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Background: Thyroid carcinoma (TC) incidence increased over the past 50 years. The explanation for this is not consensual. Objective: Compare incidental vs non-incidental TC (ITC vs NITC) regarding demographic, clinical, histological data and 5-year clinical outcomes. Design: Retrospective analysis of 225 papillary TC (PTC) cases that completed a 5-year follow-up. Methods: Created 2 groups: ITC (including the incidentalomas) and NITC (cases of palpable or visible nodules or with thyroid compressive complaints). Results: Included 225 PTC (122 were ITC). There were 95 women in ITC and 78 in NITC. ITC patients were significantly older (53.3 ± 14.8 vs 47.2 ± 17.7, P = 0.006). Groups had no differences in family history of TC. ITC mean tumour size was smaller (19.1 ± 9.2 vs 28.6 ± 16.2, P < 0.01). Tumours > 20 mm comprised 36.1% of ITC and 58.2% of NITC. We found no differences in tumour multifocality, histological thyroiditis, aggressive PTC subtypes, capsule or lymph-vascular invasion and gross extrathyroidal extension. There were no differences regarding the number of patients submitted to RAI or in RAI activity. pTMN staging showed higher prevalence of T3a and T4 cases (P < 0.01), and M1 status (P = 0.025) in NITC. There were no differences in the rates of persistence of disease. Logistic regression showed that the diagnostic modality had no impact on the 5-year clinical outcome. Conclusion: ITC patients were older and had smaller tumours. NITC showed no worst histological features or 5-year clinical outcome. Approximately, one third of ITC had diameters > 20 mm. As even large tumours can be ITC, overdiagnosis is the most likely cause of increasing incidence of TC.

Drs Tsybrovskyy, Sobrinho-Simões, and Tallini (1) argue that, when we conclude that the incidental detection of tumors larger than 2 cm suggests that overdiagnosis is the most likely cause for the rise in the incidence of thyroid cancer (TC), we are equating carcinomas found incidentally with ‘overdiagnosis’. According to Tsybrovskyy et al., the term ‘overdiagnosis’ can only be attributed to a condition that is both incidental and harmless, which would not be the case in our study since a significant proportion (36%) of incidental thyroid carcinomas (ITC) were larger than 2 cm in size, and only 61.5% of the patients were completely disease free at the 5-year follow-up. We think that Tsybrovskyy et al. have misinterpreted our writing since our conclusion, which was clearly stated in the manuscript, is that because a significant proportion of ITC patients had tumor diameters above 20 mm, overdiagnosis, and not environmental or lifestyle risk factors, is the most likely cause for the rise in the incidence of TC that is occurring worldwide. This is so because the rising incidence of TCs of all sizes and stages at diagnosis has been an argument used by others to consider that overdiagnosis alone is unlikely to account entirely for the increased TC incidence (2).

Abstract Background Rearrangements in the anaplastic lymphoma kinase (ALK) gene define a molecular subgroup of non-small-cell lung carcinoma (NSCLC) that should be treated with ALK-targeting tyrosine kinase inhibitors (TKIs). Objective This study aimed to portray the Portuguese reality about the diagnosis and treatment of stage IV ALK-positive NSCLC. Methods Institutions that treat lung cancer in Portugal were invited to participate in an anonymous electronic questionnaire. A total of 22/35 geographically dispersed institutions responded. A descriptive statistical analysis of the results was performed. Results Reflex molecular testing was done in 54.6% of the institutions. Next-generation sequencing (NGS) was the preferred diagnostic method (90.9%). Typically, physicians obtained molecular study results within 14–21 days. Alectinib was the most commonly used first-line treatment. For patients with brain metastases, 86.4% of the physicians preferred alectinib and 13.6% preferred first-line brigatinib. In the case of asymptomatic oligoprogression in the central nervous system, 85.7% of physicians performed local treatment and kept the patient on a TKI; if symptomatic, 66.7% gave local treatment and stayed with the TKI, while 28.6% gave local treatment and altered the TKI. For patients with symptomatic systemic progression, 47.6% and 38.1% of physicians prescribed lorlatinib after initial treatment with alectinib or brigatinib, respectively. After progression on lorlatinib, 42.9% of respondents chose chemotherapy and 57.1% requested detection of resistance mutations. Conclusions NGS is widely used for the molecular characterization of ALK-positive NSCLC in Portugal. The country has access to up-to-date therapy. Overall, national clinical practice follows international recommendations for the diagnosis and treatment of ALK-positive NSCLC.

ABSTRACT Pigment dispersion syndrome is associated with clinical features such as Krukenberg's spindles, trabecular pigmentation, Scheie's stripe and Zentmayer's ring. Another less common feature of this syndrome is retrolental pigment deposits due to anterior hyaloid detachment or a defect in the Wieger's ligament. We present two cases of pigment deposits on the posterior lens capsule. In both cases, there is bilateral dispersion of pigment throughout the anterior segment. The retrolental deposits are unilateral in the first case and bilateral in the second. Both patients report a history of ocular trauma. This is a possible important clinical sign of pigment dispersion syndrome, rarely described.

Purpose: To analyze the efficacy and safety of a MIGS device (XEN gel stent ®) in the management of glaucoma in our tertiary center. Methods: Retrospective analysis of patients submitted to XEN ® implant alone or combined with cataract surgery. Patients with previous filtering surgeries were included. Intraocular pressure (IOP) was evaluated at 1st week, 1st, 3rd, 6th and 12th months after surgery. BCVA, RNFL thickness and number of antiglaucoma medications were evaluated 1 year after surgery. Early and late complications and need for an additional glaucoma surgery were recorded. Results: Thirty-four eyes from 28 patients were included. The main diagnosis was primary open angle glaucoma (POAG) (58.8%). IOP decreased from 20.5±4.9 mmHg to 15.4±4.1 mmHg 1 year after surgery (p

El presente artículo propone una reflexión teórico-metodológica desde la psicología social sobre los desafíos que implica el trabajo de investigación con población indígena, particularmente, con personas pertenecientes al pueblo Mapuche. Se enfatizan los desafíos éticos, teóricos y las tensiones metodológicas que emergen debido a las formas de producción de conocimiento hegemónicas de la psicología, las cuales se enmarcan dentro de lógicas poscoloniales, que privilegian la perspectiva occidental sobre la de los pueblos originarios y que, en su implementación, reproducen prácticas de dominación y racialización que tienen su origen en el pasado colonial. Finalmente, se propone una reflexión con miras a repensar las relaciones con los y las participantes y nuestras prácticas investigativas desde una perspectiva decolonial.

Abstract Introduction: The coronavirus-19 pandemic threatens the lives of all people, but results in higher mortality rates for patients with end-stage kidney disease (ESKD) including those on peritoneal dialysis (PD). Telemedicine was the main alternative to reduce exposure to the virus, but it was introduced in the Brazil without proper training. Objective: To investigate the impact of telemedicine on metabolic control, peritonitis rates, and hospitalization in PD patients during the pandemic. Methods: This was a retrospective multicenter cohort study. We included all adult patients on chronic PD from 9 clinics selected by convenience during the pandemic. The outcomes of interest were measured and compared between before and after switching to telemedicine using repeated measure analysis and multilevel Poisson regression. Results: The study included 747 patients with a mean age of 59.7±16.6 years, of whom 53.7% were male and 40.8% had diabetes. Biochemical parameters including hemoglobin, potassium, phosphate, calcium, and urea serum levels did not change significantly after transition to telemedicine. There was no association between telemedicine and peritonitis rates. In contrast, hospitalization rates increased significantly in the telemedicine period. The incidence rate ratio (IRR) for hospitalization in the telemedicine period was 1.54 (95%CI 1.10-2.17; p 0.012) and 1.57 (95%CI 1.12-2.21; p 0.009) in the mixed-effects Poisson regression before and after adjustment for the presence of confounders. Admissions for hypervolemia and infections not related to PD doubled after transition to telemedicine. Conclusion: The implementation of telemedicine without proper training may lead to an increase in adverse events in PD patients.

Summary: Iron recycling prevents the development of anemia under homeostatic conditions. Whether iron recycling was co-opted as a defense strategy to prevent the development of anemia in response to infection is unclear. We find that in severe Plasmodium falciparum malaria, the onset of life-threatening anemia is associated with acute kidney injury (AKI), irrespective of parasite load. Using a well-established experimental rodent model of malaria anemia, we identify a transcriptional response that endows renal proximal tubule epithelial cells (RPTECs) with the capacity to store and recycle iron during P. chabaudi chabaudi (Pcc) infection. This response encompasses the induction of ferroportin 1/SLC40A1, which exports iron from RPTECs and counteracts AKI while supporting compensatory erythropoiesis and preventing the onset of life-threatening malarial anemia. Iron recycling by myeloid cells is dispensable to this protective response, suggesting that RPTECs provide an iron-recycling salvage pathway that prevents the pathogenesis of life-threatening malarial anemia.

¿Por qué justifican las personas la violencia intergrupal ejercida entre la policía y manifestantes en protestas sociales? En este artículo se examinan las actitudes hacia la violencia perpetrada en Chile por Carabineros contra manifestantes y la violencia ejercida por manifestantes contra Carabineros en el marco del contexto post estallido social del 18 de octubre de 2019. Se evalúa el papel que juegan la percepción de injusticia en los procedimientos y el trato de Carabineros hacia manifestantes, la evaluación de la legitimidad de Carabineros y la identificación grupal con manifestantes y Carabineros en predecir la justificación de la violencia hacia Carabineros y hacia manifestantes. Se presentan los resultados de una encuesta no-probabilística online sobre legitimidad y violencia policial realizada a adultos en Chile durante enero de 2021 (n = 2.594). A través de un análisis de sendero, se encontró que la percepción de injusticia en los procedimientos de trato de Carabineros hacia los manifestantes es un factor clave al predecir la percepción de legitimidad de esa institución. Es más, al reducir la legitimidad de Carabineros, la percepción de injusticia en los procedimientos y el trato se traducen en una menor justificación de la violencia de Carabineros y una mayor justificación de la violencia de manifestantes. El artículo termina destacando la importancia de considerar las percepciones de injusticia en los procedimientos y el trato de Carabineros para lograr reducir el conflicto entre estos y los manifestantes en protestas en Chile.

El objetivo de este trabajo es conocer las experiencias de racismo del colectivo migrante haitiano en Chile desde una perspectiva interseccional. Atendemos a sus experiencias opresivas y también a sus resistencias frente a estas experiencias. Realizamos un estudio cualitativo con 16 personas haitianas (10 hombres y 6 mujeres) de entre 21 y 44 años, residentes en Santiago de Chile, con las cuales efectuamos 29 entrevistas semiestructuradas en profundidad. Como método de análisis de información, realizamos un análisis de contenido temático desde un enfoque interseccional. Identificamos racismo estructural, prejuicios manifiestos y racismo internalizado en la experiencia de los y las participantes. El color de piel se presenta como el marcador racial más importante y se encuentra articulado con la nacionalidad, la condición de migrante y/o el sexo-género. También, damos cuenta del fenómeno de racialización sexualizada hacia los hombres haitianos. Las diversas resistencias de los y las participantes hacia el racismo, muestran un reconocimiento positivo de las posiciones sociohistóricas de las personas haitianas. De este modo, pesquisamos identidades sociales resistentes e incipientes configuradas en torno al color de piel y la nacionalidad haitiana. Para líneas de investigación futura, creemos relevante extender el estudio del racismo en Chile desde el campo de la migración internacional, para atender a las estructuras racializadas desde las cuales se ejerce racismo hacia personas de pueblos originarios, afrochilenos y/o mestizos chilenos de piel oscura. Con este trabajo buscamos contribuir a visibilizar la presencia y consecuencias del racismo en Chile, y a promover la integración integral de la comunidad haitiana.

Background: Scars interfere with the motor system; however, the influence of c-section scars has not been described yet. The aim of this study is to relate the presence of abdominal scars from a caesarean section with changes in postural control—stability and orientation and abdominal and lumbar neuromuscular control in the orthostatic position. Methods: Cross-sectional analytical observational study comparing healthy primiparous women with caesarean delivery (n = 9) and physiologic delivery (n = 12) who have delivered more than one year before. The relative electromyographic activity of the rectus abdominis, transverse abdominis/oblique internus and lumbar multifidus muscles, antagonist co-activation, the ellipse area, amplitude, displacement, velocity, standard deviation, and spectral power of the centre of pressure, and thoracic and lumbar curvatures, were evaluated in the standing position in both groups, through an electromyographic system, a pressure platform and spinal mouse system. In the “caesarean delivery” group, scar mobility was evaluated using a modified adheremeter. Results: Significant differences in CoP medial-lateral velocity and mean velocity were observed between groups (p < 0.050), while no significant differences were in the level of muscle activity, antagonist co-activation, and thoracic and lumbar curvatures (p > 0.05). Conclusions: The information provided by the pressure signal seems to identify postural impairments in women with c-sections.

Purpose: Nursing home-acquired pneumonia (NHAP) patients are at higher risk of multi-drug resistant infection (MDR) than those with community-acquired pneumonia (CAP). Recent evidence suggests a single risk factor for MDR does not accurately predict the need for broad-spectrum antibiotics. The goal of this study was to compare the rate antibiotic failure between NHAP and CAP patients. Methods: Demographic characteristics, co-morbidities, clinical and laboratory variables, antibiotic therapy, and mortality data were collected retrospectively for all patients with pneumonia admitted to an Internal Medicine Service between April 2017 and April 2018. Results: In total, 313 of 556 patients had CAP and 243 had NHAP. NHAP patients were older, and were more likely to be dependent, to have recent antibiotic use, and to experience treatment failure (odds ratio (OR) 1.583; 95% CI 1.102–2.276; p = 0.013). In multivariate analysis, patient’s origin did not predict treatment failure (OR 1.083; 95% CI 0.726–1.616; p = 0.696). Discussion: Higher rates of antibiotic failure and mortality in NHAP patients were explained by the presence of other risk factors such as comorbidities, more severe presentation, and age. Admission from a nursing home is not a sufficient condition to start broader-spectrum antibiotics.

Introdução: O emprego de Testes Rápidos (TR) para Hepatites Virais (HV) é uma estratégia oportuna para iniciar a cascata da linha de cuidados, especialmente em populações-chave, como as Pessoas em Situação de Rua (PSR). Porto Alegre-RS está no topo do ranking nacional da morbimortalidade das HV, entretanto a vigilância epidemiológica pode ser um desafio nas PSR, pois não há um campo específico para essa vulnerabilidade na notificação compulsória. O referido trabalho objetiva avaliar fatores associados à adesão na cascata da linha de cuidados da PSR com TR reagentes para HV tipo C na vigência das medidas de isolamento pelo SARS-CoV-2. Métodos: Estudo transversal, com dados do monitoramento clínico da equipe do Consultório na Rua de Porto Alegre_RS durante a pandemia pelo COVID-19. A equipe possui 5332 PSR cadastradas e realiza os TR na unidade base, e de modo “extra-muros”, como em abordagens de rua e locais de oferta de serviços sociais. Resultados: Foram analisados 498 TR para HV tipo C, ao longo do monitoramento, 39(7,8%) apresentaram TR reagente, sendo que 15(41,6%) realizaram carga viral e 11(30,5%) tiveram detecção quantitativa, com valores entre 15.451 e 7.851.465 UI/ml. Seguindo o protocolo, destas esperava-se que 11(30,5%) fossem encaminhadas, entretanto apenas 8(22,2%) o aceitaram. Entre estes, 4(11,1%) compareceram a consulta e 2(5,5%) tiveram tratamento indicado. Sobre o perfil epidemiológico observa-se que: 33(91,6%) homens cis, 3 mulheres cis (8,3%), 17(47,2%) idade igual ou maior que 50 anos, 3(8,3%) apresentam co-infecção com HIV, 7(19,4%) com tuberculose e 8(22,2%) apresentaram TR reagente para sífilis. Entre os TR reagentes, 11(30,5%) já tinham o diagnóstico prévio de HV tipo C. A replicação do TR está relacionada as abordagens “extra-muros” que dificulta a checagem dos prontuários. Ainda, 11(30,5%) perderam o vínculo no início do cuidado, ao não coletar o exame de quantificação de carga viral e 3(8,3%) por não comparecer ao especialista. Infere-se, em parte, o absenteísmo às dificuldades pela falta de documentos de identificação, a localização descentralizada dos 2 laboratórios municipais e fatores comportamentais, como 12(33,3%) uso de álcool e outras drogas. Conclusões: O monitoramento clínico, por meio da tabela Excel, permite à equipe de assistência multiprofissional a organização da gestão dos cuidados, através de buscas ativas e continuidade do seguimento do ponto em que a PSR parou, não necessitando reiniciar a cascata.

The WHO considers that antimicrobial resistance (AMR) is among the ten greatest global public health risks of the 21st century. The expansion of human populations and anthropogenically related activities, accompanied by the fragmentation of natural habitats, has resulted in increased human–wildlife interaction. Natural ecosystems are therefore subjected to anthropogenic inputs, which affect the resistome of wild animals. Thus, urgent multisectoral action is needed to achieve the Sustainable Development Goals following the One Health approach. The present work falls within the scope of this approach and aims to characterize the AMR of the faecal microbiome of the red fox (Vulpes vulpes), an opportunistic and generalist synanthropic species whose abundance has been increasing in urban and peri-urban areas. A high number of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) were screened and quantified using a high-throughput qPCR approach, and the antimicrobial susceptibility of cultivable E. coli and Enterococcus spp. were assessed interpreted with both ECOFFs and clinical breakpoints. The most abundant ARGs detected confer resistance to trimethoprim and tetracyclines, although the first were absent in one of the locations studied. Several ARGs considered to be threats to human health were identified in high relative abundances (blaTEM, ermB, aadA, tetM, tetW, tetL, drfA1 and drfA17), especially in the geographical area with greater anthropogenic influence. Although at a low percentage, resistant and multidrug-resistant (MDR) E. coli and Enterococcus spp. were isolated, including one MDR E. coli showing resistance to 12 antimicrobials from 6 different classes.

Background. Mediastinal thyroid carcinoma is extremely rare, with few cases reported in the literature. Case Report. A 73-year-old man presented with weight loss for 6 months. Imaging by computed tomography (CT) documented a large mediastinal mass below the thyroid gland and pulmonary metastases. Neck ultrasound found two spongiform nodules in the right thyroid lobe, and fine-needle aspiration citology (FNAC) of these nodules revealed they are benign. Endobronchial ultrasound-guided needle biopsy of the mediastinal mass was compatible with papillary thyroid cancer. A few weeks later, the patient developed overt hyperthyroidism due to Graves’ disease, which was treated with antithyroid drugs. 99mPertechnetate scintigraphy showed increased diffuse uptake in the thyroid parenchyma but the absence of uptake in the paratracheal mass and in the lung nodules. The patient was not considered eligible for surgical intervention or therapy with tyrosine kinase inhibitor due to tracheal and mediastinal vessel invasion and was treated with palliative radiotherapy. Two months later, restaging PET-FDG showed an intense uptake in the right lobe of the thyroid gland, lymph nodes, lungs, bone, muscle, myocardial, kidney, and adrenal gland. Conclusion. In this case, thyroid carcinoma presented as a mediastinal mass with concurrent hyperthyroidism due to Graves’ disease. Although uncommon, the clinicians should be aware of these situations. Obtaining a prompt histological examination of an intrathoracic mass is crucial to ensure an early diagnosis and treatment.

As the general population ages, more people are affected by eye diseases, such as retinopathies. It is therefore critical to improve imaging of eye disease mouse models. Here, we demonstrate that 1) rapid, quantitative 3D and 4D (time lapse) imaging of cellular and subcellular processes in the mouse eye is feasible, with and without tissue clearing, using light-sheet fluorescent microscopy (LSFM); 2) flat-mounting retinas for confocal microscopy significantly distorts tissue morphology, confirmed by quantitative correlative LSFM-Confocal imaging of vessels; 3) LSFM readily reveals new features of even well-studied eye disease mouse models, such as the oxygen-induced retinopathy (OIR) model, including a previously unappreciated ‘knotted’ morphology to pathological vascular tufts, abnormal cell motility and altered filopodia dynamics when live-imaged. We conclude that quantitative 3D/4D LSFM imaging and analysis has the potential to advance our understanding of the eye, in particular pathological, neurovascular, degenerative processes.

This special thematic section aims to bring together current research on the connections between collective memories – or representations of history – and present-day intergroup relations. Drawing from a multitude of geographical and historical contexts as well as different methodologies, we bring forth ten articles focusing on distinct aspects of the relations between representations of the past and present day intergroup dynamics. The topics covered in these articles focus on one or more of the four research lines identified within this field: 1) the antecedents of collective memories; 2) the contents and structure of collective memories; 3) the official or institutional transmission of collective memories; and 4) distinct socio-psychological correlates of collective memories in present-day societies. Together, the contributions in this special thematic section showcase current directions of research within the field and highlight the need to consider the role of representations of the past for understanding present day instances of intergroup conflict or harmony. We discuss the need for more interdisciplinary work in this field, as well as more applied research in the future.

Uhl's disease, also known as Uhl anomaly, is a rare disease secondary to selective but uncontrolled apoptosis of right ventricular myocytes during the perinatal period, after complete cardiac development, leading to the absence of right ventricular myocardium and the direct apposition of endocardium to epicardium without a myocardial layer in between, resulting in right ventricular failure.The present paper describes a case of Uhl's disease with an uncommon presentation. A 28-year-old man was admitted with dyspnea and cyanosis. Transthoracic echocardiography showed severe dilation of the right chambers, impaired right ventricular systolic function and a large ostium secundum atrial septal defect (ASD). Cardiac catheterization revealed pulmonary hypertension, with increased pulmonary capillary wedge pressure (mean 19 mmHg) and Qp:QS 0.88:1. At this point, the authors considered that a main diagnosis of ASD could not explain the clinical features and hemodynamic data. A primary disease of the right ventricle was the most likely hypothesis and cardiac magnetic resonance imaging was performed, which demonstrated an extremely thin-walled right ventricle, with almost complete absence of right ventricular free wall myocardium, compatible with Uhl's disease. Resumo: A anomalia de Ulh é uma doença rara, secundária à seletiva, contudo descontrolada apoptose dos miócitos do ventrículo direito durante o período perinatal, após o desenvolvimento cardíaco completo, o que explica a ausência de miocárdio do ventrículo direito e a direta aposição do endocárdio e epicárdio, resultando em falência do ventrículo direito. O presente artigo descreve um caso de doença de Uhl com apresentação incomum. Homem de 28 anos admitido por dispneia e cianose. O ecocardiograma transtorácico documentou dilatação grave das cavidades direitas, compromisso da função sistólica do ventrículo direito e uma grande comunicação interauricular ostium secundum. O cateterismo cardíaco revelou hipertensão pulmonar com aumento da pressão capilar (média 19mmHg); Qp:Qs 0,88:1. Neste momento, os autores consideraram que a comunicação interauricular como diagnóstico principal não explicava a apresentação clínica e os dados hemodinâmicos. Doença primária do ventrículo direito tornou-se a hipótese mais provável, pelo que se realizou uma ressonância magnética cardíaca que demonstrou um ventrículo direito com parede extremamente fina, com ausência praticamente total do miocárdio da parede livre, compatível com doença de Uhl. Keywords: Uhl's disease, Primary right ventricular disease, Cardiac magnetic resonance imaging, Palavras-chave: Doença de Uhl, Doença primária do ventrículo direito, Ressonância magnética cardíaca

Parasites have a profound impact on wildlife population dynamics. However, until some years ago, studies on the occurrence and prevalence of wildlife parasites were neglected comparatively with the studies on humans and domestic animals. In this study, we determined the parasite prevalence of two sympatric wild canids: the endangered Iberian wolf (Canis lupus signatus) and the widespread red fox (Vulpes vulpes), in central Portugal. From November 2014 to July 2015, fresh fecal samples from both species were collected monthly in several transects distributed throughout the study area. All samples were submitted to several coprological techniques. In total, 6 helminth parasites (Crenosoma vulpis, Angiostrongylus vasorum, Toxocara canis, Trichuris vulpis, Ancylostomatidae, Toxascaris leonina), and a protozoa (Balantidium coli) were identified based on size and morphology. The red fox was infected by seven different parasites while the Iberian wolf was infected by four. All parasites present in wolf were also present in the red fox. C. vulpis had the higher prevalence in red fox, while Ancylostomatidae were the most prevalent parasites in wolf. To our knowledge, this is the first study in this isolated subpopulation of the Iberian wolf. Our results show that both carnivores carry parasites that are of concern as they are pathogenic to humans and other wild and domestic animals. We suggest that surveillance programs must also include monitoring protocols of wildlife; particularly endangered species.

Group-based emotions can be experienced by group members for the past misdeeds of their ingroup towards an outgroup.. The present study examines distinct antecedents and consequences of group-based compunction and anger in two countries with a history of colonization (Portugal, N = 280 and the Netherlands, N = 184). While previous research has focused mainly on ingroup-focused antecedents of group-based emotions, such as ingroup identification and perceptions of responsibility, our research also analyzed outgroup-focused variables, such as outgroup identification and meta-perceptions. Multiple group structural equation modeling showed that group-based compunction and group-based anger have similar antecedents (exonerating cognitions, collectivism, outgroup identification and meta-perceptions). Furthermore, the results showed that the two emotions have distinct but related consequences for the improvement of intergroup relations (compensation, subjective importance of discussing the past and forgiveness assignment).

Polar lipids from microalgae have aroused greater interest as a natural source of omega-3 (n-3) polyunsaturated fatty acids (PUFA), an alternative to fish, but also as bioactive compounds with multiple applications. The present study aims to characterize the polar lipid profile of cultured microalga Emiliania huxleyi using hydrophilic interaction liquid chromatography coupled with high-resolution mass spectrometry (HILIC–MS) and fatty acids (FA) analysis by gas chromatography (GC–MS). The lipidome of E. huxleyi revealed the presence of distinct n-3 PUFA (40% of total FA), namely docosahexaenoic acid (22:6n-3) and stearidonic acid (18:4n-3), which give this microalga an increased commercial value as a source of n-3 PUFA present in the form of polar lipids. A total of 134 species of polar lipids were identified and some of these species, particularly glycolipids, have already been reported for their bioactive properties. Among betaine lipids, the diacylglyceryl carboxyhydroxymethylcholine (DGCC) class is the least reported in microalgae. For the first time, monomethylphosphatidylethanolamine (MMPE) has been found in the lipidome of E. huxleyi. Overall, this study highlights the potential of E. huxleyi as a sustainable source of high-value polar lipids that can be exploited for different applications, namely human and animal nutrition, cosmetics, and pharmaceuticals.

Enquadramento: o Investimento na Vida Pessoal (IVP) pode indicar-nos a valorização e atribuição de objetivos de vida do idoso, em todos os seus atributos e caraterísticas. Objetivo: avaliar o nível e determinantes de IVP percecionado pelos idosos institucionalizados. Metodologia: estudo não experimental, descritivo-correlacionai e quantitativo, realizado numa amostra de 90 idosos institucionalizados da região Centro do País. Foi utilizado um questionário, o índice de Barthel, escala de Apgar Familiar, escala da Espiritualidade, escala de Satisfação com a Vida e escala de Avaliação de Investimento na Vida Pessoal. Resultados: a perceção dos idosos sobre o IVP é para 37,8% elevado, moderado para 30,0% e baixo para 32,2%. Os homens avaliam o investimento de uma forma mais positiva que as mulheres (p =0,047), assim como os idosos com habilitações académicas superiores (p = 0,041) e com maior nível de independência funcional (p = 0,037) Também a família tem um efeito positivo e significativo (p = 0,020) no IVP do idoso, à semelhança da existência de mais esperança (p = 0,002) e maior satisfação com a vida (p = 0,013). Conclusão: os níveis de IVP dos idosos é diferenciados mas maioritariamente positivo e correlaciona-se de forma significativa com diversas variáveis que trabalhadas contribuem para um envelhecimento ativo e com qualidade.

O objetivo deste estudo foi avaliar o estado da referenciação de crianças à especialidade hospitalar de oftalmologia, no Centro Hospitalar do Porto, analisando os motivos de referenciação, patologias diagnosticadas, eficácia dessa referenciação e o impacto visual nas crianças. Método: Estudo retrospetivo e descritivo dos processos clínicos das crianças com idade menor ou igual a 10 anos, referenciadas à consulta de oftalmologia pediátrica entre julho de 2011 e julho de 2012. Resultados: Um total de 649 crianças foi referenciado, tendo sido os motivos mais frequentes a suspeita de estrabismo em 41,9% dos casos, rastreio de patologia oftalmológica em 22,6% e suspeita de baixa acuidade visual (AV) em 15,2%. Das crianças referenciadas por suspeita de estrabismo confirmou-se o diagnóstico em 40,8% dos casos (média das idades 4,5±2,2 anos), sendo que 16,8% das crianças referenciadas por outros motivos apresentavam também estrabismo. No total, 62,3% foram classificados como endotropias e 32,3% como exotropias. Das crianças referenciadas por suspeita de baixa AV, confirmou-se o diagnóstico em 39% dos casos e a principal causa de diminuição da AV foram as ametropias (52% dos casos). Das crianças referenciadas por outros motivos, 13,3% apresentavam diminuição mensurável da AV e 20% tinham ametropias potencialmente ambliogénicas. Apenas 40% das crianças referenciadas por suspeita de baixa AV apresentavam registo de AV no pedido de referenciação. Foi diagnosticada ambliopia em 20,1% de todas as crianças observadas. Discussão: Os problemas que mais frequentemente motivaram a referenciação para oftalmologia pediátrica foram a suspeita de estrabismo e de diminuição da AV. No entanto, confirmou-se o diagnóstico em menos de metade das crianças referenciadas e uma percentagem significativa dos casos diagnosticados foi referenciado por outro motivo. A média das idades de diagnóstico de estrabismo foi tardia e a percentagem de ambliopia elevada. Este estudo reforça a importância da realização do exame oftalmológico de rastreio nos cuidados de saúde primários e o seu impacto na referenciação, diagnóstico e tratamento atempado destas patologias em idade pediátrica.

O objetivo fundamental deste texto consiste em problematizar o contributo da obra do autor francês Michel Foucault para uma visão das principais práticas de saúde pública desenvolvidas em solo europeu a partir do século XVIII. A metodologia usada na exploração desta questão será essencialmente baseada na leitura e interpretação das principais obras do autor francês, bem como de publicações relativas a conferências, entrevistas e textos de aulas integradas nos célebres cursos que ele ministrou no Collège de France nas décadas de 70 e 80 do século XX. Em termos de resultados e sua discussão, os mesmos serão desenvolvidos à volta da defesa da tese central de que, abstraindo-nos da leitura que este autor tradicionalmente fez da associação entre o poder e a dominação, no seio da qual ele perspectiva muitas práticas de saúde pública nascidas na Europa a partir do século XVIII como sendo exercícios com vista a “disciplinar” ou “docilizar” os corpos dos indivíduos, para além desta leitura e acima dela, os relatos feitos por Michel Foucault dão-nos uma visão particularmente clara do nascimento e desenvolvimento de muitas práticas de saúde pública que hoje todos perspectivamos como direitos inalienáveis da vida democrática, e como essenciais no eixo de relação entre saúde, cidadania e democracia, mesmo que o olhar do autor francês as tenha interpretado como marcas de dominação. A conclusão à qual a investigação nos conduz de forma particularmente clara é que, sobretudo quando nos centramos na abordagem foucaultinana do nascimento e evolução trifásica da Medicina Social a partir do século XVIII, é inquestionável que a investigação e os relatos deste autor, constituem acima de tudo testemunhos históricos de excelência para qualquer investigação na área da história das práticas de saúde pública e do direito sanitário.

Financial exclusion in Brazil: a regional investigation. Despite the fact that after the second half of the nineties the studies of financial exclusion have gained strength among the studies about poverty and regional and social inequalities, a few studies about this problem had appear in the Brazilian economic literature. The present work aims to contribute to this discussion by doing a regional investigation about the phenomenon of financial exclusion inside Brazil. The main hypothesis of the study is that this phenomenon is not disassociated of the space in which it happens. Thought of the use of proxies two dimensions of financial exclusion had been studied: the access to financial services and the suitability of it.

Neste ensaio avaliou-se o efeito de diferentes misturas de substrato comercial e vermicomposto na produção de biomassa, composição química e rendimento dos óleos essenciais de Thymus zygis. Utilizaram-se 5 substratos resultantes da mistura de um vermicomposto (V) com um substrato orgânico comercial (O), em cinco proporções diferentes (v/v): V100 (100%V); VO75-25 (75%V+25%O); VO50 -50 (50%V+50%O); VO 25-75 (25%V + 75%O) e O100 (100%O). A inclusão do vermicomposto no substrato não melhorou a produção de biomassa. Na modalidade O100 produziu-se mais biomassa, tendo sido na modalidade VO25-75 onde se obteve o valor mais baixo. Na modalidade V100 todas as plantas secaram tendo-se ainda apresentado nesta modalidade o valor mais elevado de pH e de densidade real e inversamente o menor valor de espaço poroso total. Os monoterpenos oxigenados predominaram nos óleos extraídos das plantas nas modalidades O100 e VO25-75, contrariamente ao que se verificou para os monoterpenos não oxigenados tendo estes predominado nas modalidades VO75-25 e VO50-50. A concentração de timol foi elevada nas misturas testadas, em particular na modalidade VO25-75.In this trial we evaluated the effect of different mixtures of organic growing media substratum and vermicompost and their physical properties on biomass, chemical composition and yield of essential oils of Thymus zygis. Five treatments were established based on two types of organic materials (O, commercial growing media, and V, vermicompost). The following proportions were studied (v/v): V100 (100%V); VO75-25 (75%V+25%O); VO50-50 (50%V+50%O); VO 25-75 (25%V+75%O) and O100 (100%O). The inclusion of vermicompost did not improve biomass production. The treatment O100 produced more biomass and the lowest was obtained in VO25-75. On V100 treatment all plants were dead and also have showed the highest pH and particle density and conversely presented the lowest value of total pore space. Oxygenated monoterpenes predominated in the oils extracted from plants in O100 and VO25-75, contrary to what was found for non-oxygenated monoterpenes having these prevailed in VO75-25 and VO50-50. The concentration of thymol was high in the mixtures tested, particularly in VO25-75.

Resumo: Os derrames pericárdicos que surgem num contexto neoplásico são frequentes e apresentam dificuldades de diagnóstico e tratamento. Apesar de surgirem em doentes com neoplasia, 50% destes derrames têm uma etiologia benigna; surgem por mecanismos paralelos, indirectamente relacionados com o tumor. Os restantes (derrames pericárdicos neoplásicos â DPN) resultam do atingimento tumoral das estruturas peri ou epicárdicas e assumem, por si só, um pior prognóstico. As opções de tratamento disponíveis são várias, mas a ausência de normas orientadoras da sua aplicação tornam difícil avaliar perfis de rentabilidade, eficácia e segurança. A derivação pericardioperitoneal (DPP) é um método cirúrgico de drenagem da cavidade pericárdica que se tem demonstrado muito útil em DPN. No CHC, esta técnica é efectuada com o auxílio de toracoscopia videoassistida (VATS). Nos últimos 8 anos, foram submetidos a esta modalidade terapêutica 18 doentes com DPN. A técnica demonstrou ser segura, eficaz e com baixa morbilidade/mortalidade.Rev Port Pneumol 2007; XIII (1): 71-81 Abstract: Neoplasia-related pericardial effusions are a frequent finding and pose diagnostic and therapeutic challenges. Although they appear in the context of an underlying neoplastic disease, 50% of these effusions have a benign etiology; they are indirectly caused by the tumor. The remaining cases (neoplastic pericardial effusions â NPE) derive from extension of tumoral disease to the epi and/or pericardium and have, therefore, a worst prognosis. Despite several treatment options, the lack of apropriate guidelines difficults the evaluation of their efficacy and safety. Pericardioperitoneal shunt (PPS) is a surgical pericardial drainage method, which has demonstrated its use fulness in the management of NPE. At the CHC, this procedure is performed under videoassisted toracoscopic guidance (VATS). During the last 8 years, 18 patients have been submitted to this therapeutic option, which proved to be safe, efficacious and with low morbimortality rates.Rev Port Pneumol 2007; XIII (1): 71-81 Palavras-chave: Derrame pericárdico, neoplasia, derivação pericardioperitoneal, drenagem pericárdica, Key-words: Pericardial effusion, neoplasia, pericardioperitoneal shunt, pericardial drainage

The present manuscript is a theoretical revision of the major theories about intergroup relations and emotions, developed over the last decades in the field of social psychology. Following a general chronological order, we first revise the first individualistic approaches to the field of intergroup relations and social conflict. Afterwards, we revise the realistic group conflict theory and relative deprivation theory. Next, we discuss the social identity and the self-categorization theories and highlight some of the most studied dimensions of intergroup relations within this framework. To conclude, we present some of the most influential appraisal theories of emotions and the theory of intergroup emotions. We claim for an integration of several different approaches when studying intergroup relations and, more specifically, the role of different emotions in explaining instances of intergroup conflict.

Procedimentos cardíacos estão entre os mais comuns em radiologia intervencionista (RI), e podem levar a altas exposições médicas e ocupacionais, pois na maioria dos casos, são procedimentos complexos e de longa duração. Neste trabalho, foram calculados os coeficientes de conversão (CC) para o risco de câncer, normalizados pelo produto kerma área (PKA), para o paciente, médico cardiologista e enfermeira usando simulações de Monte Carlo. O paciente e o cardiologista foram representados pelos simuladores antropomórficos MASH, e a enfermeira pelo simulador antropomórfico FASH. Os simuladores foram incorporados ao código de Monte Carlo MCNPX. Dois cenários foram criados: em I a cortina de chumbo e equipamentos de proteção suspensos não foram inseridos, e em II estes equipamentos foram inseridos. Os parâmetros radiográficos empregados nas simulações de Monte Carlo foram: tensão do tubo entre 60 kVp e 120 kVp; filtração do feixe de 3,5 mmAl e área do feixe de 10 x 10 cm2. Os valores médios dos CCs para oito projeções (em 10-4/Gy.cm²) foram 1,2 para o paciente, 2,6E-03 (cenário I) e 4,9E-04 (cenário II) para o cardiologista e 5,2E-04 (cenário I) e 4,0E-04 (cenário II) para a enfermeira. Os resultados mostram uma redução significativa nos CCs para os profissionais, quando a cortina de chumbo e equipamentos de proteção suspensos são empregados. O método de avaliação empregado neste trabalho pode fornecer informações importantes sobre o risco de câncer do paciente e profissionais, e desta forma, melhorar a proteção dos trabalhadores em procedimentos cardíacos de RI.

Palavras-Chave: Cessação Tabágica/métodos; Cigarros Electrónicos/efeitos adversos; Nicotina; Portugal.

RESUMO: Os autores apresentam o caso clínico de uma doente do sexo feminino, de 48 anos, com história de diabetes mellitus tipo 2, que desenvolveu um quadro de hemoptises associado a manifestações radiológicas difusas.Foi-lhe diagnosticado um hemangioendotelioma epitelioide pulmonar, tumor de natureza vascular, com comportamento intermédio entre os hemangiomas benignos e os angiossarcomas.Não há descrição na literatura quanto ao beneficio da utilização de radioterapia ou quimioterapia, pelo que, o tratamento preconizado nesta situação foi apenas sintomático.REV PORT PNEUMOL 2000; VI (2): 155-162 ABSTRACT: The authors report the clinical case of a 48-year­old female patient, with a history of diabetes mellitus type 2. She developed hemoptysis associated with widespread radiological manifestations. An epithelioid hemangioendothelioma of the lung was diagnosed. This is a tumor of a vascular nature with an intermediate behaviour between a benign hemangioma and a angiosarcoma.As there is no description of the benefits of radiotherapy or chemiotberapy in the literature, the treatment recommended in this case for this condition was simply symptomatic.REV PORT PNEUMOL 2000; VI (2): 155-162 Palavras-chave: Hemangioendotelioma, Tumor, Diagnóstico, Key-words: Hemangioendothelioma, Tumor, Diagnosis

Introdução: A violência escolar é um problema de Saúde Pública com graves consequências individuais e sociais. A apresentação deste caso tem como objectivo alertar os médicos de família para a alta prevalência de bullying e realçar a importância da sua actuação na prevenção, no diagnóstico, no tratamento das possíveis repercussões e na orientação da família. Descrição do caso: Adolescente de 15 anos, pertencente a uma família nuclear na fase V do ciclo de Duvall. Após várias consultas no ano de 2010, recorreu à consulta aberta da sua médica de família, apresentando queixas de agressão por parte dos colegas da escola. Referiu, ainda, insónia, irritabilidade, falta de apetite e recusa escolar. Os funcionários da escola não se mostraram sensibilizados. O director de turma sinalizou o caso à comissão de protecção de crianças e jovens (CPCJ) por abandono escolar, não aceitando a justificação das faltas pela médica de família, nem a iniciativa da família em procurar outra escola para o inscrever. O caso foi discutido entre a médica de família e o responsável da CPCJ, tendo sido concluído que a sinalização foi indevida. Após a integração numa nova escola, o adolescente começou a revelar sofrimento emocional com risco de auto e hetero-agressão, sendo referenciado a pedopsiquiatria de urgência. Este adolescente revelou sintomatologia depressiva reactiva a violência escolar - bullying. Comentário: A orientação de um caso de bullying envolve o esforço de uma equipa multidisciplinar. O médico de família está numa posição privilegiada para identificar situações de risco, aconselhar as famílias e rastrear comorbilidades psiquiátricas. Assim, o médico de família deve questionar a ocorrência de bullying quando existem sintomas psicossomáticos sem explicação, problemas na escola, comportamentos disruptivos ou evidência de pensamentos de suicídio. A ênfase deve ser colocada na prevenção primária, devendo treinar-se o desenvolvimento de habilidades sociais.

The Sclerosing Mesenteritis is a rare idiopathic disease. It represents the final stadium of progression of the chronic inflammatory illnesses of the intestinal mesentery, with predominance of fibrosis. The clinical manifestations are varied and unspecific. Diagnosis, that demands high degree of suspicion, can be presumed for imaging study, that discloses heterogeneous mass with tumor-like appearance, and confirmed on the basis of anatomo-pathological examination. The treatment is empirical and the prognostic is habitually favourable, over all in initial stadiums of the illness, being in a minority fatal. The authors describe the clinical case of a 50 years-old woman, admitted in the hospital for abdominal pain, ascitis and fever and that by radiological suspicion of peritoneal carcinomatosis and negative complementary study for primitive neoplasm, was submitted to an exploring laparotomy. Observed accented thickening of the mesentery that formed an extensive adherent conglomerate of bowel loops, whose biopsy had disclosed to be a sclerosing mesenteritis. Was verified an irrelevant answer to the treatment and an unfavourable, lethal, clinical course. The authors provide a literature review concerning the most relevant aspects of this disease.

Resumo: Relatamos dois casos de carcinoma pulmonar de não pequenas células (CPNPC) com metástases cerebrais que após quimioterapia sistémica receberam em segunda e terceira linha erlotinib 150 mg/dia, oral, com resposta completa das lesões secundárias cerebrais e franca resposta parcial das lesões torácicas.A metastização cerebral, bastante prevalente no contexto do CPNPC, está associada a escassas opções terapêuticas eficazes e, consequentemente, a uma sobre-vida mediana de 4 a 6 meses.Estes casos alertam para o erlotinib como uma excelente opção terapêutica para estes doentes. Os autores propõem um ensaio clínico com este fármaco neste grupo de doentes, procurando determinar da resposta objectiva.Rev Port Pneumol 2008; XIV (Supl 3): S35-S42 Abstract: We report two cases of brain metastases in context of non small cell lung cancer (NSCLC). After having progressed to chemotherapy they received erlotinib 150 mg/m2 orally daily, with complete response of brain metastasis and partial response of thoracic lesions.Brain metastases are both prevalent and a major cause of mortality in NSCLC, with few systemic treatment options. Median survival after whole brain radiotherapy is 4-6 months and the role of systemic therapy for brain metastases is limited with the most drugs use to stage IV disease ineffective in this setting.This case demonstrates that brain metastases may be sensitive to erlotinib and give to us growing body of evidence that EGFR-associated tyrosine kinase inhibition is a feasible strategy in the management of NSCLC patients with brain metastasesWe propose further study into the continued use of this drug in the situation where there is a differential response.Rev Port Pneumol 2008; XIV (Supl 3): S35-S42 Palavras-chave: Erlotinib, metástase cerebral, cancro do pulmão, Key-words: Erlotinib, brain metastasis, lung cancer

Introdução: A proteinúria é um achado laboratorial comum em adultos assintomáticos, que em circunstância alguma deve ser menosprezado. A utilização de tiras teste é o método mais utilizado na detecção da proteinúria, mas, como apresenta uma elevada taxa de falsos positivos, impõe-se a utilização de outros métodos na sua confirmação/monitorização. Objectivos: Efectuar uma revisão dos principais mecanismos fisiopatológicos de proteinúria e dos métodos actualmente utilizados na sua detecção e quantificação. Discutir a sua importância clínica e apresentar um possível protocolo de abordagem diagnóstica. Rever as terapêuticas específicas disponíveis, principalmente no contexto da Doença Renal Crónica (DRC). Metodologia: Foi realizada uma pesquisa na Pubmed de artigos originais, de artigos de revisão e de meta-análises até Abril de 2007 e foram consultadas fontes documentais de referência, nas áreas da Nefrologia e da Medicina Interna. Foram ao todo incluídos 63 artigos. Conclusões: A utilização de um algoritmo diagnóstico ajuda na distinção entre as causas benignas (doença febril, exercício físico, desidratação...) de outras causas menos frequentes, mas mais graves (glomerulopatias, gamapatias monoclonais...). A presença de proteinúria deve ser confirmada obrigando a estudo complementar, nomeadamente com análises quantitativas (proteinúria das 24 horas ou razão proteína/creatinina em amostra aleatória de urina). Os doentes com proteinúria persistente e cuja causa para a mesma não se identifica após investigação clínica, devem referenciados à consulta de Nefrologia. Nos doentes renais crónicos, a detecção e o tratamento precoces da proteinúria melhoram o prognóstico a curto e a longo prazo. Considerando o aumento da prevalência da DRC na população geral, o Médico de Família tem um papel preponderante na identificação dos indivíduos em risco de doença renal e na vigilância dos factores de risco a ela associados, designadamente da proteinúria.

Primary hyperparathyroidism is a rare occurrence in pregnancy with significant risks to the mother and the foetus, witch is related to the level of serum calcium. A 41-year-old women, gravida 2, para 1, presented at 22 weeks gestation with nausea, vomiting and mild cognitive dysfunction associated with hypercalcemic crisis. The hypercalcemia was observed to be related to parathyroid hyperplasia that was surgically removed. Complete resolution of her symptomatology and hypercalcemia occurred postoperatively. The pregnancy was complicated with transient hypertension. A small for gestational age healthy male infant was delivered at term with no neonatal complications related with this pathology.

Para o Carcinoma Pulmonar não Pequenas Células (CPNPC), localmente limitado a cirurgia com intenção curativa e o tratamento de eleição. Cerca de 35% para o estádio I e 60% para o estádio II recidivam quer localmente, mas especialmente a distancia.E objectivo deste estudo avaliar a influência da invasão vascular (linfática e/ou hematica) detectada na peça cirúrgica, na sobrevida dos nossos doentes.Realizamos uma avaliação retrospectiva que incluiu 58 doentes em estádio I (pT1-2 N0 M0) com estas características: 42 homens, 16 mulheres; idade mediana 63 (35 â 81); Trinta e seis (62%) dos doentes eram fumadores. T1N0M0=6; T2N0M0=52.Nestes doentes foram realizadas 49 lobectomias, 1 bilobectomias e 8 pneumectomias, sempre com esvaziamento ganglionar. Em todos a margem cirúrgica estava livre. Encontramos 29 (50%) adenocarcinomas, 5 (8%) bronquiolo-alveolares, 21 (37%) carcinomas epidermóides e 3 (5%) grandes células. Em 6 havia invasão vascular exclusiva. Em 13 tinham simultaneamente invasão vascular e da pleura visceral. Onze apresentavam exclusivamente invasão da pleura visceral. Os 28 restantes não apresentavam na peça invasão vascular ou pleural.Classicamente fazemos desde há anos quimioterapia adjuvante sempre que relatada invasão vascular e/ou invasão pleural. Destes 30 cumpriram quimioterapia adjuvante-4 ciclos de Carboplatinio+Etoposido (4 doentes); Carboplatinio+Gemcitabina (15 doentes) e Carboplatinio+Vinorelbina (11 doentes).Do total de doentes do estudo só 19 tem um follow-up de 5 anos. Nestes a taxa de sobrevida cifra-se nos 79%. Contudo, 42 possuem já um follow-up de 2 anos. A sobrevida global aos 2 anos cifra-se nos 83%, sendo de 40% para aqueles com invasão vascular versus de 94% para aqueles sem invasão vascular, diferença com significado estatístico.Para estes doentes com CPNPC, estádio I patológico, a presença de invasão vascular parece preditivo duma ocorrência mais precoce de doença recidivante local ou sistémica. : The complete resection of local limited non-small cell lung cancer (NSCLC) represents the therapy of choice. Nevertheless 35% of patients with a stage I and 60% with a stage II, have a local or systemic relapse.It was our aim to evaluate the influence of vessels invasion (blood vessels and lymphatic) on survival rate.We made a retrospective study including 58 patients, with pathologic stage I (pT1-2 N0 M0); 42 men, 16 women; median age=63 (35-81). Smokers=36 (62%). T1N0M0=6, T2N0M0=52.In these patients were performed 49 lobectomies, 1 bilobectomie and 8 pneumectomies, always with systematic lymphadenectomy. We found 29 (50%) adenocarcinomas, 5 (8%) bronquioloalveolar carcinomas, 21 (37%) squamous carcinomas and 3 (5%) large cell carcinomas. 6 of these cases had exclusive vascular invasion, 11 exclusive visceral pleural invasion, 13 visceral and vascular invasion and the last 28 cases had no vascular or visceral invasion. In the 30 patients with vascular or pleural invasion, were performed adjuvant chemotherapy: four patients carboplatin with etoposide; fifteen patients carboplatin with gemcitabine and eleven patients carboplatin with vinorelbine.Only nineteen of the patients have a 5 year follow-up (five-year survival rate=79%). 42 patients have already a 2-year follow-up. The global 2-year survival rate is 83% being 40% for those with vascular invasion, in opposition to 94% for those without vascular invasion (statistically significant).In conclusion, for NSCLC, stage I, the presence of vascular invasion seems to be predictive of a more premature local or systemic metastatic disease. Palavras-chave: Carcinoma pulmonar não-pequenas células, prognóstico, invasão vascular, Key-words: Non-small cell lung carcinoma, prognosis, vascular invasion