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® ) is an oral multikinase inhibitor that blocks tumor cell proliferation and angiogenesis and is used for the treatment of advanced renal cell carcinoma, hepatocellular carcinoma, and other solid tumors including metastatic differentiated thyroid cancer, at a starting dose of 400 mg twice daily (1-4). The most common adverse effects are fatigue, diarrhea, and various other dermatologic side effects (1). Recently, a meta-analysis of dermatological toxicities associated with sorafenib has been published, (5) and a hand-foot-skin reactions (HFSR) was most often found, but also rash/desquamation, alopecia, pruritus and dry skin. Nail involvement has been reported, in particular sub-ungual splinter hemorrhages (6). We describe a patient with longitudinal melanonychia and blue lunulae that developed during sorafenib therapy of metastatic thyroid carcinoma.

BACKGROUND Nail unit melanoma (NUM) is a variant of acral lentiginous melanoma. The differential diagnosis is wide but an acquired brown streak in the nail of a fair-skinned adult person must be considered a potential melanoma. Dermoscopy helps clinicians to more accurately decide if a nail apparatus biopsy is necessary. OBJECTIVE Detailed evaluation of clinical and dermoscopy features and description of conservative surgery of in situ NUM. METHODS Retrospective study of in situ NUM diagnosed and treated with conservative surgical management in the authors' center from 2008 to 2013. RESULTS Six cases of NUM were identified: 2 male and 4 female patients, age range at diagnosis of 44 to 76 years. All patients underwent complete nail unit removal with at least 6-mm security margins around the anatomic boundaries of the nail. The follow-up varies from 4 to 62 months. CONCLUSION Nail unit melanomas pose a difficult diagnostic and therapeutic challenge. Wide excision is sufficient, whereas phalanx amputation is unnecessary and associated with significant morbidity for patients with in situ or early invasive melanoma. Full-thickness skin grafting or second-intention healing after total nail unit excision is a simple procedure providing a good functional and cosmetic outcome.

Auteur(s) : Ana Filipa Duarte1, Osvaldo Correia1,2, Rosa Azevedo3, Maria do Carmo Palmares2, Luis Delgado2 1Centro de Dermatologia Epidermis, Instituto CUF, Apartado 55031, 4050-401 Porto, Portugal 2Department of Immunology, Faculty of Medicine, University of Porto, Portugal 3Department of Pathology, Instituto Portugues de Oncologia, Porto, Portugal Fixed drug eruption (FDE) is a skin drug eruption that usually appears as a solitary or a small number of well circumscribed, cutaneous [...]

A short frenulum is not uncommon and is an important cause of male dyspareunia. Surgical frenuloplasty may alleviate symptoms, but there is a risk of residual scarring leading to further symptoms. Laser frenuloplasty, consisting of frenulum vaporization by laser CO2, is an alternative simple, safe and efficacious procedure. We report three cases of successful treatment of a short frenulum with laser CO2 with good aesthetical results and complete resolution of symptoms.

Background: Eccrine hidrocystomas are rarely described benign cystic lesions, mainly presenting in middle-aged women in the centrofacial area and usually associated with a chronic course, seasonal variability and no proved and consistently efficacious treatments. Case Report: We report 2 patients, a 45- and a 56-year-old woman, with multiple facial eccrine hidrocystomas suggested by dermatoscopy, confirmed by histology and treated with botulinum toxin A with excellent results. Conclusion: Our report stresses the role of dermatoscopy in the diagnosis and follow-up of these lesions, as well as the impact of repeated treatments with botulinum toxin A in eccrine hidrocystomas suggesting it as a first-line treatment for multiple eccrine hidrocystomas because it is easy to use and has no risk of scars.

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Congenital atrichia (CA) is a rare form of irreversible alopecia with an autosomal recessive mode of inheritance, usually associated with a mutation in the human hairless (HR) gene located at chromosome 8. Papular lesions may develop as an additional phenotypic feature. Herein we describe a case of CA supported by trichoscopy, histology and genetic analysis. The patient’s single brother had also universal alopecia. To our knowledge this is the second report of a specific pathogenic mutation (c.2818C>T) of the HR, which until now had only been identified in a family with CA and papular lesions, emphasizing the difficulty to establish a strict correlation between HR genotyping and the phenotype.

Congenital atrichia (CA) is a rare form of irreversible alopecia with an autosomal recessive mode of inheritance, usually associated with a mutation in the human hairless (HR) gene located at chromosome 8. Papular lesions may develop as an additional phenotypic feature. Herein we describe a case of CA supported by trichoscopy, histology and genetic analysis. The patient’s single brother had also universal alopecia. To our knowledge this is the second report of a specific pathogenic mutation (c.2818C>T) of the HR, which until now had only been identified in a family with CA and papular lesions, emphasizing the difficulty to establish a strict correlation between HR genotyping and the phenotype.

A otite externa canina é uma doença frequente em clínica de pequenos animais. O objectivo geral deste estudo foi a caracterização da otite externa numa população de canídeos de base hospitalar, e os objectivos específicos foram determinar da presença de otalgia em canídeos com otite externa e correlacionar com os factores intrínsecos da doença. O desenvolvimento deste tema de dissertação foi realizado na Faculdade de Medicina Veterinária na Universidade Lusófona de Humanidades e Tecnologias e no Hospital Veterinário da Arrábida (HVA) no âmbito do estágio curricular do Mestrado Integrado de Medicina Veterinária, no período de Setembro de 2012 e Março de 2013. A amostra incluiu trinta canídeos com sintomatologia de otite externa, a partir dos quais se obteve uma história clínica, um exame otológico, e se avaliou a otalgia associada através da pressão do tragus e da elevação do pavilhão auricular. As raças puras, bem como os animais com orelhas pendentes foram mais afectados pela otite externa. A otite aguda foi mais observada que a otite crónica. A lesão observada em todos os canídeos da amostra foi o eritema e a sua presença foi sempre associada a otite externa. Concluiu-se que o exsudado purulento esteve sempre associado à presença de agentes infecciosos, mais especificamente a cocos e/ou bastonetes. A otalgia esteve presente em 41% de casos, estando a maior parte associados às otites infecciosas. O teste de pressão do tragus foi mais sensível na detecção de dor, do que a elevação do pavilhão auricular., The canine external otitis is a disease with high incidence in small animal medicine. The aim of this study was to characterize external otitis in a canine hospital-based population, and the specific objectives were to determine the presence of ear pain in dogs with external otitis and correlate it with the intrinsic factors of the disease. The development of this dissertation topic was held at Faculdade de Medicina Veterinária of Universidade Lusófona de Humanidades e Tecnologias and at Hospital Veterinário da Arrábida within the curricular internship of the Master of Veterinary Medicine, between September 2012 and March 2013. Our sample included thirty dogs with symptoms of external otitis, from which it was obtained a medical history, otologic examination, and evaluated the associated ear pain by pressing the tragus and elevating the outer ear. The pure breeds, as well as animals with drooping ears were most affected by external otitis. Acute otitis was more observed than chronic otitis. The damage observed in all sample was erythema and its presence has always been associated with external otitis. We concluded that the purulent exudate was always associated with the presence of infectious agents, specifically coccus and / or bacillus. Otalgia was present in 41% cases, being mostly associated with infectious otitis. The tragus pressure test was more sensitive in detecting pain than the elevation of the outer ear method., Orientação : Pedro Faísca ; Co-orientação : Ana Oliveira ; Responsbilidade externa : Ângela Martins

Dissertação de mestrado em Exercício e Saúde em Populações Especiais, apresentada à Faculdade de Ciências do Desporto e Educação Física da Universidade de Coimbra A educação de jovens e crianças com deficiência tem sofrido inúmeras mudanças nas últimas décadas, sendo a inclusão de alunos com deficiência motora nas aulas de Educação Física uma realidade presente nos dias de hoje. A autoeficácia dos professores tem uma grande influência nas atitudes favoráveis face à inclusão destes alunos. Cabe ao professor ter sensibilidade e sentir-se capaz para poder partilhar de forma justa esta experiência enriquecedora para todos e, acima de tudo, implementar de forma correta as alterações necessárias para que os alunos com deficiência se sintam incluídos. Desta forma, o presente estudo exploratório tem como principal objetivo avaliar a fiabilidade do instrumento Physical Educators’ Self-Efficacy Toward Including Students with Disabilities – (PESEISD) (Taliaferro, Block, Harris e Krause, 2010), traduzido e adaptado para a realidade portuguesa por Campos e Ferreira (2012) e verificar a autoeficácia dos professores face à inclusão de alunos com deficiência motora nas aulas de Educação Física. A amostra é constituída por 77 professores de Educação Física, 55 do sexo masculino e 22 do sexo feminino com idades compreendidas entre os 24 e 59 anos, média de idades= 34.68 e um desvio padrão= 8.99. Os resultados obtidos no estudo apresentam a existência de uma fiabilidade bastante elevada do questionário (α=0.958) e de valores aceitáveis dos níveis de autoeficácia dos professores. Emerge assim, o interesse de continuar a alargar o leque de pesquisas na área, aprofundando a investigação e validação do instrumento e das suas propriedades. The education of children and youth with disabilities has undergone numerous changes in recent decades, thus the inclusion of students with physical disabilities in physical education classes is a reality nowadays. The teachers' self-efficacy has a great influence on favorable attitudes towards the inclusion of these students. The teacher has to be sensitive and feel able to fairly share this enriching experience for all, and above all, correctly implement the necessary changes so that students with disabilities feel included. Thus, this exploratory study has the main objective of evaluating the reliability of the instrument Physical Educators' Self-Efficacy Toward Including Students with Disabilities - (PESEISD) (Taliaferro, Block, Harris and Krause, 2010), translated and adapted for the Portuguese reality by Campos e Ferreira (2012) and check the self-efficacy of teachers towards the inclusion of students with physical disabilities in physical education classes. The sample consists of 77 physical education teachers, 55 males and 22 females aged between 24 and 59 years, mean age = 34.68, standard deviation = 8.99. The results of the study show that there is a very high reliability of questionnaire (α = 0.958) and acceptable values of the teachers levels of self-efficacy. Thus, there is interest of continuing to expand the range of research in the area, to deeply investigate and validate the instrument and its properties.

Despite progress in understanding the molecular basis, the diagnosis of neurofibromatosis 1 (NF 1) is based on clinical criteria, established by the National Institute of Health (NIH) Consensus Conference in 1987. The association of NF1 and piebaldism has been reported, but some authors disagree with this co-occurrence. In the light of present knowledge, we highlight that both entities might co-exist in the same patient.

As opções estratégicas e sua coerência são factores chave para o sucesso das organizações no mundo competitivo e em constante mudança nos dias de hoje. O presente trabalho é um caso pedagógico empresarial e como tal, apresenta duas vertentes complementares. Por um lado a análise de uma situação empresarial real e por outro a sua ‘resolução’ através de uma metodologia pedagógica. O caso descreve o modelo de negócio da Odisseias, uma empresa criada em 2005 e que atua no mercado das experiências em Portugal. A Odisseias teve um crescimento exponencial desde o seu início, conseguindo inesperadamente em 2012 passar do terceiro lugar a líder de mercado, atingindo receitas superiores a cinco milhões de euros. O objectivo do caso é sobretudo identificar, analisar e constatar a validade das variáveis que sustentam o êxito e a continuidade desta área de negócio no mercado, e posteriormente, através da utilização de ferramentas de análise apropriadas, possibilitar ao público-alvo do caso, estabelecer uma linha de evolução para a empresa, não só a nível interno, mas também, externo. Paralelamente, a resolução deste problema empresarial é apresentada de forma a ser utilizada para fins pedagógicos, potenciando a aprendizagem de metodologias e instrumentos de gestão, que orientam a definição de uma Estratégia em qualquer mercado. Este trabalho pretende, ao nível da Gestão Empresarial, ser um contributo válido para a sistematização do processo de elaboração de uma estratégia empresarial. Para a Pedagogia, pretende-se munir o mercado de um instrumento eficaz de ensino, que permita exercitar a tomada de decisão, de forma consistente e estruturada. The strategic options and its coherence are key factors for the success of all organizations in this fast changing and competitive world we currently live in. This paper is a business pedagogical case and as such, presents two complementary perpectives. On one hand, the analysis of a real business situation and on the other, the resolution of problematics encountered relating from a pedagogical perspective. The case describes the business model of Odisseias, a company criated in 2005 that operates in the gift voucher’s market in Portugal. Odisseias has grown exponentially since its start-up, which allowed the company unexpectedly to move from third player in the market to leader with revenues of more than five million euros in 2012. The aim of this business case is to identify, analyze and verify the validity of the variables that underpin the success of the company and the continuity of this industry. Through the use of suitable analitic tools, the readers should be able to establish the evolution of the company, not only internally, but also externally. In addition, the resolution of this business problem is presented in a way that is suitable to be used for educational purposes, enhacing learning methodologies and management tools that guide the definition of a strategy, in any market. At the level of business management, this study intends to be a valid contribution for the sistematization of the process of developing a business strategy. For pedagogy, the purpose of this study is to provide an effective tool of teaching that support the decision making process in a consistent and structured manner.

Dissertação de Mestrado em Energia para a Sustentabilidade, apresentada à Faculdade de Ciências e Tecnologia da Universidade de Coimbra. Esta dissertação tem por objeto verificar a viabilidade económica e financeira de um projeto de investimento integrado tanto na gestão de resíduos como no setor elétrico de uma pequena ilha, com o objetivo de alcançar o desenvolvimento sustentável da região através da implementação das melhores práticas ambientais, económicas e sociais. Inicia-se a análise com um breve enquadramento da economia do ambiente, procurando demonstrar a relação entre a escassez dos recursos e o desenvolvimento sustentável, seguido de uma análise de caráter teórico ao setor elétrico e da gestão de resíduos em ilhas pequenas. Examinam-se os principais indicadores e conceitos da avaliação de projetos de investimentos, procurando conhecer as especificidades do método a utilizar na análise do projeto. Segue-se a apresentação do setor elétrico e da gestão de resíduos em Portugal com o intuito de perceber o funcionamento dos mesmos de acordo com a legislação em vigor. Procedeu-se a uma análise ao ambiente económico e social da ilha em que o projeto se localiza, assim como ao setor da gestão de resíduos e elétrico da mesma. De acordo com as características do projeto, estipuladas para as fases de investimento e exploração, demonstrou-se que o projeto em questão não é viável economicamente para os diversos cenários formulados. This dissertation aims to verify the economic and financial viability of an investment project inserted both in the setor of waste management and in the electric sector of a small island, with the aim of achieving sustainable development in the region through the implementation of best environmental practices, economic and social. It begins with a brief analysis of the economic of the environment, trying to demonstrate the relationship between the lack of resources and sustainable development, followed by a theoretical analysis of the electric sector and waste management on small islands. It examines the main concepts of indicators and evaluation of investment projects, in order to understand the specifics of the method used in the analysis of the project. Below will be made a presentation of the electricity sector and waste management in Portugal in order to understand the functioning of the same according to law. An analysis of economic and social environment of the island where the project is located was made, as well as the sector of waste management and electricity of the same, trying to meet their specific requirements. According to the characteristics of the project, set for investment and operation, it was demonstrated that the project in question is not economically viable in the various scenarios formulated.

Paraneoplastic syndromes (PS) are diseases or symptom complexes associated with malignancy, usually of internal origin, but not directly related to mass effects, invasion, or metastatic spread. Rarely, cutaneous squamous cell carcinoma (SCC) may be associated with PS. We present a patient with a giant SCC located on the right leg and a pheochromocytoma. Considering the concurrent onset and parallel course of both pheochromocytoma and SCC in this patient, and the complete resolution of the endocrine abnormalities after resection of the skin tumor, it was possible to conceive of the pheochromocytoma as a paraneoplastic phenomenon. To our knowledge, this association has not been previously described.

Reinforcement Learning algorithms offer interesting features for the control of autonomous systems, such as the ability to learn from direct interaction with the environment, and the use of a simple reward signalas opposed to the input-outputs pairsused in classic supervised learning. The reward signal indicates the success of failure of the actions executed by the agent in the environment. In this work, are described RL algorithmsapplied to two case studies: the Crawler robot and the widely known inverted pendulum. We explore RL capabilities to autonomously learn a basic locomotion pattern in the Crawler, andapproach the balancing problem of biped locomotion using the inverted pendulum.

The prevalence of atopic dermatitis is increasing in western societies and this disease has a significant effect on the quality of life of patients and their families. The pathophysiology is complex, but there are recent insights on innate and adaptive immunity dysfunction in this condition that increases the predisposition to colonization/infection with characteristic types of microorganisms. We provide an up-to-date review of the pathophysiology of atopic dermatitis, highlighting the clinical implications of skin barrier dysfunction and immunological deregulation. We suggest a useful approach for handling exacerbations and infectious events.

The Processionary (Thaumetopoea pityocampa Schiff), is an endemic insect of pine and cedar trees, existing both in rural and urban areas. Ocular toxicity, once rare due to the efficacy of eradication methods, is caused by the insects' hair and is expected to be more frequent with its recrudescence. We report two clinical cases and review the epidemiology of Processionary and its eye injuries. Case 1: a 64 year-old patient complained of red eye and foreign body sensation after being gardening. She had a BCVA of 0.5 and biomicroscopy revealed an epithelial erosion, flare (++), Tyndall (+++) and the presence of a setae in the deep corneal stroma. Case 2: a 28 year-old patient complained of severe pain in the right eye and hyperemia after having had contact with a caterpillar. He presented with a BCVA of 0.6, Tyndall (+++) and multiple filaments (over 20) at different depths in the cornea. Case 3: a 23 year-old patient refers to the ER with foreign body sensation and constant lacrimation in the right eye after having been completing military exercises in an urban park. He presented a BCVA of 0.3, multiple epithelial erosions in the nasal half of the cornea that cove-red multiple orange strands and an anterior chamber reaction (Tyndall +). Therapy was initiated with topical steroids and symptomatic surveillance. Ocular toxicity due to Processionary hairs, whose movement occurs preferentially towards the posterior pole, includes early signs (conjunctivitis, keratitis, and uveitis) and late signs (cataract, pars planitis, vitritis, and retinitis). The 3 cases presented had early lesions, having fully recovered from the inflammatory condition after 6 months. However, inactive setae were still visible in the corneal stroma. Intraocular migration, which can occur years after the initial episode, is possible and might be severe, thus requiring a life-long surveillance.Processionary recrudescence has been observed, both in rural and urban areas. It is therefore imperative to be familiar with eye injuries caused by the insect and its treatment.

Docetaxel is a semisynthetic taxane used in the treatment of several malignancies. A 60-year-old male patient suffering from a non–small cell lung cancer with bone metastasis was under treatment with docetaxel and developed acral erythema involving photoexposed areas. Onycholysis and melanonychia were also observed. Drug-induced acral erythema usually involves the palms and soles, but it may occur in more atypical areas such as the backs of the hands and feet and also the face, as occurred in this patient. The nail changes are usually observed after several cycles of docetaxel, but tend to resolve gradually over several weeks despite continued treatment. Early recognition of skin and nail changes in the setting of docetaxel treatment, especially with an unusual presentation, is of paramount importance not only for patient reassurance, but also to avoid unnecessary withdrawal of drug treatment.

Cutaneous mastocytosis is characterized by increased numbers of skin mast cells that release mediators causing pruritus, urticaria, and flushing. Most pediatric mastocytosis patients exhibit the pattern of urticaria pigmentosa, which typically appears during the first two years of life and resolves spontaneously in late adolescence. However, while the disease is active, patients are frequently symptomatic and uncomfortable, which justifies symptomatic treatment. We report 2 patients, a 14-month-old girl and a 26-month-old boy, with localized cutaneous erythematous lesions with a positive Darier sign. In each, a punch biopsy confirmed the diagnosis of mastocytosis. Treatment was instituted with pimecrolimus cream twice a day and oral antihistamine. An almost complete response was achieved after 4 months of therapy in both patients, with no clinical evidence of recurrence after 4 years and 2 years of follow-up, respectively. In children, the treatment of mastocytosis is directed primarily to avoiding potential mast cell degranulating agents and alleviating symptoms. Topical calcineurin inhibitors act by inhibiting T-cell activation and cytokine release; they may suppress mast cell- mediated reactions by reducing their degranulation. These two cases suggest that in localized cutaneous mastocytosis they are a safe and efficacious alternative to topical steroid therapy.

There are no pathognomonic findings for cutaneous infection caused by Mycobacterium chelonae. The type and duration of therapy varies considerably among reports and no single antibiotic is considered the treatment of choice. A 61-year-old patient, suffering from rheumatoid arthritis (treated with metotrexate and salazopyrine), presented with violaceous nodules of the right leg that had been evolving for 6 months. She was underwent several skin biopsies. Tissue culture of the last showed an atypical mycobacteria, identified as M. chelonae. Despite improvement after a two-week course of treatment with clarithromycin, a switch to ciprofloxacin was made because of gastrointestinal intolerance. After 3 months, only slight improvement of the lesions was achieved and clarithromycin was reintroduced; significant clinical improvement occurred by the third month. Clarithromycin was continued a further two months until the patient quit on her own and. no recurrence was observed. Infections caused by M. chelonae frequently occur in the setting of immunological impairment. Contaminated water is the natural reservoir, but we were unable to establish the source of contamination. As was previously described, there was a significant delay between clinical presentation and diagnosis. Thus, a high index of suspicion and multiple biopsies with culture are of paramount importance to confirming the diagnosis.

Author(s): Ferreira, Olga; Duarte, Ana Filipa; Baudrier, Teresa; Mota, Alberto; Simoes, Joana Sobrinho; Azevedo, Filomena

Erythema multiforme major (EMM) is an acute, self-limited mucocutaneous disease characterized by the abrupt onset of symmetrical fixed red papules evolving to target lesions. It is triggered mainly by infections, such as herpes simplex virus (HSV) and Mycoplasma pneumoniae, or drugs. In instances of extensive skin lesions with “giant” targets, prominent involvement of several mucous sites and fever, it may be difficult to distinguish from Stevens-Johnson syndrome (SJS), a rarer, life-threatening reaction which is mainly drug-induced. We report a 7-year old boy with SJS and Chlamydia pneumoniae infection and 3 patients with erythema multiforme (EM) and co-infection with Chlamydia pneumoniae: a 3-year old girl and a 29-year old man developed EMM lesions associated to Mycoplasma pneumoniae and Chlamydia pneumonia and a 20-year old woman with EMM associated to herpes simplex type 2 and Chlamydia pneumoniae infection. None of the 4 patients had history of drug intake in the last two months. Chlamydia pneumoniae is an intracellular bacteria responsible for respiratory infections. Despite the fact that its role in SJS/EMM has been rarely reported, our cases suggest that it may cause SJS and trigger EM when co-infecting a patient, either with Mycoplasma pneumoniae or herpes simplex. We conclude that infection by Chlamydia pneumoniae should be suspected and ruled out in every patient with SJS/EMM, especially in those with signs of respiratory infection.

Resumen en español: "El manejo forestal comunitario es frecuentemente apuntado como una forma de promover la conservación de la biodiversidad y de generar ingresos para las poblaciones rurales al mismo tiempo. En México, una fracción importante de la explotación forestal es realizada por empresas forestales comunitarias y esta es una actividad en crecimiento. En el presente trabajo se estudiaron los impactos de la forestería sobre la diversidad de plantas leñosas y la estructura de un bosque de pinoencino de los Altos de Chiapas. En las tierras ejidales de Fray Bartolomé de Las Casas, se inventariaron adultos, juveniles y plántulas de especies de plantas leñosas, se midió la cobertura de dosel, se controlaron variables edáficas y se aplicaron entrevistas semiestructuradas a actores-clave. El inventario se llevó a cabo en dos áreas de corta en etapas distintas del aprovechamiento y un área testigo sin aprovechamiento maderero comercial. Aunque las diferencias en riqueza específica, dominancia y equidad fueron pequeñas, se evidenciaron diferencias florísticas entre tratamientos para los diferentes estratos considerados. También el diámetro cuadrático promedio, la densidad de individuos juveniles, su correlación con la densidad de individuos adultos y la cobertura de dosel revelaron el impacto del aprovechamiento forestal. Se concluye que la forestería comunitaria, como se plantea ahora, aunque sea una solución para mantener e incluso expandir la cubierta vegetal, no lo es para mantener la biodiversidad de los bosques aprovechados. "

Background: Nail unit melanoma (NUM) is a rare variant of acral lentiginous melanoma. The differential diagnosis is wide but an acquired brown streak in the nail of a fair-skinned person must be considered a potential melanoma. Dermatoscopy helps clinicians to more accurately decide if a nail apparatus biopsy is necessary. Methods: We report the case of a 61-year-old Caucasian woman with melanonychia occupying the central portion of the right thumbnail plate with 1 year of evolution. Dermatoscopy showed a brown pigmentation overlaid by longitudinal irregular lines. An excisional biopsy was performed, and pathological examination revealed melanoma in situ. For safety reasons, the nail unit was totally removed down to the phalangeal bone 3 weeks later, and a full-thickness skin graft taken from the arm was used for reconstruction. Conclusion: NUMs pose a difficult treatment challenge. Wide excision with phalanx amputation is not satisfactory for patients with in situ and early invasive melanoma. Full-thickness skin grafting after total nail unit excision is a simple procedure providing a good functional and cosmetic outcome.

Unilateral laterothoracic exanthem is a self-limited disease that occurs most commonly in children. It is characterized by unilateral exanthem, often in axillary region. The etiology is unknown, but a viral agent is suspected. We report a 1-year-old white girl with unilateral laterothoracic exanthem associated with Epstein Barr virus infection, suggesting this virus has a possible etiologic role.

Pellagra is a nutritional disease caused by the deficiency of niacin. It presents with a photodistributed rash, gastrointestinal symptoms, and neuropsychiatric disturbances. In the Western world, this disease is mostly confined to alcoholics or the impoverished. However, this condition must be recognized in other clinical settings because it is easily treated and can be fatal if not identified. We describe a case of pellagra caused by esophageal carcinoma and alcoholism; we also review the literature.

Eyelid lesions frequently are a diagnostic challenge. We report a case of a 46-year-old woman with a 5-year history of yellowish symmetric progressively growing papules on the eyelids, resembling xanthelasma. A skin biopsy was performed that revealed the rare variant of clear cell syringoma. The lesions were treated with CO2 laser and surgical excision; there was no evidence of recurrence after 6 months of follow-up.

The meibomian glands, present within the tarsus, produce an oily fluid which is part of the tear film. The obstruction of this gland is common, and results in a meibomian cyst or chalazion. Initially, a chalazion may spontaneously resolve, or respond to conservative measures such as warm compresses and topical antibiotics. However, sometimes the lesion becomes persistent and prominent, leading to visual and aesthetic problems, requiring a surgical solution. We report a 23-year-old man, with a right lower eyelid chalazion, persisting for more than 1 year, refractory to local measures that was submitted to surgical correction via the subconjunctival approach. This report emphasizes the advantages of this technique, namely the fast and simple procedure, with an excellent cosmetic result.

Clonal disorders of large granular lymphocytes (LGL) represent a rare spectrum of biologically distinct lymphoproliferative diseases originating either from mature T cells or natural killer cells. Both subtypes can manifest as indolent or aggressive disorders. We report a 77-year-old woman with rheumatoid arthritis, splenomegaly, and neutropenia who developed a painful leg ulcer refractory to treatment and thigh telangiectatic lesions. Because of the association of rheumatoid arthritis, splenomegaly, and nonspecific neutropenia, the diagnosis of Felty syndrome was initially made. Further investigation allowed the diagnosis of a CD56 – natural killer–cell LGL leukemia and documented skin infiltration by natural killer cells. Cutaneous manifestations of LGL leukemia have been rarely reported. This report of pseudo-Felty syndrome with CD56 – LGL leukemia, presenting with a leg ulcer and telangiectasia, enhances the role of dermatology in the diagnosis of hematologic neoplasia.

Besides its use for the control of seizures, carbamazepine is being increasingly prescribed for neuropathic pain and depression, and this may explain the increased incidence of cutaneous drug reactions, namely Setevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis associated with this drug. We report a case of a 42-year-old woman, medicated with levotyroxin for years and carbamazepine for fifteen days due to a depressive state. A mucous and cutaneous eruption suddenly appeared and the diagnosis of SSJ was made. Skin biopsy confirmed the clinical diagnosis and patch testing and intradermal test were negative. The remaining laboratory findings were normal. Supportive measures and a course of oral predisolone (started at 1.5 mg/Kg) with progressive tapering were introduced and carbamazepine was immediately stopped, with a complete clinical resolution within two weeks.

Dissertação de Mestrado em Tecnologia e Gestão do Ambiente/ Engenharia Mecânica, apresentada à Faculdade de Ciências e Tecnologia da Universidade de Coimbra Esta dissertação resulta do trabalho realizado durante o segundo semestre do ano lectivo 2007/2008, no âmbito da Dissertação Final do Mestrado Integrado em Engenharia do Ambiente, no ramo da Tecnologia e Gestão do Ambiente. O crescente aumento do preço do barril do petróleo e os importantes impactes ambientais associados ao uso e produção dos combustíveis fósseis tem contribuído para o potencial uso do hidrogénio como substituto dos combustíveis fósseis. Contudo, a maior parte do hidrogénio é produzido com base no “steam reforming” do gás natural e outras fontes de energia fósseis, sendo apenas 3% com base em fontes renováveis. Por conseguinte, deve surgir uma mudança para que seja cada vez mais produzido hidrogénio com base em fontes renováveis. Para isso são necessários estudos para avaliar o potencial de sistemas de bio-hidrogénio (bio-H2), abordando aspectos tecnológicos, energéticos e ambientais, encontrando oportunidades de melhoria. Esta dissertação tem como principal objectivo a realização de um estudo de Avaliação de Ciclo de Vida (ACV) da produção de bio-hidrogénio (bio-H2) com base em biomassa lenho-celulósica e, com base no modelo de ciclo de vida desenvolvido, sugerir melhorias de optimização, em termos energéticos e ambientais, na cadeia de produção do mesmo. A densidade energética dos combustíveis é um factor importante em termos logísticos e de autonomia e, deste modo, o segundo objectivo deste estudo compara, ambiental e energeticamente, os processos de liquefacção e compressão do hidrogénio e o seu impacto no ciclo de vida do biocombustível. O último objectivo pretende comparar o ciclo de vida (CV) do bio-H2, comprimido e liquefeito, com o diesel, mediante a quantificação dos benefícios energéticos e ambientais. Nesta dissertação realizou-se uma breve abordagem às diferentes tecnologias de produção de hidrogénio com base em fontes renováveis e não renováveis. As alternativas mais decorrentes de produção de hidrogénio são a conversão termoquímica (“reforming”, gaseificação e pirólise), conversão electroquímica (electrólise) e conversão bioquímica (fotobiológico, digestão anaeróbia e fermentação). Neste estudo, o sistema de produção de hidrogénio teve como base a conversão termoquímica da biomassa através do processo de gaseificação. O estudo de Avaliação de Ciclo de Vida foi realizado no intuito de investigar as necessidades energéticas e os impactes ambientais inerentes à produção e utilização de bio-H2 com base em biomassa lenho-celulósica, para a região centro de Portugal. Foi desenvolvido e implementado um modelo de ciclo de vida (“well to wheels”), o qual apresenta as seguintes etapas principais: i) produção e transporte da biomassa; ii) produção do gás de síntese; iii) produção, transporte e armazenamento do bio-H2; e iv) utilização do bio-H2 em veículos ligeiros. O modelo considera duas alternativas tecnológicas para a produção e utilização de bio-H2 (fases iii e iv do ciclo de vida), nomeadamente: compressão do bio-H2 (35 MPa) e a sua utilização em veículos “fuel cell”; e liquefacção do bio-H2 (-253ºC) e a sua utilização em motores de combustão interna. Foi descrito detalhadamente o sistema de produção de bio-H2 para as duas alternativas e elaborado o respectivo inventário de ciclo de vida. Os dados recolhidos para a produção e transporte da biomassa são referentes a Portugal e os dados para os restantes processos foram recolhidos na literatura técnico-científica. A análise dos resultados está divida em duas partes: “well to tank”; e “well to wheels”, sendo apresentada a energia primária fóssil requerida e os impactes ambientais do ciclo de vida do bio-H2, por MJ de energia final do Bio-H2, (“well to tank”) e por km percorrido (“well to wheels”). Realizou-se uma análise detalhada das fases de ciclo de vida e da comparação das duas alternativas consideradas (compressão e liquefacção). Adicionalmente, os resultados numa perspectiva “well to wheels” para os dois veículos propulsionados a bio-H2 são comparados, energética e ambientalmente, com um veículo propulsionado a diesel. Os resultados obtidos, do ponto de vista “well to tank”, permitiram verificar que a produção e transporte do bio-H2 comprimido necessita de 1,05 MJ de energia primária fóssil por cada MJ de bio-H2 produzido, enquanto o bio-H2 liquefeito necessita de 1,18 MJ (mais 12%). A principal razão para esta diferença reside no processo de densificação energética, pois o processo de liquefacção requer mais 39% de energia primária fóssil do que o processo de compressão. Os resultados da avaliação dos impactes ambientais foram obtidos com base no método CML-2000 “mid-point”. A emissão de gases com efeito de estufa (GEE), numa perspectiva “well to tank” varia entre os 96 gCO2-eq (bio-H2 comprimido) e 106 gCO2-eq (bio-H2 liquefeito) por cada MJ de bio-H2 produzido. O processo que requer mais energia primária fóssil (32% da energia total requerida) e que tem maiores impactes ambientais é o “reforming”. A razão do significativo contributo no ciclo de vida, deve-se ao elevado consumo de electricidade, a qual representa 95% da energia total requerida e contribui com 81% das emissões totais de GEE. Em termos do consumo de energia primária fóssil no ciclo de vida (“well to wheels”) os resultados permitiram verificar que um veículo “fuel cell” propulsionado a bio-H2 comprimido é mais eficiente do que um veículo com motor de combustão interna propulsionado a bio-H2 liquefeito, uma vez que, este necessita de mais 55% de energia primária fóssil por km percorrido. Os resultados obtidos na avaliação ambiental apresentaram valores mais elevados para o ciclo de vida do bio-H2 liquefeito em todas as categorias de impacte ambiental. Este estudo permitiu concluir que o bio-H2 comprimido, em termos energéticos e ambientais, é mais eficiente que o liquefeito, numa perspectiva “well to tank”. Relativamente ao ciclo de vida (“well to wheels”) a alternativa mais eficiente energética e ambientalmente é a utilização de bio-H2 comprimido num veículo “fuel cell”, contudo, a utilização em motores de combustão interna é vista, pela indústria automóvel, como uma solução promissora, pois permite uma maior flexibilidade em conjugar este combustível com outros combustíveis (e.g. gasolina) para o mesmo veículo. Através da comparação realizada entre os veículos que utilizam bio-H2 com os veículos que utilizam diesel concluiu-se que o bio-H2 comprimido requer menores quantidades de energia primária fóssil, por cada km percorrido. Em termos de GEE, um veículo “fuel cell” propulsionado a bio-H2 comprimido pode evitar emissões na ordem dos 54% (155 gCO2-eq) e dos 34% (67 gCO2-eq) em comparação com veículos com motores de combustão interna propulsionados a bio-H2 liquefeito e a diesel, respectivamente. A análise a uma possível implementação de uma central de produção de bio-H2 com base em biomassa lenho-celulósica para Portugal não é uma perspectiva promissora. Constatou-se, através dos resultados preliminares obtidos, que a quantidade de biomassa e de área de cultivo necessárias à produção de bio-H2, em elevada escala, apresenta limitações significativas face à realidade portuguesa.

Doutoramento em Ciências Biomédicas

Auteur(s) : Ana Nogueira1, Ana Filipa Duarte1,2, Sofia Magina1,2, Aurea Canelhas3, Carlos Resende1, Filomena Azevedo1 1Department of Dermatology and Venereology, Hospital S. Joao, EPE, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal 2Faculty of Medicine, Oporto University, Hospital S. Joao, EPE, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal 3Department of Pathology, Hospital S. Joao, EPE, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, [...]

Bilateral orbital metastases restricted to the extraocular muscles (EOMs) are exceedingly rare. We report a case of bilateral extraocular muscle metastases from a small cell lung carcinoma and provide a review of the relevant literature. A 56-year-old smoker presented with proptosis, motility changes, and a relative afferent pupillary defect of the left eye, with a previous history of a small cell lung carcinoma. An orbital computerized tomography scan revealed a mass restricted to the left medial rectus. An incisional biopsy confirmed metastasis. Visual acuity of the left eye decreased rapidly, and right globe proptosis became evident. Orbital magnetic resonance imaging at two months follow-up showed marked left orbital mass enlargement and a new right lateral rectus mass. The patient was maintained on palliative care and died from metastatic disease-related complications. info:eu-repo/semantics/publishedVersion

Piebaldism is a rare disorder present at birth and inherited as an autosomal dominant trait. It results from a mutation in the c-kit proto-oncogene and is associated with a defect in the migration and differentiation of melanoblasts from the neural crest. Clinical manifestations and phenotypic severity strongly correlates with the site of mutation within the KIT gene. Here we report a 3-year-old boy and his 33-year-old father with leukoderma and poliosis associated with clinical criteria for Neurofibromatosis type 1. Genetic study of both revealed a p.Gly610Asp mutation in the KIT gene. This familiar mutation has not yet been reported in the literature. There are rare reports of piebaldism in association with neurofibromatosis type I.

Porokeratosis is a group of hereditary or acquired diseases with abnormal epidermal keratinization. A 71-year-old man was admitted to the Surgery Department after an attack of acute pancreatitis complicated with pancreatic necrosis, which required surgical resection. Three weeks after the admission, the patient was observed by our Dermatology department with sudden onset of a generalized eruption of asymptomatic flat papules with a hyperkeratotic rim, sparing the face, palms, soles, and mucous membranes. A skin biopsy was performed at the border of a leg lesion, which disclosed the presence of cornoid lamella, confirming the clinical diagnosis of disseminated superficial porokeratosis (DSP). The skin eruption spontaneously subsided about one month after pancreatic resection. The late onset of DSP in our patient may represent a type of immunosuppression-induced porokeratosis. Possibly, the pathologic clone of keratinocytes for porokeratosis was present, but remained latent until there was a decrease in the immunological status. It is possible that this relative and transient state of immunosuppression was the result of the concurrent necrotizing pancreatitis. This case represents an unusually good outcome of DSP. To the authors best knowledge, this is the first case of DSP related to severe acute pancreatitis.

Rowell syndrome is a rare distinctive entity first described in 1963 by Rowell and coworkers. It consists in erythema multiforme-like lesions associated with lupus erythematosus. Zeitouni et al. recently redefined the major and minor diagnostic criteria. Major criteria are lupus erythematosus, erythema multiforme-like lesions and speckled pattern of antinuclear antibody. Minor criteria are chilblains, positive anti-La (SS-B) or anti-Ro (SS-A) antibody and reactive rheumatoid factor. We report a case of a 63-year-old woman, with no previous history of lupus erythematosus, who developed erythema multiforme-like lesions and laboratory findings consistent with Rowell syndrome.

Tese de doutoramento em Biociências, na especialidade de Ecologia, apresentada ao Departamento de Ciências da Vida da Faculdade de Ciências e Tecnologia da Universidade de Coimbra The genus Corema has an amphi-atlantic distribution and includes two species: C. album, endemic to the Atlantic coast of the Iberian Peninsula and C. conradii, endemic to the Northeastern coast of North America. Both species are dioecious coastal shrubs; plant sexual dimorphism is noticeable in the floral structures and the presence of fruits in female plants. Due to the different costs of reproduction, male and female plants have different physiological requirements and performance. The main hypothesis driving this work is that sex-related differences in physiology and performance lead to demographic biases of the Corema populations and influence the interactions of male and female plants with their associated biota. Three C. album populations in the west coast of Portugal (both in sand dunes and in coastal woodlands) and three C. conradii populations in the east coast of Canada were studied. The demography of the C.album populations was characterized to identify sex related biases, and a competition/facilitation effect of C. album plants on the neighbouring flora was assessed. Adjustment of fruit maturation by female plants was investigated in the context of the serial adjustment hypothesis (Lloyd 1980). The interactions of male and female Corema plants with soil dwelling biota were investigated to assess sex-related and habitat related differences; these included nematode and fungal endophyte communities, particularly ericoid mycorrhiza (ErM), associated with the rhizosphere of both species. A possible interaction between the nematode communities and ErM colonization was investigated. Systematic male biases in sex ratios were not found in the studied C. album populations and most sampled plots showed complete spatial randomness in the distribution of the individuals of both sexes, suggesting that female plants can compensate for the higher reproductive effort they bear. Female C. album plants presented low fruit sets, but infructescences with more fruits also had larger and heavier drupes. Together with the dynamic environmental conditions and the lack of evidence of pollen limitation, this suggested the low fruit sets are the result of an adjustment of the fruit production and maturation to resource availability. Such a strategy can ensure the production of the optimal number of fruits in each season, as well as minimize the delayed costs of reproduction that accumulate along several reproductive periods, by adapting effort to the conditions of each reproductive event. As the dominant plant species in the surveyed areas, C. album canopy cover had a detrimental effect on all plant life-forms (Raunkiær 1937) except for geophytes. Sex-related differences were found in the composition and abundance of the plant parasitic nematode (PPN) communities for both Corema species. The plant phenological stage significantly influenced the abundance of free-living nematodes, PPN genera and nematode community indices in C. album. Significant sex-related differences in PPN community associated with C. album and on the abundance of three PPN genera (Criconema, Hemicriconemella and Meloidogyne) were apparent during the fruiting season but not during flowering, suggesting that interactions with the nematode community were dependent not only on plant sex but also on the phenological stage of the plant. The fungal endophyte community associated with the Corema roots included several taxa: ericoid mycorrhizal fungi, ecto mycorrhizal fungi, and dark septate endophytes. Sex-related differences were not detected in the composition, or in the diversity of the fungal endophyte community in either Corema species, nor in the percentage of colonization of the roots by ErM in C. album; plants growing in the same area had similar endophyte communities, irrespective of plant sex. The diversity of endophytes and root colonization frequency in C. album were higher during the fruiting season, but no statistical interaction between plant sex and phenological stage was detected on the root colonization frequency, indicating that ErM of C. album do not respond to changes in resource demand by the plant. Interactions between the ErM and the nematode community were only apparent during the fruiting season, when ErM colonization frequency was highest. Corema album and C. conradii are the dominant shrubs on the coastal barrens and sand dunes they inhabit. These ecosystems are of particular importance as they represent the transition between the sea shore and inland areas, protecting the productive activities inland from salt spray, winds and erosion. The present work provides the first insights to the below-ground ecology of these coastal species emphasizing the importance of an integrative perspective of the interactions among organisms for the understanding of coastal ecosystems. O género Corema tem uma distribuição anfi-Atlântica e inclui duas espécies: C. album, endémica da costa Atlântica da Península Ibérica e C. conradii, endémica do Norte da costa este da América do Norte. Ambas as espécies são arbustos costeiros dióicos; o dimorfismo sexual é observável nas estruturas florais e na presença de frutos nas plantas femininas. Devido às diferenças nos custos da reprodução, machos e fêmeas têm necessidades fisiológicas e desempenhos diferentes. A hipótese principal que guia este trabalho é que diferenças fisiológicas e de desempenho, associadas ao sexo, dão origem a enviesamentos demográficos nas populações de Corema e influenciam as interações das plantas masculinas e femininas com os organismos que lhes estão associados. Foram estudadas três populações de C. album na costa oeste de Portugal (tanto na duna como no pinhal costeiro) e três populações de C. conradii na costa este do Canadá. A demografia das populações de C. album foi caracterizada para identificar enviesamentos relacionados com o sexo e foi avaliado um efeito de competição/facilitação das plantas de C. album sobre a flora associada. Investigou-se o ajustamento da maturação de frutos pelas plantas femininas no contexto da hipótese de ajustamento sequencial (Lloyd 1980). Investigaram-se as interações de plantas de Corema masculinas e femininas com organismos do solo para avaliar diferenças associadas ao sexo e ao tipo de habitat; estas incluíram as comunidades de nemátodes e de fungos endofíticos, particularmente micorrizas ericóides (ErM), associadas à rizosfera de ambas as espécies. Investigou-se uma possivel interação entre as comunidades de nemátodes e a colonização por ErM. Não se encontraram enviesamentos sistemáticos favoráveis aos machos nas populações de C. album estudadas e a maioria das parcelas amostradas apresentou uma distribuição espacial dos indivíduos de ambos os sexos completamente aleatória, sugerindo que as fêmeas são capazes compensar o esforço reprodutivo mais elevado que suportam. As plantas femininas de C. album apresentaram uma baixa produção de frutos em relação ao número de flores, mas infrutescências com mais frutos tinham drupas maiores e mais pesadas. Isto sugeriu, em conjunto com as condições ambientais dinâmicas e a falta de evidências de limitação de pólen, que os baixos números de frutos por infrutescência se devem ao ajustamento da produção e da maturação dos frutos à disponibilidade de recursos. Esta estratégia não só assegura a produção de um número ótimo de frutos em cada época reprodutiva, como minimiza os custos de reprodução acumulados ao longo de vários períodos reprodutivos, ao adaptar o esforço a cada evento de reprodução. Sendo a espécie vegetal dominante nas áreas amostradas, a cobertura por C. album teve um efeito prejudicial em todas as formas de vida vegetais (Raunkiær 1937), à excepção dos geófitos. Encontraram-se diferenças relacionadas com o sexo na composição e abundância das comunidades de nemátodes fitoparasitas (PPN) em ambas as espécies de Corema. O estado fenológico da planta influenciou significativamente a abundância de nemátodes de vida livre, géneros de PPN e os valores dos índices ecológicos das comunidades de nemátodes em C. album. Diferenças significativas relacionadas com o sexo da planta na comunidade de PPN associada a C. album e na abundância de três géneros de PPN (Criconema, Hemicriconemella e Meloidogyne) foram visíveis durante a época de frutificação, mas não durante a de floração, sugerindo que as interações com a comunidade de nemátodes dependem, não só do sexo da planta, mas também do seu estado fenológico. A comunidade de fungos endofíticos associada às raízes de Corema incluiu vários taxa: fungos que formam micorrizas ericóides, ecto-micorrizas e endófitos dark septate. Não se detetaram diferenças associadas ao sexo na composição nem na diversidade das comunidades de fungos endofíticos de qualquer das espécies de Corema, nem na percentagem de colonização das raízes de C. album por ErM; plantas que cresciam nas mesmas áreas apresentaram comunidades de endófitos semelhantes, independentemente do sexo da planta. A diversidade de endófitos e a colonização das raízes de C. album foram maiores durante a frutificação, mas não se detectou interação estatística entre o sexo da planta e o seu estado fenológico na frequência de colonização das raízes, o que indica que as ErM não respondem à variação na necessidade de recursos por parte de planta. As interações entre ErM e a comunidade de nemátodes foram detetadas apenas durante a época de frutificação, quando houve maior frequência de colonização por ErM. Corema album e C. conradii são os arbustos dominantes nas falésias e dunas costeiras que habitam. Estes ecossistemas são de particular importância já que representam a transição entre a orla costeira e as áreas interiores, protegendo as atividades produtivas do interior contra a salinidade, o vento e a erosão. Este trabalho apresenta as primeiras perspetivas sobre a ecologia da rizosfera destas duas espécies costeiras, enfatizando a importância de uma perspetiva integradora das interações entre organismos para a compreensão dos ecossistemas costeiros.

Dissertação de Mestrado em Engenharia Mecânica, apresentada à Faculdade de Ciências e Tecnologia da Universidade de Coimbra A presente dissertação tem como principal objetivo esclarecer o conceito de eficiência energética no setor doméstico e verificar os seus níveis em Portugal, possibilitando o estudo dos potenciais de poupança neste setor. Nesta dissertação pretendia-se realizar várias auditorias in situ, o que não foi possível no tempo útil disponível. Deste modo, optou-se pela aquisição de dados de monitorização de modo a suprir a falta de tempo. Como os dados fornecidos não permitiram a análise elaborada de cada consumidor, como inicialmente previsto, optou-se por reformular a dissertação, realizando um estudo mais teórico sobre a avaliação e otimização do uso eficiente de energia no sector residencial. Para a realização deste trabalho analisaram-se os barómetros de consumo a nível nacional e europeu de modo a comparar as vertentes mais desfavoráveis do nosso país, quando comparado com outros países da união europeia, e ainda com o objetivo de explicar a importância da redução de gastos energéticos neste setor. Abordou-se ainda a temática da caracterização social nacional, a mudança de tarifas, de potências contratadas e ainda a temática da etiquetagem energética. Este estudo conta também com a análise de medições realizadas através do processo de monitorização, onde se fez a comparação entre dados obtidos através de um inquérito fornecido com os dados dos consumos de energia elétrica resultantes de um ano de medição. Visando a relação entre consumo energético e os hábitos das pessoas residentes na habitação, torna-se necessário fazer uma correta caracterização do seu estilo e parâmetro de consumo. Foi neste sentido que se sentiu a necessidade de criar um questionário próprio e mais completo que o fornecido, de modo a que se pudesse realizar corretamente a descrição da habitação, da envolvente e equipamentos, da caracterização social do agregado e dos seus hábitos de consumo. Abstract This paper has as main objective to clarify the concept of energy efficiency of domestic and check your levels in Portugal, allowing the study of the potential savings in this sector. In this dissertation was intended to perform various audits in situ, which was not possible in the time available. Thus, we opted for the acquisition of monitoring data in order to address the lack of time. Because the data provided did not allow the analysis prepared for each consumer, as originally planned, we decided to redesign the paper, making a more theoretical study on the evaluation and optimization of energy efficiency in the residential sector. For this work analyzed the barometers of the national consumption and Europe in order to compare the worst aspects of our country, when compared with other European Union countries, and with the aim of explaining the importance of reducing energy expenditure in this sector. It also addressed the issue of national social characteristics, changes in rates of contracted power and still the issue of energy labeling. This study also includes the analysis of measurements made through the monitoring process, which made the comparison between data obtained from a survey of the data supplied with electric power consumption resulting from a year of measurement. Aiming at the relationship between energy consumption and habits of residents in housing, it is necessary to make a correct characterization of his style and consumption parameters. This was why he felt the need to create our own questionnaire and more complete than the one provided, so that he could properly perform the description of the housing, environment and equipment, from household and social characteristics of their habits.