidades hoje”, abordam-se alguns caminhos da procura da cidade do futuro na atualidade e em diferentes latitudes e contextos socio‑territoriais. Em “Os futuros sonhados dos pobres, dos escorraçados” chama-se a atenção para os sonhos de futuro que os mais deserdados, que fogem do presente, transportam consigo e procuram implantar no território, sempre que têm essa possibilidade. São valorizados exemplos do Portugal meridional, percecionado ao longo de séculos como terra de promissão. Segue-se um apontamento sobre cidade e utopia, dueto inseparável desde os primórdios de qualquer civilização urbana e que permanece vivo nos nossos dias em variados contextos políticos, sociais e geográficos. É aberta uma menção particular ao urbanismo de génese ilegal que ocorreu na Europa do Sul na segunda metade do século XX. Releva-se ainda a importância da revolução das novas tecnologias da informação, não só na construção da cidade do futuro, como no renascer de utopias. A concluir chamamos a atenção para a permanência do papel determinante da urbanização e das cidades na resolução de um grande número de problemas com que a Humanidade e cada indivíduo se vão confrontando: “O ar da cidade torna o homem livre”. Um planeta de cidades pode ajudar os humanos na senda da prosperidade e da felicidade.

LANDSCAPE’S RETURN TO GEOGRAPHY – MYSTICAL NOTES – Landscapehas returned to the geographer’s agenda, at the same time that its actuality is manifested in other fields such as the Arts, Science and Humanities. Nowadays, as far as geographical approaches are concerned, we can consider several concepts of landscape, articulated with the different paradigms of this science.Apart from discussing this issue and its incidence in modern literature, the paper emphasizes some of the «new» sensory dimensions of the landscape: the olfactory (smellscape), the sonic (soundscape), the tactile (landscapes of touch). Components of memory (biographical landscapes) are also brought up as well as the importance of scale in studying landscape.

Innovation holds an important role in the economic development process. The competitive potential of national and regional economies is based on the ability to manage the changing technological process. Economic competition does no longer exclusively depend on the factor costs, which vary geographicaly, because technology can now eliminate the territory disadvantages. Productivity is the crucial element in the competitive capacity of any economy. Productivity, as can easily be proved, is deeply dependent on technological development; this is only possible if there is constant innovation. This paper starts with a brief discussion on the theoretical issues regarding innovation in relation to regional economies. In the second section the Portuguese R&D system is analised in terms of finance and human resources. Particular attention is paid to the entrepreneurial R&D effort, namely in manufacturing activity. Finally, some limitations of the innovation policy in the EU are pointed out, together with its consequences for the least favoured regions.

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Innovation holds an important role in the economic development process. The competitive potential of national and regional economies is based on the ability to manage the changing technological process. Economic competition does no longer exclusively depend on the factor costs, which vary geographicaly, because technology can now eliminate the territory disadvantages. Productivity is the crucial element in the competitive capacity of any economy. Productivity, as can easily be proved, is deeply dependent on technological development; this is only possible if there is constant innovation. This paper starts with a brief discussion on the theoretical issues regarding innovation in relation to regional economies. In the second section the Portuguese R&D system is analised in terms of finance and human resources. Particular attention is paid to the entrepreneurial R&D effort, namely in manufacturing activity. Finally, some limitations of the innovation policy in the EU are pointed out, together with its consequences for the least favoured regions.

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Background: The indiscriminate application of substances for aesthetic purposes, such as silicone in breast implants, leads to the production of common local signs such as inflammation, skin irregularities, edema, erythema, vascular neoformations, and ulcers, which can evolve into general symptoms such as fever, asthenia, weakness, arthralgia or activate the immune system abnormally, causing the appearance of autoimmune diseases. This set of signs and symptoms is called adjuvant-induced autoimmune/inflammatory syndrome., Clinical Case: We present the case of a 50-year-old woman with a history of silicone-based breast implants who spontaneously developed a hemorrhagic coagulopathy, type A acquired hemophilia was documented, that is, autoantibodies against coagulation factor VIII. Thanks to the work of a multidisciplinary team, it is possible to successfully diagnose and treat the patient with bridging agents, implant removal and management of associated symptoms., Conclusion: the importance of knowing the pathology is recognized, which, although it is rare, when it occurs has a high mortality rate if it is not diagnosed and treated on time., (© 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

The term pulmonary vascular resistance [PVR] describes, in part, the forces opposing the flow across the pulmonary vascular bed. The equation traditionally used is based on the assumption that the pulmonary capillaries, as well as some others vessels in series behave like a Poiseuille resistance. This assumption implies a laminar type of flow of a homogeneous Newtonian fluid, however blood is not a Newtonian fluid and flow is pulsatile in the pulmonary circulation. Neglecting these factors [which only slightly undermines the application of the equation] and others as well [like distension and recruitment of the vessels], will, however, not give us a true clinically practical solution for the calculation of PVR, because the concept of the equation is only true or partially true for part of the pulmonary circulation. In other parts of the lung, flow depends mainly on the behaviour of capillaries as a Starling resistor. If we considered always pulmonary venous pressure [measured clinically as left atrial pressure or pulmonary wedge pressure] as the effective downstream pressure for the calculation of PVR and we ignore or disregard the existence of a significant "critical closing pressure" [whatever the cause] in the lung it will lead to additional erroneous concept regarding PVR calculations and, in addition for the real hemodynamic conditions of the pulmonary vascular bed. Because, at least two different models of perfusion exist in the lung it is inadmissible from a theoretical point of view to calculate PVR, based on only in one of these models. According to the present knowledge of the pulmonary circulation hemodynamics, an improved definition for the PVR could be obtained: 1. by a multipoint pulmonary vascular pressure/flow plot at high flows and 2. with the use of the pulmonary artery occlusion pressure [PAOP] in addition to the determination of the pulmonary wedge pressure technique [PWP], in order to establish the estimated downstream pressure of the pulmonary circulation at zero flow. Therefore, pulmonary hemodynamic determinations of the PVR are better defined with the analysis of the pressure-flow relationships in addition to the information derived from the PAOP/PWP measurements. However, if none of the previous pressure-flow relationships [in order to obtain the slope = PVR at high flows] or the effective downstream pressure measurements [in order to estimate the critical closing pressure at zero flow] are applied for the analysis of the pulmonary circulation, a cautious interpretation of the measured variables [mean pulmonary artery pressure and cardiac output] is preferable to wrong conclusions made from a meaningless variable, the "calculated PVR".