V. H. Rodrigues

Epidemiology of autism spectrum disorder in Portugal: prevalence, clinical characterization, and medical conditions

The objective of this study was to estimate the prevalence of autistic spectrum disorder (ASD) and identify its clinical characterization, and medical conditions in a paediatric population in Portugal. A school survey was conducted in elementary schools, targeting 332 808 school‐aged children in the mainland and 10 910 in the Azores islands. Referred children were directly assessed using the Diagnostic and Statistical Manual of Mental Disorders (4th edn), the Autism Diagnostic Interview–Revised, and the Childhood Autism Rating Scale. Clinical history and a laboratory investigation was performed. In parallel, a systematic multi‐source search of children known to have autism was carried out in a restricted region. The global prevalence of ASD per 10 000 was 9.2 in mainland, and 15.6 in the Azores, with intriguing regional differences. A diversity of associated medical conditions was documented in 20%, with an unexpectedly high rate of mitochondrial respiratory chain disorders.

Effect of population-based screening on breast cancer mortality

Although the wider scientifi c community has long embraced the benefi ts of population-based breast screening, there seems to be an active anti-screening campaign orchestrated in part by members of the Nordic Cochrane Centre. These contrary views are based on erroneous interpretation of data from cancer registries and peerreviewed articles. Their specifi c aim seems to be to support a pre-existing opposition to all forms of screening. These individuals, making claims of poor methods, selectively discount overwhelming scientifi c evidence from numerous randomised trials in diff erent countries that organised screening reduces breast cancer mortality. They claim that the signifi cant decrease in breast cancer mortality achieved by screening is due to improvements in treatment alone, discounting the benefi ts of early detection. If true, this would imply that breast cancer is an exception among adenocarcinomas in that early detection does not improve prog nosis—a claim contrary to the evidence. For women with breast cancer, early detection also results in improved quality of life from less extensive surgical treatment. Women with screen-detected breast cancer in the UK have half the mastectomy rate of women with symptomatic cancers— ie, 27% versus 53%. Organised, high-quality breast screening is an important public health initiative by numerous governments worldwide. These policies are based on robust and extensive analysis of individualised patient data from scientifi c trials, with particular attention paid to the balance of potential benefi ts and harms. To imply that such an international action is mass misrepresentation, or that screening is done for the benefi t of self-interested professionals, is as perverse as it is unjustifi ed. Comprehensive guidelines deal with the entire screening process. Organisations responsible for screening programmes regularly review published evidence on the eff ects of mammographic screening, and also contradictory interpretations. We consider the interpretation by Jorgensen, Keen, and Gotzsche, of the balance of benefi ts and harms to be scientifi cally unsound. Women would be better served by focusing eff orts on how best, and not whether, to provide breast screening. The signatories below, charged with provision and implementation of breast screening in many diff erent countries, remain convinced that the scientifi c foundation for populationbased, quality-assured, organised breast screening is one of the major accomplishments of the translation of clinical cancer research into public health practice. Early detection, in combination with appropriate treatment, signifi cantly lowers breast cancer mortality and improves the life quality of patients with the disease.

Ascertainment and evaluation of interval cancers in population-based mammography screening programmes: a collaborative study in four European centres

Objectives: The purpose of the present study was to estimate the interval cancer (IC) rates in four population-based mammography screening programmes in four countries with different health-care environments, different access to cancer registry data, and different age groupsof women invited. Setting: The screening programmes in Coimbra (Portugal), Dublin (Ireland), Stockholm (Sweden), and Turin (Italy) participated in the study. Methods: All cancer cases were searched for in cancer registries. IC rates and other outcome measures from the screeningprogrammes were estimated and compared between the centres. Poisson regression model was used to estimate the proportional incidence based on IC rate in relation to expected total breast cancer incidence rate in the absence of screening. Results: There was a more than tenfold difference inthe number of invited women at the first round between the involved centres. The IC rates varied between 4.3 and 23.8 per 10,000 women screened. The levels of IC rates in relation to the estimated background incidence varied from 0.35 up to 0.46 depending on age groups involved in the programme,but did not differ significantly between three of the four involved centres. Conclusions: IC rates were quite similar between three of the four centres despite the differences in target population, invited ages, length of building-up of the programmes and different health-care organizations.Different access to complete cancer registry data is likely to explain the lower IC rates in the fourth centre.

A socio-demographic study of aging in the Portuguese Population - The EPEPP study

The increase in life expectancy (LE) observed in Western societies, has resulted in a steep rise of older population. This stresses the importance of the research on aging, to better adequate health and social care organization and improve the quality of life (QoL). The aim of the EPEPP-1 (abbreviated from the Portuguese name: Estudo do Perfil de Envelhecimento da População Portuguesa) study was to characterize the socio-demographic components of the elderly Portuguese population in order to disclose factors that could play a role in the aging process and in the elderly QoL. This observational descriptive study, was performed in 2672 individuals older than 54 years taking into account gender and the residence area (rural vs. urban). A questionnaire about social network (marital status, living alone, the hours spent alone, confidents), and social status (education, occupation) was applied. Social network score revealed significant age and gender trends, women and older people performing worst, but with no difference according to residence area. Almost a third was unmarried and spent eight or more hours per day alone, and a fifth lived alone. Social status revealed that being older female and resident in a rural area quoted worst in the prevalence of illiteracy and undifferentiated occupation. The authors concluded that social isolation, illiteracy and undifferentiated occupation are prevalent in Portuguese older population. Identification of further determinants of isolation, adjustment of procedures to be included in social networks and development of actions directed to education are important fields of intervention influencing the elderly QoL.

Mass redistribution in variable mass systems

We have developed an alternative formulation based on F = Ma rather than F = d P/d t for studying variable mass systems. It is shown that F = Ma can be particularly useful for analysing systems with variable mass, as illustrated by various examples involving chains and ropes. The method implies the division of the whole system into two parts, which are considered separately, allowing us to explore certain aspects as constraint forces.

Conformation of cationic N,N-di­methyl­glycine in di­methyl­glycinium tri­fluoro­acetate

In the title compound, C(4)H(10)NO(2)(+).C(2)F(3)O(2)(-), the main N-C-COOH skeleton of the protonated amino acid is nearly planar. The C=O/C-N and C=O/O-H bonds are syn and the two methyl groups are gauche to the methylene H atoms. The conformation of the cation in the crystal is compared to that given by ab initio calculations (Hartree-Fock, self-consistent field molecular-orbital theory). The trifluoroacetate anion has the typical staggered conformation with usual bond distances and angles. The cation and anion form dimers through a strong O-H.O hydrogen bond which are further interconnected in infinite zigzag chains running parallel to the a axis by N-H.O bonds. Weaker C-H.O interactions involving the methyl groups and the carboxy O atoms of the cation occur between the chains.

Structural and insulator-to-metal phase transition at 50 GPa in GdMnO 3

We present a study of the effect of very high pressure on the orthorhombic perovskite GdMnO3 by Raman spectroscopy and synchrotron x-ray diffraction up to 53.2 GPa. The experimental results yield a structural and insulator-to-metal phase transition close to 50 GPa, from an orthorhombic to a metrically cubic structure. The phase transition is of first order with a pressure hysteresis of about 6 GPa. The observed behavior under very high pressure might well be a general feature in rare-earth manganites.

l-Tryptophan 4-nitro-phenol tris-olvate.

The title compound, C(11)H(12)N(2)O(2)·3C(6)H(5)NO(3), comprises a zwitterionic amino acid formed by two nearly planar groups: (i) the indole ring and Cβ, and (ii) the carboxyl group, Cα, as well as the amine N atom, with r.m.s. deviations of 0.0084 and 0.0038 Å, respectively. The angle between these idealized planes is 39.47 (9)°. The amine group of the amino acid is in a syn (-sc) arrangement relative to the ring system. The overall crystal structure results from the packing of sheets parallel to the (001) planes. These sheets are formed by a pair of screw axis related parallel networks bound by hydrogen-bond and π-π stacking interactions. The intermolecular cohesion of all organic residues in each of the latter two-dimensional networks is achieved via strong hydrogen bonding, nitro-π and π-π stacking interactions.

Dynamic and structural properties of orthorhombic rare-earth manganites under high pressure

We report a high-pressure study of orthorhombic rare-earth manganites AMnO3 using Raman scattering (for A = Pr, Nd, Sm, Eu, Tb, and Dy) and synchrotron x-ray diffraction (XRD), for A = Pr, Sm, Eu, and Dy. In all cases, a phase transition was evidenced by the disappearance of the Raman signal at a critical pressure that depends on the A cation. For the compounds with A = Pr, Sm, and Dy, XRD confirms the presence of a corresponding structural transition to a noncubic phase, so that the disappearance of the Raman spectrum can be interpreted as an insulator-to-metal transition. We analyze the compression mechanisms at work in the different manganites via the pressure dependence of the lattice parameters, the shear strain in the ac plane, and the Raman bands associated with out-of-phase MnO6 rotations and in-plane O2 symmetric stretching modes. Our data show a crossover across the rare-earth series between two different kinds of behavior. For the smaller A cations considered in this study (Dy and Tb), the compression is nearly isotropic in the ac plane, with only small evolutions of the tilt angles and cooperative Jahn-Teller distortion. As the radius of the A cation increases, the pressure-induced reduction of Jahn-Teller distortion becomes more pronounced and increasingly significant as a compression mechanism, while the pressure-induced tilting of octahedra chains becomes conversely less pronounced. We finally discuss our results in light of the notion of chemical pressure and show that the analogy with hydrostatic pressure works quite well for manganites with the smaller A cations considered in this paper but can be misleading with large A cations.

Clinicopathological differences between interval and screen-detected breast cancers diagnosed within a screening programme in Northern Portugal:

Objective To evaluate clinicopathological differences between screen-detected (SD) and interval (IC) breast cancers diagnosed in women enrolled in an organized breast screening programme in 2000--2007. Setting Breast Cancer Screening Programme of the north region of Portugal. Methods Using data from the screening programme and from the population-based North Region Cancer Registry, SD and IC were identified. Information on screening history, age, date of diagnosis, tumour size, histological type and grade, lymph node status, tumour stage, biomarkers, and treatment was obtained from the cancer registry and from clinical and pathological reports. Association between mode of detection and these clinicopathological characteristics was estimated by unconditional logistic regression. Results A total of 442 SD and 112 IC were identified in women aged 50--69. Compared with SD, IC were diagnosed in younger women (60.0 ± 5.8 years and 58.4 ± 6.0 years, respectively), were larger (tumour size >20 mm: 60.2% versus 25.1%), lobular (6.3% versus 16.1%), with a higher differentiation grade (grade 3: 17.7% versus 38.9%), had more lymph node metastases, more advanced stage, and oestrogen receptor (ER) negative (12.9% versus 29.0%) and progesterone negative, and HER2 positive. After multivariable analysis, compared with SD, IC were more likely to be larger than 20 mm, lobular, of grade 3 and negative for ER. Conclusion Our results are consistent with other studies. IC’s have a more aggressive biology than SDs. Our findings did not show any unexpected pattern requiring changes to our screening procedures, but continuous identification and characterization of IC is advisable.