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The Mycobacterium abscessus complex (MABC) is an emerging, difficult to treat, multidrug-resistant nontuberculous mycobacteria responsible for a wide spectrum of infections and associated with an increasing number of cases worldwide. Dominant circulating clones (DCCs) of MABC have been genetically identified as groups of strains associated with higher prevalence, higher levels of antimicrobial resistance, and worse clinical outcomes. To date, little is known about the genomic characteristics of MABC species circulating in Portugal. Here, we examined the genetic diversity and antimicrobial resistance profiles of 30 MABC strains isolated between 2014 and 2022 in Portugal. The genetic diversity of circulating MABC strains was assessed through a gene-by-gene approach (wgMLST), allowing their subspecies differentiation and the classification of isolates into DCCs. Antimicrobial resistance profiles were defined using phenotypic, molecular, and genomic approaches. The majority of isolates were resistant to at least two antimicrobials, although a poor correlation between phenotype and genotype data was observed. Portuguese genomes were highly diverse, and data suggest the existence of MABC lineages with potential international circulation or cross-border transmission. This study highlights the genetic diversity and antimicrobial resistance profile of circulating MABC isolates in Portugal while representing the first step towards the implementation of a genomic-based surveillance system for MABC at the Portuguese NIH.

Pulmonary alveolar microlithiasis (PAM) is a genetic lung disorder that is characterized by the accumulation of calcium phosphate deposits in the alveolar spaces of the lung. PAM is discovered incidentally on radiographs performed for other purposes, and the typical disease course is characterized by slowly progressive respiratory failure over decades. Treatment remains supportive. A 62-year-old woman presented in the emergency department with dyspnoea and fatigue. On physical examination she had crackles on pulmonary auscultation and digital clubbing. A CT scan of the chest showed multiple high-density areas throughout the lung parenchyma, suggesting the presence of alveolar microlithiasis. This CT finding is the typical radiological presentation of PAM, while the hallmark presentation is clinical–radiological dissociation.

The application of whole genome sequencing of Mycobacterium tuberculosis directly on clinical samples has been investigated as a means to avoid the time-consuming need for culture isolation that can lead to a potential prolonged suboptimal antibiotic treatment. We aimed to provide a proof-of-concept regarding the application of the molecular capture of M. tuberculosis genomes directly from positive sputum samples as an approach for epidemiological and drug susceptibility predictions. Smear-positive sputum samples (n = 100) were subjected to the SureSelectXT HS Target Enrichment protocol (Agilent Technologies, Santa Clara, CA, USA) and whole-genome sequencing analysis. A higher number of reads on target were obtained for higher smear grades samples (i.e., 3+ followed by 2+). Moreover, 37 out of 100 samples showed ≥90% of the reference genome covered with at least 10-fold depth of coverage (27, 9, and 1 samples were 3+, 2+, and 1+, respectively). Regarding drug-resistance/susceptibility prediction, for 42 samples, ≥90% of the >9000 hits that are surveyed by TB-profiler were detected. Our results demonstrated that M. tuberculosis genome capture and sequencing directly from clinical samples constitute a potential valid backup approach for phylogenetic inferences and resistance prediction, essentially in settings when culture is not routinely performed or for samples that fail to grow.

Tuberculosis (TB) is a transmissible disease listed as one of the 10 leading causes of death worldwide (10 million infected in 2019). A swift and precise diagnosis is essential to forestall its transmission, for which the discovery of effective diagnostic biomarkers is crucial. In this study, we aimed to discover molecular biomarkers for the early diagnosis of tuberculosis. Two independent cohorts comprising 29 and 34 subjects were assayed by proteomics, and 49 were included for metabolomic analysis. All subjects were arranged into three experimental groups—healthy controls (controls), latent TB infection (LTBI), and TB patients. LC-MS/MS blood serum protein and metabolite levels were submitted to univariate, multivariate, and ROC analysis. From the 149 proteins quantified in the discovery set, 25 were found to be differentially abundant between controls and TB patients. The AUC, specificity, and sensitivity, determined by ROC statistical analysis of the model composed of four of these proteins considering both proteomic sets, were 0.96, 93%, and 91%, respectively. The five metabolites (9-methyluric acid, indole-3-lactic acid, trans-3-indoleacrylic acid, hexanoylglycine, and N-acetyl-L-leucine) that better discriminate the control and TB patient groups (VIP > 1.75) from a total of 92 metabolites quantified in both ionization modes were submitted to ROC analysis. An AUC = 1 was determined, with all samples being correctly assigned to the respective experimental group. An integrated ROC analysis enrolling one protein and four metabolites was also performed for the common control and TB patients in the proteomic and metabolomic groups. This combined signature correctly assigned the 12 controls and 12 patients used only for prediction (AUC = 1, specificity = 100%, and sensitivity = 100%). This multiomics approach revealed a biomarker signature for tuberculosis diagnosis that could be potentially used for developing a point-of-care diagnosis clinical test.

Setting: Nontuberculous mycobacteria (NTM) are increasingly recognized as causative agents of opportunistic infections in humans for which effective treatment is challenging. There is, however, very little information on the prevalence of NTM drug resistance in Portugal. Objective and Design: Our aim was to analyze the drug susceptibility testing (DST) performed in NTM at the Portuguese National Health Institute Dr. Ricardo Jorge from February 2003 to February 2016. A total of 262 DST were included in the analysis. Results: Most (94%) M. avium intracellulare complex isolates showed in vitro susceptibility to clarithromycin. All M. kansasii isolates were susceptible to rifampicin and ethambutol and 97.1% were susceptible to isoniazid. The majority of rapidly-growing mycobacteria (RGM) demonstrated in vitro susceptibility to amikacin, clarithromycin and cefoxitin. However, in RGM there was a marked increase on the relative risk of having sulfamethoxazole resistance in isolates resistant to ciprofloxacin compared to susceptible isolates. Conclusion: Tested NTM in Portugal revealed in vitro susceptibility to most of the antimicrobials currently recommended for treatment. However, our results also suggest that sulfamethoxazole should be avoided in treatment of RGM resistant to ciprofloxacin (or vice versa). Further trials that correlate the in vitro DST results with the clinical outcome are needed in order to reach conclusions on efficient antimicrobial therapy. Keywords: Nontuberculous mycobacteria, Drug susceptibility testing, Antibiotic resistance, Antimicrobial treatment

A partir da perspectiva hindu, conhecida como advaita ou adualidade, Panikkar faz uma crítica à primazia do pensamento científico em detrimento de uma visão mais holística da realidade que, para ele, estaria relacionada à experiência de uma nova inocência. Tal experiência exige uma visão do terceiro olho, que integra a razão e os sentidos, que também pode ser chamada de experiência mística ou intuição advaita. Na visão panikkariana, a mística é uma relação adualista entre a ação e a contemplação, o conhecimento e o amor. Através de pesquisa bibliográfica em uma perspectiva metodológica crítico-analítica, mostraremos de que forma ele constrói sua crítica e aponta o caminho que, ao seu entender, leva a um tipo de conhecimento amoroso, mais integrado ao que chama de experiência da Vida.

This paper aims to critically review the documentation process of the performance-based collaborative artwork Luís Vaz 73 (1975), created by the visual artist and performer Ernesto de Sousa (1921-1988), and the composer, pianist and conductor, Jorge Peixinho (1940-1995). The documentation process was developed in four phases: identification of the conservation problem, which contextualizes the documentation process; gathering of documentation, published and unpublished; documentation production, which includes interviews to relevant actors; and assessment and systematization, which organizes all relevant information and discusses the main weaknesses of the process. This documentation methodology opens a new perspective based on the relationship between the production of documentation and its application in the (re)presentation of the work This methodology looks for a reflexive approach, where the main challenges of the documentation process are reflected upon, thus informing future generations about this process.

Este texto foi publicado na revista World Faith Insights 26, 1990, p. 7-16 e é a transcrição de uma palestra proferida pelo teólogo e filósofo catalão Raimon Panikkar (1918-2010). Por se tratar de uma transcrição fiel da linguagem oral, nosso desafio nesta tradução foi adequar o texto à linguagem escrita sem, no entanto, perder os traços característicos do palestrante e autor.

Raimon Panikkar (1918-2010), teólogo e filósofo, nascido em Barcelona, de família cristã-hindu, foi um dos principais expoentes do diálogo inter-religioso. Destaca-se, neste contexto, sua expressão que se tornou célebre: parti cristão, me descobri hindu e retornei budista, sem jamais ter deixado de ser cristão. Em meu retorno, me descobri um melhor cristão. Para entendê-la, compreendemos ser fundamental adentrar o sentido de advaita (adualidade). A forma como a perspectiva védica do advaita está inserida em sua obra e constitui em recurso para a sua concepção do diálogo inter-religioso é o tema principal desta pesquisa. O autor desenvolveu importantes conceitos ao longo de sua obra e podemos identificar não só uma influência, mas uma referência clara à tradição hindu e, mais propriamente, à perspectiva advaita, tantas vezes mencionada por ele e que identificamos como uma espécie de fio condutor ou de fator explicativo para muitas de suas teorias. Esta pesquisa procura investigar de que forma o advaita se constitui em caminho de construção do diálogo inter-religioso nas obras de Panikkar. Para tal, contextualizamos a perspectiva advaita nas origens do Hinduísmo e a sua utilização por parte do autor, a partir de uma análise crítica do pensamento filosófico ocidental, em sua experiência mística, também definida por ele como experiência da Vida. Analisamos suas teorias da visão trinitária e cosmoteândrica, baseadas na Trindade cristã, o seu conceito de cristologia nomeado de cristofania e o desenvolvimento de uma atitude pluralista, que servirá como base para o diálogo inter-religioso em sua obra, a partir do paradigma pluralista da Teologia do Pluralismo Religioso. E identificamos o advaita na construção do que ele entende por diálogo intra-religioso, o encontro do outro em si mesmo, através do que denomina amor advaita. Uma peregrinação que acontece na interioridade do ser humano, paralelamente ao diálogo inter-religioso. Trata-se de uma pesquisa teórica, através de uma perspectiva metodológica crítico-analítica, tendo em vista a sua aplicação no diálogo inter-religioso, embasadas na bibliografia de Panikkar, mas também na de alguns autores que dialogam, criticam e/ou servem como referência para ele.

O cancro do pulmão é a causa mais comum de morte por doença oncológica. Os doentes com diagnóstico de neoplasia - qualquer que seja a localização - têm risco acrescido de desenvolver um segundo tumor. Pretendeu-se caracterizar uma população com neoplasia do pulmão e o diagnóstico síncrono ou metácrono de tumor primário com outra localização. Foi feito um estudo retrospectivo, referente ao período de 2000-2007, analisando-se os processos clínicos de doentes seguidos na Unidade de Pneumologia Oncológica do nosso hospital em que estavam referenciadas duas neoplasias. Dos doentes seguidos na Unidade (n=1046) no período referido, 4,2% (n=44) tinham evidência de duas neoplasias. A maioria (88,6%) dos doentes eram homens, com idade média elevada (70,1±10 anos). Oitenta e seis por cento (n=38) tinham hábitos tabágicos e 65,4% dos doentes com registo de história familiar de neoplasia (n=26) tinham história familiar relevante (n=17). A doença oncológica manifestou-se em primeiro lugar na próstata, cólon, cabeça e pescoço ou bexiga. O cancro do pulmão foi em geral a segunda neoplasia. O intervalo de tempo médio entre a primeira e a segunda neoplasia foi de 62,9±64,9 meses (max: 240, min: 0), sendo que geralmente a segunda neoplasia foi detectada em estádio avançado. A sobrevivência média foi de 8,6±8,24 meses (max: 32; min: 1), permanecendo vivos quatro doentes. Os presentes dados levam-nos a sugerir vigilância clínica prolongada em doentes com diagnóstico prévio de cancro. Sugerimos um algoritmo que possibilite vigiar melhor estes doentes e estudo prospectivo para verificar se existem marcadores moleculares nesta população.Lung cancer is the leading form of cancer death worldwide. Cancer patients are at a high risk of developing a second cancer. The present study attempts to determine the characteristics of a population with lung cancer diagnosed with another cancer. We analysed records of patients from the Department of Lung Oncology of our hospital from 2000 to 2007 who were identified as having two or more tumours. We found 4.2% (n=44) multiple cancers among the registered cases (n=1046), 88.6% males, (high) mean age 70.1±10 years old. About 86% (n=38) of the patients were smokers or ex -smokers. From the patients with record of family history, 65.4% (n=17) had relevant family history of cancer. The majority of the first malignancy diagnosed was prostate, colon, head and neck and bladder. Lung cancer was essentially the second malignancy. The mean time lag between the two diagnoses was 62.9±64.9 months (max. 240, min. 0), with the second cancer usually detected at an advanced stage. The mean survival of patients who had a second primary lung cancer was 8.6±8.24 months (max. 32, min. 1), with four patients still surviving. Lung cancer was essentially the second malignancy. The mean time lag between the two diagnoses was 62.9±64.9 months (max. 240, min. 0), with the second cancer usually detected at an advanced stage. The mean survival of patients who had a second primary lung cancer was 8.6±8.24 months (max. 32, min. 1), with four patients still surviving.

Resumo: O cancro do pulmão é a causa mais comum de morte por doença oncológica. Os doentes com diagnóstico de neoplasia â qualquer que seja a localização â têm risco acrescido de desenvolver um segundo tumor. Pretendeu-se caracterizar uma população com neoplasia do pulmão e o diagnóstico síncrono ou metácrono de tumor primário com outra localização. Foi feito um estudo retrospectivo, referente ao período de 2000-2007, analisando-se os processos clínicos de doentes seguidos na Unidade de Pneumologia Oncológica do nosso hospital em que estavam referenciadas duas neoplasias. Dos doentes seguidos na Unidade (n=1046) no período referido, 4,2% (n=44) tinham evidência de duas neoplasias. A maioria (88,6%) dos doentes eram homens, com idade média elevada (70,1±10 anos). Oitenta e seis por cento (n=38) tinham hábitos tabágicos e 65,4% dos doentes com registo de história familiar de neoplasia (n=26) tinham história familiar relevante (n=17). A doença oncológica manifestou-se em primeiro lugar na próstata, cólon, cabeça e pescoço ou bexiga. O cancro do pulmão foi em geral a segunda neoplasia. O intervalo de tempo médio entre a primeira e a segunda neoplasia foi de 62,9±64,9 meses (max: 240, min: 0), sendo que geralmente a segunda neoplasia foi detectada em estádio avançado. A sobrevivência média foi de 8,6±8,24 meses (max: 32; min: 1), permanecendo vivos quatro doentes.Os presentes dados levam-nos a sugerir vigilância clínica prolongada em doentes com diagnóstico prévio de cancro. Sugerimos um algoritmo que possibilite vigiar melhor estes doentes e estudo prospectivo para verificar se existem marcadores moleculares nesta população.Rev Port Pneumol 2010; XVI (3): 391-405 Abstract: Lung cancer is the leading form of cancer death worldwide. Cancer patients are at a high risk of developing a second cancer. The present study attempts to determine the characteristics of a population with lung cancer diagnosed with another cancer.We analysed records of patients from the Department of Lung Oncology of our hospital from 2000 to 2007 who were identified as having two or more tumours. We found 4.2% (n=44) multiple cancers among the registered cases (n=1046), 88.6% males, (high) mean age 70.1±10 years old. About 86% (n=38) of the patients were smokers or ex-smokers. From the patients with record of family history, 65.4% (n=17) had relevant family history of cancer. The majority of the first malignancy diagnosed was prostate, colon, head and neck and bladder.Lung cancer was essentially the second malignancy. The mean time lag between the two diagnoses was 62.9±64.9 months (max. 240, min. 0), with the second cancer usually detected at an advanced stage. The mean survival of patients who had a second primary lung cancer was 8.6±8.24 months (max. 32, min. 1), with four patients still surviving.Our results suggest that extended follow-up is needed in these patients, using screening strategies which follow international recommendations, and with control of carcinogenic risk factors such as smoking. We suggest a tailored risk algorithm and a further study to assess if there are particular molecular markers in these patients.Rev Port Pneumol 2010; XVI (3): 391-405 Palavras-chave: Neoplasias múltiplas, neoplasia metácrona, neoplasia síncrona, neoplasia do pulmão, vigilância, Key-words: Multiple cancers, metachronous cancer, synchronous cancer, lung cancer, follow-up

Advances in the magnetic sensing technology have been driven by the increasing demand for the capability of measuring ultrasensitive magnetic fields. Among other emerging applications, the detection of magnetic fields in the picotesla range is crucial for biomedical applications. In this work Picosense reports a millimeter-scale, low-power hybrid magnetoresistive-piezoelectric magnetometer with subnanotesla sensitivity at low frequency. Through an innovative noise-cancelation mechanism, the 1/f noise in the MR sensors is surpassed by the mechanical modulation of the external magnetic fields in the high frequency regime. A modulation efficiency of 13% was obtained enabling a final device’s sensitivity of ~950 pT/Hz1/2 at 1 Hz. This hybrid device proved to be capable of measuring biomagnetic signals generated in the heart in an unshielded environment. This result paves the way for the development of a portable, contactless, low-cost and low-power magnetocardiography device.

Uma das principais problemáticas no controlo da tuberculose é o aparecimento de casos de tuberculose multirresistente (TB -MR) e tuberculose extensivamente resistente (TB -XDR). A detecção precoce da resistência a fármacos, directamente a partir de amostras respiratórias, é essencial para que se assegure o tratamento atempado, adequado e eficaz da tuberculose, bem como para prevenir a disseminação destes casos de especial gravidade. O nosso objectivo foi avaliar a sensibilidade e comparar os resultados obtidos com um método de genética molecular disponível comercialmente - MTBDRplus® - e o isolamento, identificação e testes de sensibilidade clássicos, directamente a partir de amostras respiratórias. Estudamos 68 amostras, com baciloscopia positiva. O MTBDRplus® permitiu identificar, directamente a partir das amostras respiratórias, o complexo Mycobacterium tuberculosis em todos os casos em que o estudo cultural e a identificação clássica chegaram a esse mesmo resultado. Nas amostras em que culturalmente isolámos estirpes sensíveis, com o MTBDRplus® encontrámos sempre perfis genéticos do tipo selvagem (63,2%). Relativamente às amostras em que culturalmente isolámos estirpes resistentes, com o MTBDRplus® encontrámos sempre perfis genéticos com mutações ou com ausência do perfil do tipo selvagem (36,8%). Este estudo permitiu concluir que o MTBDRplus® assegura a detecção rápida de resistências a fármacos em estirpes do complexo M. tuberculosis, com resultados totalmente sobreponíveis aos obtidos com os métodos bacteriológicos clássicos.Nowadays, the greatest concern of tuberculosis control programmes is the appearance of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis. Rapid determination of drug resistance in clinical samples, with Mycobacterium tuberculosis complex (MTC), is the prerequisite for initiating effective chemotherapy, ensuring successful treatment of the patient and preventing further spread of drugresistant isolates. The aim of our study was to determine the sensitivity of the new MTBDRplus® assay in comparison to culture, identification and classic DST, directly from smear-positive clinical specimens. A total of 68 smear-positive sputum specimens were processed by both the classical mycobacteriological methods and the molecular assay, MTBDRplus®. MTBDRplus® assay allowed an accurate identification of MTC species by detection of the specific band in all samples, from which we also isolated and identified MTC strains by culture methods. In the samples from which we isolated susceptible strains (63.2%), wild type patterns were found using MTBDRplus ® assay. The samples from which we isolated resistant strains (36.8%) showed specific mutations associated with the correspondent resistant phenotype. Our study indicated that this assay allows rapid detection of resistance, always in agreement with classic methods.

Resumo: Foi realizado um estudo de epidemiologia molecular a estirpes de Mycobacterium tuberculosis isoladas em hospitais de Lisboa. Analisaram-se geneticamente os isolados de Mycobacterium tuberculosis com o método restriction fragment length polymorphism (RFLP) utilizando a sequência de inserção IS6110 como sonda, com o objectivo de detectar as estirpes da família Lisboa e determinar a diversidade genética das estirpes de Mycobacterium tuberculosis isoladas em Lisboa, identificando os mais importantes factores de risco de transmissão da tuberculose.Foram analisados 290 isolados de Mycobacterium tuberculosis, dos quais 64,8% se encontraram agrupados em clusters; mesmo excluindo as estirpes que apresentaram mais de 5 cópias de IS6110, a percentagem de agrupamento foi de 60,7%. A multirresistência foi observada em 4,1% das estirpes e encontraram-se todas em clusters. Quarenta e cinco isolados (18,2%) pertenciam à família Lisboa. Considerando a percentagem relativamente alta de estirpes em cluster detectada neste estudo, cremos que a transmissão activa continua a ser uma realidade em Lisboa. Para além disso, as estirpes dos clusters Lisboa representam as estirpes predominantes que circulam em Lisboa. continuando muito relacionadas com a resistência aos antibacilares, embora correspondam a uma percentagem inferior à verificada em estudos anteriores.Rev Port Pneumol 2007; XIV (2): 239-259 Abstract: We conducted a molecular epidemiology study of Mycobacterium tuberculosis strains isolated from patients in Lisbon hospitals. We used restriction fragment length polymorphism (RFLP) to detect Lisbon family strains and to determine the genetic diversity of Mycobacterium tuberculosis strains isolated in Lisbon, through identification of the most important risk factors of tuberculosis transmission analysis, with the insertion sequence IS6110 as a probe to fingerprint isolates of Mycobacterium tuberculosis. 64.8% of the 290 Mycobacterium tuberculosis isolates were grouped in clusters. This figure was 60.7% if we excluded strains with five or fewer IS6110 copies. Multidrug-resistance was observed in 4.1% of the strains and they were all in clusters. Forty-five (18.2%) strains were included in the Lisbon family. Considering the relatively high percentage of strains in cluster detected in this study, we believe that active transmission is still taking place in Lisbon. Moreover, clusters of Lisbon strains represent the predominant strains circulating in Lisbon and are still related to drug resistance although presenting a lower percentage than that observed in previous studies.Rev Port Pneumol 2007; XIV (2): 239-259 Palavras-chave: Mycobacterium tuberculosis, multirresistência, epidemiologia molecular, Key-words: Mycobacterium tuberculosis, multidrugresistance, molecular epidemiology

Departing from the experience gathered in the research project Documentation of Contemporary Art, this paper discusses a decision-making model for the preservation of contemporary complex artworks. In this project, social sciences disciplines and current conservation theories are brought together. For this model, qualitative methodologies for artist’s interviews and decision-making theories are applied.

Multidrug- (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) present a challenge to disease control and elimination goals. Lisbon, Portugal, has a high TB incidencerate and unusual and successful XDR-TB strains that have been found in circulation foralmost two decades. For the last 20 years, a continued circulation of two phylogenetic clades, Lisboa3 and Q1, which are highly associated with MDR and XDR, have been observed. In recent years, these strains have been well characterized regarding the molecular basis of drug resistance and have been inclusively subjected to whole genome sequencing (WGS). Researchers have been studying the genomic diversity of strains circulating in Lisbon and its genomic determinants through cutting-edge next generation sequencing. An enormous amount of whole genome sequence data are now available for the most prevalent and clinically relevant strains circulating in Lisbon. It is the persistence, prevalence and rapid evolution towards drug resistance that has prompted researchers to investigate the properties of these strains at the genomic level and in the future at a global transcriptomic level. Seventy Mycobacterium tuberculosis (MTB) isolates, mostly recovered in Lisbon, were genotyped by 24-loci Mycobacterial Interspersed Repetitive Unit – Variable Number of Tandem Repeats (MIRU-VNTR) and the genomes sequenced using a next generation sequencing platform – Illumina HiSeq 2000. The genotyping data revealed three major clusters associated with MDR-TB (Lisboa3-A, Lisboa3-B and Q1), two of which are associated with XDR-TB (Lisboa3-B and Q1), whilst the genomic data contributed to elucidating the phylogenetic positioning of circulating MDR-TB strains, showing a high predominance of a single SNP cluster group 5. Furthermore, a genome-wide phylogeny analysis from these strains, together with 19 publicly available genomes of MTB clinical isolates, revealed two major clades responsible for MDR/XDR-TB in the region: Lisboa3 and Q1. The data presented by this study contributes to the expanding knowledge of MTB genomic diversity yielding insights on microevolution and identification of novel compensatory mutations. Additionally, the analysis of nonsynonymous/ synonymous ratios revealed heterogeneities across the chromosome, genotype and Clusters of Orthologous Groups, highlighting possible and different evolution strategies. Overall, the results that are presented support the notion of an increasing genomic diversity that may support both setting and host adaptation.

This article focuses on the study of the historical context and the conservation issues of large rolled paintings on the Portuguese altarpieces of the 18th to 20th centuries, emphasizing their originality and dynamism. Widely used in Portugal, this type of painting is exposed during a specific period of time of the liturgical year and, depending on scenic claims, is presented or simply stored through the system that moves it. This particularity originates characteristic degradation processes as well as very specific needs of exhibition.

In this paper, we describe how magnetoresistive sensors can be integrated with microelectromechanical systems (MEMS) devices enabling the mechanical modulation of DC or low frequency external magnetic fields to high frequencies using MEMS structures incorporating magnetic flux guides. In such a hybrid architecture, lower detectivities are expected when compared with those obtained for individual sensors. This particularity results from the change of sensor’s operating point to frequencies above the 1/f noise knee.

Resumo: Os agentes inibidores dos receptores de membrana tirosina cinase como o EGFR tem sido um alvo atractivo, visto que o EGFR está sobreexpresso em cerca de 80% dos CPNPC. O erlotinib em monoterapia após falência de pelo menos um esquema de quimio-terapia prévia prolonga a sobrevivência e melhora a qualidade de vida, embora com modesta taxa de resposta. As mulheres, não fumadores, adenocarcinomas e asiáticos estão associados a melhor resposta. É neste grupo de doentes que mais frequentemente se encontra a mutação do EGFR. Os autores descrevem dois casos, com importante controlo sintomático e aumento do tempo para a progressão independente-mente do tipo de resposta à terapêutica (estabilização ou resposta parcial).Rev Port Pneumol 2008; XIV (Supl 3): S53-S60 Abstract: Agents that inhibit the activity of cell membrane receptor tyrosine kinases, such as the human epidermal growth factor receptor (EGFR) have been an attractive target because EGFR is expressed by 80% of NSCLC. Erlotinib as monotherapy in the treatment of NSCLC after failure of at least one prior chemotherapy regimen, prolonged survival and improved quality of life, although modest response rate. Women, Asiens, patients with Adenocarcinoma and never smokers, were more likely than other patients to have a response to erlotinib. This is the group of patients that most commonly have an EGFR mutation. The authors describe two cases, with important control of symptoms and increased time to progression, independently o response rate (stable disease or partial response).Rev Port Pneumol 2008; XIV (Supl 3): S53-S60 Palavras-chave: Carcinoma pulmonar de não pequenas células, terapêutica, inibidores do EGFR, erlotinib, Key-words: Non-small cell lung cancer, treatment, EGFR inhibitors, erlotinib

ABSTRACT Objective: To characterize clinically all of the patients with spontaneous pneumomediastinum (SPM) admitted to an adult pulmonology ward in Lisbon, Portugal. Methods: This was a retrospective descriptive study of all adult patients (≥ 18 years of age) diagnosed with SPM between January of 2004 and September of 2015. Results: At least one predisposing factor was identified in most (88.9%) of the 18 patients who presented with SPM during the study period. With regard to precipitating factors, bouts of cough were present in 50.0% of the patients. Other precipitating factors included a sudden increase in tobacco consumption, inhaled drug use, occupational inhalation of varnish fumes, intense exercise, and vomiting. The most common complaints were dyspnea (in 83.3%) and chest pain (in 77.8%). Other complaints included cough, neck pain, dysphagia, and odynophagia. Subcutaneous emphysema was found in most of the patients. The diagnosis of SPM was based on chest X-ray findings in 61.1% of the patients. Conclusions: Although SPM is a rare condition, it should be considered in the differential diagnosis of chest pain and dyspnea. It can develop without a triggering event or conclusive findings on a chest X-ray, which is usually sufficient for diagnosis.

Este estudo, resultado de uma abordagem etnográfica, analisa aspectos psicossociais e possibilidades políticas de agência e negociação no funcionamento de uma feira agroecológica. Além da observação participante, foram realizadas dezenove entrevistas com produtores(as) e consumidores(as) que permitiram construir uma rede de temas recorrentes e atravessamentos discursivos sobre as relações estabelecidas no cotidiano dessa forma de comércio alimentar. O processo de pesquisa possibilitou analisar as relações na feira a partir de duas dimensões centrais: comunitárias e de gestão. Esses aspectos se mostraram articulados a discursos ambientalistas e formas de resistência à economia majoritária e às práticas alimentares industrializadas, tensionando-se com formas de elitização do consumo e idealização do rural.