Abstract: Income variables from the Brazilian population census (IBGE) are often used as proxies for the population’s socioeconomic level in spatial analyses of urban segregation, inequality and social exclusion. However, income variables are dependent on reference values (minimum wage) that change over time, which can be challenging for multitemporal analysis. This paper discusses this issue and proposes a methodology to adjust income data that allows a meaningful comparison between the datasets of two Census periods. The methodology was applied to five medium-sized cities of the state of São Paulo by adjusting income data from Census 2000 and 2010 according to the period’s inflation rates. The analysis shows that the methodology mitigates the comparability issues. Results better reflect the changes in population composition and in residential patterns of different income groups that took place over the 2000s in Brazil in medium-sized cities.

VATER é uma associação não aleatória de defeitos congénitos associados com patogénese comum. Inclui malformações como anomalias vertebrais, atrésia ou imperfuração anal, fístula traqueo-esofágica com atrésia esofágica e displasia renal ou radial. O acrónimo VATER foi inicialmente utilizado para descrever esta associação, mas outras anomalias, como defeitos cardíacos e anomalias dos membros, foram mais tarde também consideradas alterações cardinais e incluídas, modificando o acrónimo para VACTERL. Embora estejam descritos poucos casos na literatura, a associação do espetro VATER/VACTERL pode ser precocemente detetada na ecografia do primeiro trimestre de gravidez. Os autores apresentam dois casos de associação VATER/VACTERL, em que a suspeita do diagnóstico na ecografia das 12 semanas foi confirmada através de estudo anatomopatológico. O diagnóstico pré-natal de associação VACTERL é desafiante e dificilmente estabelecido no primeiro trimestre de gravidez, requerendo competências específicas e experiência para interpretar o exame ecográfico. O diagnóstico precoce é importante para o aconselhamento do casal. A abordagem da condição pode passar por interrupção médica da gravidez ou realização do parto num hospital com cuidados diferenciados para o recém-nascido.

VATER is a nonrandom association of congenital defects with common developmental pathogenesis including/which includes malformations like vertebral defects, anal atresia or imperforate anus, tracheoesophageal fistula with esophageal atresia, and radial or renal dysplasia. VATER acronym was initially used to describe this association, but other malformations, like cardiac defects and limb anomalies, were later also considered cardinal features and included, changing the acronym to VACTERL. Although few cases have been reported, VATER/VACTERL spectrum association can be detected in first-trimester ultrasound. Herein, the authors describe two cases of VATER/VACTERL association suspected during the 12-week ultrasound and confirmed in anatomopathological study. Prenatal VACTERL association diagnosis is challenging and rarely detected in the first pregnancy trimester. It requires skill and experience to interpret ultrasound findings and some features are difficult to recognize before birth. Early diagnosis is important for parental counselling and delivery planning. Management options include medical pregnancy termination and delivery in a tertiary center to improve outcomes.

Abstract Objective To describe a case of radiation-induced uterine carcinosarcoma 6 years after a cervical squamous cell carcinoma treatment, which imposed some diagnostic and management challenges. Case Report A 57-year-old woman with a history of pelvic chemoradiotherapy ~ 6.5 years before the event described in this study, following an International Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical cancer, presented with a cervical mass, involving the uterine cavity, the cervical canal and the upper two thirds of the vagina. The biopsy showed a poorly differentiated carcinoma, and a positron emission tomography (PET) scan excluded distant metastasis, although it was unable to define the origin of the tumor as either a new primary malignancy of the endometrium/cervix or as a cervical recurrence. Surgical staging procedure was performed, and the diagnosis was endometrial carcinosarcoma, FIGO stage IIB. The patient was not able to complete the adjuvant therapy, and the progression of the disease was remarkable. Conclusion The present case highlights one of the less common but more serious consequences of radiotherapy for cervical cancer, which has an increasing incidence in younger women, raising concerns about the long-termconsequences of its management.

Na abordagem dos indivíduos com hiperidrose palmar (HP) primária em que o tratamento conservador não é satisfatório, a simpaticectomia torácica toracoscópica (STT) constitui uma alternativa terapêutica eficaz e segura. Métodos e material: Estudo retrospetivo com objetivo de avaliar a qualidade de vida em doentes submetidos a STT por HP, no período entre 1 Janeiro de 2009 e 31 de Dezembro de 2014. Foram consultados os processos clínicos de todos os doentes operados, tendo ainda sido realizada uma entrevista clinica com aplicação do questionário de qualidade de vida SF-36. Foi efetuada posteriormente a análise estatística dos dados recolhidos utilizando o software SPSS Statistics (versão 20). Resultados: No período em análise, foram operados 21 doentes, dos quais 14 responderam ao questionário. Verificou-se que a STT foi um procedimento eficaz em 100% dos doentes, tendo-se apurado um resultado de qualidade de vida razoável pelo questionário SF-36. A maioria dos doentes tem a perceção de melhoria da qualidade de vida após a STT. Neste estudo, 85,7% dos doentes desenvolveu hiperidrose compensatória (HC). Discussão: Neste estudo confirmámos o benefício associado à STT, em consonância com outros estudos publicados. No entanto, é de referir algumas limitações do trab alho como a subjetividade dos sintomas, o reduzido tamanho amostral, o viés de memória inerente e a complexidade do questionário SF-36. A possibilidade de HC deve ser abordada no processo de decisão do doente para este procedimento, dada a sua incidência elevada. Conclusão: A STT é um procedimento seguro e eficaz e está associado a uma melhoria da qualidade da vida dos indivíduos com HP.

When approaching patients with primary palmar hyperhidrosis (PH), refractory to conservative treatment, endoscopic thoracic sympathectomy (ETS) is a safe and effective alternative. Methods and materials: Retrospective study in order to assess the quality of life of patients with PH undergoing ETS, from 1 of January 2009 to 31 of December 2014. The data was collected from the medical registries of each patient and from a clinical interview with the application of the quality of life SF-36 questionnaire. The statistical analysis was preformed using SPSS version “xpto”. Results: In this period, 21 patients were operated, 14 of which answered the questionnaire. It was found that ETS is an effective procedure in 100% of patients, who have a reasonable quality of life as assessed by the SF-36 questionnaire. Most patients have a perception of improved quality of life after ETS. In this study, 85.7% of patients developed compensatory hyperhidrosis (CH). Discussion: In this study we confirmed the benefit associated to ETS, in line with previous studies. However, this study as some limitations such as the subjectivity of the symptoms, the small sample size, the recall bias and the complexity of the SF-36 questionnaire. When referring a patient to ETS, the possibility of CH should be addressed in patient's decision-making process given its high incidence. Conclusion: The ETS is a safe and effective procedure and is associated with an improved quality of life of individuals with PH.

Resumo Os teratomas maduros císticos do ovário, ou tumores dermoides, são as neoplasias benignas mais frequentes em mulheres jovens. A sua transformação maligna é rara, e ocorre emmenos de 2% dos casos. A composição histológica heterogénea destes tumores pode ser responsável pela ocasional elevação de marcadores tumorais, como o Ca19-9 e o Ca125. Descrevemos umcaso de teratoma maduro cístico do ovário numa paciente de 50 anos com o segundo valor mais elevado de Ca19-9 (8922,76 UI/mL) descrito na literatura. Concluímos que níveis anormalmente elevados de Ca19-9 não estão necessariamente associados a tumores malignos, e podem conduzir a intervenções médicas desnecessárias e contribuir para o aumento da ansiedade da paciente. Portanto, as características clínicas, os estudos imagiológicos e os marcadores tumorais devem ser interpretados cuidadosamente, e não devem limitar o tipo de conduta cirúrgica.

Abstract Mature cystic teratomas, or dermoid tumors, are the most common benign ovarian neoplasms in young women. Malignant transformation is rare, and occurs in less than 2% of the cases. The heterogeneous histological composition of these tumors may be responsible for the occasional elevation of various tumor markers, such as Ca19-9 and Ca125. We describe one case of mature cystic teratoma in a 50-year old woman with the second highest level of Ca19-9 (8922.76 UI/mL) described in the literature. We concluded that abnormal levels of Ca19-9 are not necessarily associated with ovarian malignancy, and may lead to unnecessary medical intervention and patient anxiety. Therefore, the clinical features, imaging studies and antigen testing should be interpreted carefully, and should not limit the surgical approach.

Objetivo Avaliar a precisão da determinação ultrassonográfica da estimativa de peso fetal recorrendo apenas a parâmetros lineares (comprimento do fémur - FL - e espessura de tecido mole a meio da coxa fetal - STT), no período precedente ao parto. Métodos Realizamos umestudo prospectivo que incluiu gestações simples de termo, comfeto cefálico, nas quais o parto ocorreu nas 48h seguintes à avaliação ecográfica. A inclusão no estudo foi feita nomomento de admissão ao bloco de partos para cesariana eletiva, indução do trabalho de parto ou trabalho de parto espontâneo. Foram excluídas todas as grávidas não caucasianas, com diagnóstico de diabetes gestacional ou evidência de rotura de membranas. A estimativa de peso fetal foi calculada através de uma fórmula previamente publicada [estimativa de peso fetal = [1]1687,47 + (54,1 x FL) + (76,68 x STT). A relação entre o peso real e o peso estimado foi analisada através da correlação de Pearson. O desempenho desta fórmula foi avaliado através do cálculo da percentagem de erro absoluto e não absoluto. Os recém-nascidos foram divididos em3 grupos consoante o peso real: < 3000 g; 3000 g - 4000 g; e > 4000 g; para cada grupo foi calculada diferençamédia entre a estimativa de peso e o peso real e a percentagem de erro associada. Resultados Incluímos 145 casos no estudo, cuja estimativa de peso e peso real se correlacionaram significativamente, apesar do valor de correlação ser pouco elevado (p < 0,001; R2 = 0,197). Globalmente, a percentagem de erro absoluto foi 10,6%. A percentagem de erro mais baixa correspondeu ao grupo com peso real entre 3000 g e 4000 g. Conclusões Comeste estudo demonstramos uma correlação fraca entre o peso real e a estimativa de peso fetal ultrassonográfica, quando calculada combase numa fórmula que usa o comprimento do fémur e a espessura de tecido mole a meio da coxa fetal, ambos parâmetros lineares. Ainda que a exclusão de parâmetros circunferenciais no cálculo da estimativa de peso fetal se venha a provar benéfica, esta não parece ser uma fórmula simultaneamente simples e precisa no cálculo da estimativa de peso fetal.

Objective To evaluate the accuracy of fetal weight prediction by ultrasonography labor employing a formula including the linear measurements of femur length (FL) and mid-thigh soft-tissue thickness (STT). Methods We conducted a prospective study involving singleton uncomplicated term pregnancies within 48 hours of delivery. Only pregnancies with a cephalic fetus admitted in the labor ward for elective cesarean section, induction of labor or spontaneous labor were included. We excluded all non-Caucasian women, the ones previously diagnosed with gestational diabetes and the ones with evidence of ruptured membranes. Fetal weight estimates were calculated using a previously proposed formula [estimated fetal weight = [1] 1687.47 + (54.1 x FL) + (76.68 x STT). The relationship between actual birth weight and estimated fetal weight was analyzed using Pearson's correlation. The formula's performance was assessed by calculating the signed and absolute errors. Mean weight difference and signed percentage error were calculated for birth weight divided into three subgroups: < 3000 g; 3000-4000g; and > 4000 g. Results We included for analysis 145 cases and found a significant, yet low, linear relationship between birth weight and estimated fetal weight (p < 0.001; R2 = 0.197) with an absolute mean error of 10.6%. The lowest mean percentage error (0.3%) corresponded to the subgroup with birth weight between 3000 g and 4000 g. Conclusions This study demonstrates a poor correlation between actual birth weight and the estimated fetal weight using a formula based on femur length and mid-thigh soft-tissue thickness, both linear parameters. Although avoidance of circumferential ultrasound measurements might prove to be beneficial, it is still yet to be found a fetal estimation formula that can be both accurate and simple to perform.

Vaginal radical trachelectomy has been established as a valuable fertility-preserving treatment in women with early stage cervical cancer. Pregnancies after this procedure may pose several clinical challenges. The aim of this study was to report pregnancy outcomes after vaginal radical trachelectomy. We surveilled four pregnancies in three different patients. No first trimester miscarriages were observed. One of the patients suffered a second trimester pregnancy loss as a consequence of a preterm premature rupture of membranes. A total of three pregnancies reached the third trimester, and one delivered prematurely, at 29 weeks of gestation. A caesarean section was performed in all cases that reached viability. Good maternal and neonatal outcomes are possible in pregnancies after radical trachelectomy. Obstetrical surveillance must be undertaken in a maternal-fetal unit included in a tertiary hospital, in order to achieve the best results.

There is a growing concern on the relationship between anthropogenic carbon dioxide and climate changes. A promising approach is the adsorption technology using mesoporous MCM-41 materials that can be easily synthesized to depict structures adequate to the flow of gas. The aim of this study was to improve the synthesis of MCM-41 using cationic surfactant mixtures and apply the resulting materials to CO2 adsorption. To that end, the simplex-centroid design was applied to optimize CO2 adsorption from seven mesoporous MCM-41 materials synthesized by the hydrothermal method using surfactants from hydrophobic chains of different sizes. The cationic surfactants used were tetradecyltrimetylammonium bromide, cetyltrimethylammonium bromide, trimethyloctadecylammonium bromide and their mixture at ratios of 1:1 and 1:1:1. The CO2 adsorption was investigated using thegravimetric method at 298 K and pressures up to 40 bar. The resulting materials, labelled C17, C19, C21, C17C19, C19C21, C17C21 and C17C19C21, were characterized by XRD, FTIR, TG and SEM and showed significant differences in structure as well as in the mass of CO2 adsorption. The response models showed that the best combination of the surfactants resulted from C17C19 sample, which presented synergistic interactions reaching the highest value of CO2 adsorption (0.62 g CO2/g adsorbent), compared to other samples.

This work aimed to study the kinetics of thermal and catalytic pyrolysis using Ti-MCM-41 as catalyst in order to assess the catalytic pyrolysis efficiency compared to thermal pyrolysis of elephant grass. Ti-MCM-41 molecular sieve was synthesized by hydrothermal method from hydrogel with the following molar composition:1.00 CTMABr: 4.00 SiO2:X TiO2: 1 + X Na2O: 200.00 H2O, whichstructure template used was cetyltrimethylammonium bromide (CTMABr). The materials synthesized were characterized by X-ray diffraction, IR spectroscopy, thermogravimetric analysis and specific area by the BET method, for subsequent application in the biomass pyrolysis process. The kinetic models proposed by Vyazovkin and Flynn-Wall were used to determine the apparent activation energy involved in the thermal and catalytic pyrolysis of elephant grass and the results showed that the catalyst used was effective in reducing the apparent activation energy involved in the thermal decomposition of elephant grass.

Objectivos: Caracterizar o consumo de álcool nos adolescentes, verificar a sua relação com sexo e idade e determinar os motivos de consumo. Tipo de estudo: Observacional, transversal e analítico. Local: Escolas do 3.º ciclo/secundárias do distrito de Bragança. População em estudo: Jovens dos 13 aos 19 anos a frequentar as referidas escolas. Métodos: Adolescentes seleccionados por amostragem aleatória (etapas múltiplas). Dimensão calculada da amostra: 955 indivíduos (para prevalência esperada: 45%; nível de precisão: 3,0%; IC: 95%). Variáveis: sexo; idade; consumo de álcool e motivos de consumo. Dados recolhidos por questionário validado (AAIS; Pontuação: 0-79), tratados pelo teste do qui-quadrado (α = 0,05) utilizando software Excel® e SPSS®. Resultados: Obtiveram-se 1061 inquéritos validados, 51,6% do sexo feminino; 18,5% com 13-14 anos, 59,9% com 15-17 anos e 21,7% com 18-19 anos. Quanto ao consumo, 89,8% já experimentaram álcool, dos quais 96,4% no último ano e 69,5% dos jovens apresentam pelo menos consumo mensal. Destes, 226 bebem todos os fins-de-semana e 21 diariamente; 27,7% praticam «binge drinking». Verificou-se que 68,3% dos jovens apresentam consumo de risco. Relacionando o sexo com o consumo de álcool, verificou-se que o sexo masculino apresenta maior consumo (p=0,032). Na amostra obtida, o grupo etário dos 18-19 anos é aquele que apresenta um consumo mais elevado. Relativamente aos motivos de consumo, destacam-se o acompanhar os amigos (coping) e o paladar, independentemente do sexo e grupo etário. Conclusões: O consumo de álcool encontrado nesta faixa etária é elevado e superior à literatura, existindo um predomínio do sexo masculino. O meio social assume-se como um factor determinante, nomeadamente o consumo para acompanhar os amigos e assim corresponder às expectativas do grupo. Dados os resultados obtidos, torna-se fundamental o desenvolvimento de estratégias de intervenção a este nível.

Aim: To characterize consumption of alcohol by adolescents, to study the association of alcohol consumption with gender and age and to determine the main reasons for consumption of alcohol by adolescents. Type of study: Cross-sectional. Location: High schools of the district of Bragança, Portugal. Population: Teenagers aged 13 to 19 years old. Methods: In the sample, 51.6% of the subjects were females, 18.5% were 13-14 years old, 59.9% were 15-17 years old and 21.7% were 18-19 years old. The required sample size was 955 based on expected proportion of alcohol consumption of 45% with a 3% level of precision. Variables studied included gender, age, alcohol consumption and reasons for consumption. Data were collected using a validated questionnaire (AAIS) with scores ranging from 0-79. Associations between variables were tested using the with chi-square statistic with significance set at the 0.05 level. Results: The authors obtained 1061 questionnaires.In the sample, 96.4% had consumed alcohol in the previous year; 69.5% of the subjects consumed alcohol at least monthly. 226 subjects drank every weekend and 21 drank daily; 27.7% practiced binge drinking. A risky pattern of alcohol consumption occurred in 68.3% of the adolescents. Consumption was higher among boys (p=0,032) and increased with age. “Coping with peer pressure” and “taste” were given as the main reasons for drinking, independent of gender or age. Conclusions: The proportion of adolescents consuming alcohol in this study was high compared to other published figures. This was higher among males and older studernts. The social environment is a strong determinant of drinking. In light of these results, an intervention strategy appears necessary in this population.

O gênero Billbergia Thunb. é atualmente constituído por 64 espécies distribuídos em dois centros de diversidade: a Mata Atlântica e a Floresta Amazônica. No Estado do Rio de Janeiro, o gênero é representado por 14 espécies ocorrentes em ecossistemas florestais e nas restingas: B. amoena (Lodd.) Lindl., B. brasiliensis L.B. Sm., B. distachia (Vell.) Mez, B. euphemiae E. Morren, B. horrida Regel, B. iridifolia (Nees & Mart.) Lindl., B. lymanii E. Pereira & Leme, B. macracantha E. Pereira, B. pyramidalis (Sims) Lindl., B. sanderiana E.Morren, B. tweediana Baker, B. vittata Brongn. ex C.Morel e B. zebrina (Herb.) Lindl. O trabalho consta de descrições, ilustrações e comentários taxonômicos e fitogeográficos das espécies.

The genus Billbergia Thunb. comprises 64 species occurring in two centers of diversity: Atlantic Forest and Amazon Forest. In Rio de Janeiro State, the genus is represented by 14 species found in Atlantic forest and restinga: B. amoena (Lodd.) Lindl., B. brasiliensis L.B. Sm., B. distachia (Vell.) Mez, B. euphemiae E. Morren, B. horrida Regel, B. iridifolia (Nees & Mart.) Lindl., B. lymanii E. Pereira & Leme, B. macracantha E. Pereira, B. pyramidalis (Sims) Lindl., B. sanderiana E. Morren, B. tweediana Baker, B. vittata Brongn. ex C.Morel and B. zebrina (Herb.) Lindl. Here we present descriptions, figures and notes on taxonomy and geographic distribution of the species.