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Dissertação de Mestrado em Relações Internacionais - Estudos da Paz, Segurança e Desenvolvimento apresentada à Faculdade de Economia Em 1949, a Doutrina Truman definiu um novo paradigma na conjuntura económica internacional ao propor desenvolver economicamente os países “menos desenvolvidos”. Todos os países deveriam cooperar no seio das instituições internacionais numa rede comercial mais justa, e os países ricos deveriam disponibilizar o seu conhecimento técnico-científico para que os países pobres conseguissem impulsionar o crescimento e a produção da sua economia e atingir os mesmos níveis de bem-estar dos países ricos. A “invenção” do desenvolvimento ocidental tornou hegemónico um modelo baseado nos princípios da modernidade europeia, no conhecimento científico racional, economicista e individualista. O desenvolvimento enquanto projeto de modernização perpetua um pensamento colonial, cria linhas abissais e desacredita outros conhecimentos julgados como não-modernos, incluindo os conhecimentos populares, camponeses ou indígenas e invisibiliza outras realidades que se encontram no Sul Global. Para ultrapassar a matriz colonial é necessário descolonizar pensamentos e práticas, possível se a pedagogia for tida como um processo político de aprendizagem, des-aprendizagem e reaprendizagem onde seja possível refletir coletivamente sobre a condição colonial e agir no sentido de derrubar as opressões que origina e perpetua. Ao longo desta dissertação proponho-me a debater o paradigma do desenvolvimento e, através de uma crítica pós-desenvolvimentista, a propor a pedagogia como ferramenta metodológica útil na criação de sociedades críticas e plurais. O paradigma económico e pedagógico irá convergir no movimento do Comércio Justo, que serve de estudo de caso, por procurar criar sociedades mais justas e equitativas através do pagamento de preços justos aos pequenos produtores, eliminação dos intermediários e acessibilidade na entrada do comércio internacional, e pelo trabalho de sensibilização junto da sociedade civil pelos direitos dos trabalhadores e do ambiente. Pretende-se então responder à pergunta: como é que o Comércio Justo pode ser uma prática pedagógica, integrada nas agendas de Educação para o Desenvolvimento, que promove formas de desenvolvimento mais justas a nível social, económico e ambiental, contribuindo para uma maior equidade social? O objetivo é analisar as potencialidades deste movimento e das suas ferramentas na criação de sociedades mais justas e equitativas através do fomento de uma Educação para o Desenvolvimento e Cidadania Global que seja também crítica e procure alternativas. In 1949, the Truman Doctrine defined a new paradigm in the international economic climate by proposing to economically develop the "least developed" countries. All countries should cooperate within international institutions in a fairer trade network, and rich countries should make their scientific and technical knowledge available so that poor countries could boost the growth and production of their economy and achieve the same levels of well-being as rich countries. The "invention" of Western development has made hegemonic a model based on the principles of European modernity, rational, economic and individualistic scientific knowledge. Development as a modernisation project perpetuates colonial thinking, creates abyssal lines and discredits other knowledge judged as non-modern, including popular, peasant or indigenous knowledge, and makes other realities in the Global South invisible. To overcome the colonial matrix it is necessary to decolonise thoughts and practices, which is possible if pedagogy is seen as a political process of learning, unlearning and re-learning where it is possible to reflect collectively on the colonial condition and act to overthrow the oppressions it originates and perpetuates. Throughout this dissertation I propose to debate the development paradigm and, through a post-developmentalist critique, to propose pedagogy as a useful methodological tool in the creation of critical and plural societies. The economic and pedagogical paradigm will converge in the Fair Trade movement, which serves as a case study, by seeking to create more just and equitable societies through the payment of fair prices to small producers, the elimination of intermediaries and accessibility at the entrance to international trade, and by working to raise awareness in civil society of workers' rights and the environment. The aim is then to answer the question: how can Fair Trade be a pedagogical practice, integrated into Development Education agendas, that promotes more socially, economically and environmentally just forms of development, contributing to greater social equity? The aim is to analyse the potential of this movement and its tools for creating more just and equitable societies by promoting a Development Education and Global Citizenship that is also critical and seeks alternatives.

Recognition of facial lentigo maligna (LM) is often difficult, particularly at early stages. Algorithms and multivariate diagnostic models have recently been elaborated on the attempt to improve the diagnostic accuracy. We conducted a cross-sectional and retrospective study to evaluate dermatoscopic criteria aiding in diagnosis of flat pigmented facial lesions (FPFL). We examined 46 FPFL in 42 Caucasian patients and found that 4 of 20 dermatoscopic criteria reached the significance level required for features indicating malignancy namely, hyperpigmented follicular openings, obliterated follicular opening, annular-granular structures, and pigment rhomboids. Concomitant presence of at least 2 or 3 of the 4 mentioned criteria was significantly more frequent in LM than in pigmented actinic keratosis (PAK). However, despite more frequently seen in LM, these features were also displayed in some of the PAK and other FPFL, so we found them not specific for LM. Although dermatoscopy enhances the diagnostic accuracy in evaluating FPFL, histopathology remains the gold standard for correct diagnosis, making evident the need for improvements in early noninvasive diagnosis of LM.

Necrobiotic xanthogranuloma (NXG) is a rare form of inflammatory granulomatous disease of the skin characterized by the presence of pruritic to painful lesions, generally located in the periorbital area, although trunk and proximal extremities may also be involved. We report a case of a 69-year-old male patient with extensive involvement of the trunk, upper and lower extremities, and an associated gamma monoclonal gammopathy. The skin biopsy was consistent with the diagnosis of NXG. Necrobiosis lipoidica and granuloma annulare were the major differential diagnosis in this case. We highlight the importance of searching for clinical and histological features that may differentiate these entities, which is crucial to select an adequate therapeutic and surveillance strategy.

Introduction: Lentigo maligna (LM) is a rare form of in situ melanoma, frequently seen as a large patch in elderly patients. The aim of this study was to assess clinical and dermoscopic features of LM. Material and Methods: A retrospective study of LM patients presenting to our center between July 2007 and July 2017 was performed. Demographic data, anatomical location, laterality, diameter, Clark level, Breslow stage, “ABCD” signs and dermoscopic features were registered. Facial versus extrafacial LM were compared. Results: We found 21 LM, of which 12 had an extrafacial location and 9 a facial location. Half of the extrafacial lesions were located on an upper limb. The median age at diagnosis was 63 years (ranging from 38 to 84 years). Most LM cases were female (16/21) with phototype II (13/21). More than half of the patients (11/21) had a history of a skin neoplasm or actinic keratosis. The median diameter found was 6 mm (interquartile range = 4.5 mm), ranging from 1 to 15 mm. Five lesions were invasive (median Breslow depth of 0.2 mm), and 4 of them were extrafacial. Discussion: In this study LM was more frequently found in an extrafacial location and as a small patch with a 6-mm diameter medium. The epidemiology of LM/LM melanoma might be changing. Full body examination and dermoscopy are of the utmost importance for the diagnosis. Dermatologists should be aware and search for small lesions outside the face and neck, particularly in middle-aged female patients with photo-damaged skin.

Repairing surgical defects of the nasal tip is challenging, mainly because of the lack of freely mobile skin available peripherally. The Peng flap is a one-stage cutaneous flap that circumvents this difficulty by recruiting skin from the nasal dorsum and sidewall regions. The design produces a tridimensional shape perfectly adapted to the configuration of the nasal tip and allows for an inconspicuous closure of the defect. We present three examples of full-thickness skin defects involving the nasal tip, reconstructed using a modified version of the Peng flap, and present the experience at our department with this surgical technique.

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016 Submitted by Biblioteca da Faculdade de Medicina da Universidade de Lisboa (repositorio@medicina.ulisboa.pt) on 2017-01-17T16:15:16Z No. of bitstreams: 1 AnaBSeixas.pdf: 712260 bytes, checksum: 32ccc4837abe2236ac9119beb11c7168 (MD5) Made available in DSpace on 2017-01-17T17:04:22Z (GMT). No. of bitstreams: 1 AnaBSeixas.pdf: 712260 bytes, checksum: 32ccc4837abe2236ac9119beb11c7168 (MD5) Previous issue date: 2016

Repairing surgical defects of the nasal tip is challenging, mainly because of the lack of freely mobile skin available peripherally. The Peng flap is a one-stage cutaneous flap that circumvents this difficulty by recruiting skin from the nasal dorsum and sidewall regions. The design produces a tridimensional shape perfectly adapted to the conFiguretion of the nasal tip and allows for an inconspicuous closure of the defect. Herein, we describe a modified version of a Peng flap in a single-stage procedure, performed in three patients subjected to excison of basal cell carcinomas

A 56-year-old white woman developed a distinctive skin eruption over her mammary, lumbosacral, and pubic areas 2 weeks after the start of esomeprazole therapy for dyspeptic symptoms. Skin biopsy disclosed a spongiotic dermatitis with predominantly lymphocytic dermal infiltrate. Treatment with a tapering dose of corticosteroid and withdrawal of the suspected drug led to a rapid resolution of the eruption without residual dyschromia. Patch testing with esomeprazole 2% in petrolatum was negative at 48 and 72 hours but became positive on day 6. Oral-controlled provocation test induced the reappearance of the lesions over the mammary areas, confirming the putative involvement of this drug. Therefore, the patient was diagnosed as having a nonpigmented fixed drug eruption associated with esomeprazole. This compound is a proton-pump inhibitor developed as the S-isomer of omeprazole to improve its pharmacokinetic properties. Reports of cutaneous reactions to proton-pump inhibitors are quite common, but reports of such reactions to esomeprazole are rare, which demonstrates the need for higher clinical awareness and knowledge of reactions to these drugs.

Retronychia represents proximal ingrowth of the nail that occurs when the nail embeds backwards into the proximal nail fold. It is suspected when there is a persistent paronychia, particularly in the setting of trauma. Important clinical criteria for diagnosis are inflammation of the proximal nail fold, granulation tissue emerging from under the nail fold, thickening of the proximal portion of the nail plate and interruption of nail growth. The condition is rarely diagnosed and often misinterpreted, and is therefore unnecessarily treated with systemic antibiotics and antifungals. Avulsion of the nail confirms the diagnosis and it is the curative treatment. Conservative treatment with an adhesive technique is a valid option in early cases. We report 20 cases of retronychia diagnosed in our department between 2010 and 2013.

Mestrado em Microbiologia O ambiente hospitalar é caracterizado por uma grande diversidade de diferentes espécies bacterianas, as quais podem tornar-se resistentes a antibacterianos. Apesar da natureza específica de efluentes hospitalares, estes são considerados com a mesma carga poluente e como constituintes das águas residuais urbanas, sendo descarregados para redes de esgotos urbana, recolhidos e cotratados com os efluentes municipais na ETAR. O objetivo do estudo consistiu em avaliar a estrutura das comunidades microbianas e determinar a ocorrência e abundância de genes relacionados com resistência a antibióticos (blaCTX-M, blaVIM, blaTEM, blaSHV e intl1) de efluentes hospitalares (internamento e laboratório de microbiologia) e efluentes urbanos (pré e pós-tratamento na ETAR de Cacia). Procedeu-se com a análise por DGGE e por PCR quantitativa. As amostras foram colhidas em duas estações diferentes, revelando as diferenças na estrutura da comunidade bacteriana. As comunidades dos efluentes das hospitalizações e dos efluentes de pré e pós-tratamento ficaram agrupadas no mesmo cluster, enquanto as comunidades predominantes nos efluentes do laboratório de microbiologia localizaram-se num outro cluster. Os cinco genes selecionados estavam presentes em todos os efluentes. Os efluentes hospitalares tiveram a maior abundância total dos genes do que os efluentes urbanos. De todos os genes, blaVIM teve uma abundância notável devido a sua alta abundância de águas residuais nas hospitalizações e enfermarias, seguido por Intl1. blaCTX-M, blaTEM e blaSHV demonstraram abundancias mais baixas. No que diz respeito ao tratamento biológico aplicado na ETAR de Cacia, uma vez que a abundância de genes foi menor após o tratamento, é previsível que o tratamento possa ser moderadamente eficaz. Os nossos resultados mostram que os ambientes hospitalares tendem a ser um ambiente complexos devido à elevada diversidade microbiana, às pressões seletivas criadas pelo uso de antimicrobianos e pelos eventos de transferência lateral de genes. A rede de esgotos urbanos e da ETAR de Cacia representam reservatórios de resíduos de antibióticos, determinantes de resistência a antibióticos e bactérias resistentes a antibióticos. Hospital environment is characterized by multiplicity of different bacterial species, which some of them can become resistant to antibacterial. Despite the specific nature of hospital effluents, they are considered to be the same pollutant and constituent load as urban wastewaters, being discharged to public sewage networks, collected and co-treated with the urban effluents in the WWTPs. The aim of the study was to evaluate structure of microbial communities and to determinate the occurrence and abundance of genes associated with antibiotic resistance (blaCTX-M, blaVIM, blaTEM, blaSHV and intl1) of Hospital wastewaters (hospital wards and microbiology laboratory) and urban effluents (pre- and post-treatment of WWTP of Cacia). DGGE and qPCR were performed. The samples were collected in two different seasons, revealing differences in bacterial structure community. Hospitalizations and pre-and post-treatment communities were grouped in the some cluster, while microbiology laboratory communities were located in other cluster. The five genes selected were present in all effluents. The hospital wastewaters had the highest total abundance of the genes than the urban effluents. Of all genes blaVIM had a notable abundance due its high abundance in hospitalizations wastewater, followed by intl1. blaCTX-M, blaTEM, blaSHV had the lowest abundances. Regarding with the biological treatment applied in the WWTP of Cacia, once the abundance of the genes was lower after the treatment, it is predictable that the treatment can be moderately effective. Our results show that hospital settings tend to be an environment complex due the high microbial diversity of commensal and nosocomial pathogenic, the selective pressures created by antimicrobial use and the events of lateral gene transfer. The urban sewage network and the WWTP of Cacia represent a receptor of antimicrobial residues and antibiotic-resistance bacteria.

Mestrado em Microbiologia Submitted by Nuno Cruz (nuno@ua.pt) on 2016-03-30T12:02:31Z No. of bitstreams: 1 Dissertação.pdf: 2142955 bytes, checksum: 49198ac3c5d106f92e1237f286a06086 (MD5) Made available in DSpace on 2016-03-30T12:02:32Z (GMT). No. of bitstreams: 1 Dissertação.pdf: 2142955 bytes, checksum: 49198ac3c5d106f92e1237f286a06086 (MD5) Previous issue date: 2015

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.

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.

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.

Cork particles were oxypropylated under pressure at a relatively high temperature and yielded a mixture of liquid polyols composed of propylene oxide homopolymer (PPO) and cork macromolecules bearing oligo(propylene oxide) grafts.