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With an empathetic face, she leaves an office in one of the corridors of the Santa Maria Hospital that nobody wants to cross – the Radiotherapy corridor.
She’s as reserved as she’s gentle. Vera Mendonça is now a specialist in Radiotherapy and says she’s a “daughter of this house;” she studied at the Faculty of Medicine of the University of Lisbon and she stayed at the Santa Maria Hospital were she specialised. While she was an intern and a new mother of twins – the first 2 out of a total of 6 children -, she chose Pneumology in her second year of general internship, but her experience in internal emergency room soon showed that it was not the right choice for her. It was a conversation with two of her best friends that aroused her curiosity to learn more about Radiotherapy. A department that didn’t have a central emergency room, was very innovative from the technological point of view, and offered more stable schedules for someone who was also a mother, was the choice she deems to have been the right one.
That’s when she met her tutor, Marília Jorge, who had always worked with breast cancer and Gynaecology; she wanted to stay with her in Pathology and that’s where she’s spent the last 8 years.
She’s at the emergency room one day a week, from 8 a.m. to 9 p.m.; there they receive patients from the hospital and referral areas and deal mainly with 3 clinical situations: the vena cava syndrome (obstruction of blood flow through the superior vena cava), bleeding (which stops with radiotherapy), and spinal cord compression (lesions and illnesses that put pressure on the spinal cord). Her role is to decide what dose of radiation to administer starting at 24-48h, single dose or divided into several days (with a smaller dose per fraction).
What brought us together to talk was the issue of breast cancer and what happens to a woman who undergoes radiotherapy. We were looking for simple questions for those who are faced with bad news for the first time and we realised that when we open doors with answers, everything seems to become less dark.

Please demystify radiotherapy for us.
Vera Mendonça: It’s one of the therapeutic modalities used to treat cancer. About 50% of cancer diseases are currently treated with radiotherapy. This treatment is associated with surgery, used as a single therapy, or associated with surgery and chemotherapy.

And how is radiotherapy applied?
Vera Mendonça: It’s applied using a machine known as linear accelerator; one of the great technological advances was the replacement of the cobalt pump by the linear accelerator, and it was from that point on, in the mid-1990s, that it was possible to do 3D radiotherapy; that’s because treatments are now being planned by CAT (in some Centres they are planned by RMI or PET – Positron-emission tomography, a nuclear medical imaging technique that uses molecules which include a radioactive component). The advancement in imaging techniques has also improved treatment planning, and that is a great advantage because we are able to irradiate our target organ more effectively and evaluate the doses of radiation that reach the organs at risk precisely because we design them individually.

When we do a treatment with radiations we are killing bad cells, of course, but we are also hitting healthy cells. In this difficult balance, is it still better to kill bad cells, even if you’re hitting good cells?
Vera Mendonça: Yes, of course; partly because the radiobiology of radiation treatments allows it, “healthy cells” are able to recover because radiation acts in a phase of the cell cycle in which malignant cells cannot recover from the damage that is done to their DNA, but benign cells can. And that’s why treatments are fractionated and we don’t give the full dose of radiation in a single day (with a few exceptions); we divide the radiation into several daily fractions, so cells can recover in the meantime. It’s 5 days of treatment, 2 days of rest. This break is very important to recover from damage.

We know there is collateral damage to the cells, but that’s on the inside. And on the outside, what happens to a patient subject to radiotherapy?
Vera Mendonça: They feel more tired, and that happens in general to patients who receive radiation. From the pathophysiological point of view there’s no specific reason for that. Maybe the fact that they come and go every day is exhausting, as these are curative treatments. The total dose is divided into small daily fractions, but they must come every working day. Currently we have more condensed breast treatment schemes that are equally effective in terms of local control and cosmetic outcome, and so instead of offering patients 5- or 6-week-long treatments, we are offering 3- to 4-week-long treatments, which means that we’re slightly increasing the dose per fraction. This has all been studied and confirmed, of course. But it’s important to note that even these women who undergo 3-week-long treatments mention fatigue. On the other hand, when it comes to toxicity, and according to the area we are dealing with, it’s a problem that emerges as the weeks go by; in the case of the breast, the skin will become progressively redder and wounds may appear. The degree of toxicity depends on the type of skin, hydration, adherence to the requested care, previous therapies, co-morbidities. These are ways to minimise cutaneous toxicity, which is the only one that the patient can see. We can’t see pulmonary or cardiac toxicity; we only detect it and diagnose it when there are complaints.

But if there are no obvious complaints, they will not undertake medical examinations to screen for collateral lesions, is that it?
Vera Mendonça: Yes, if there are no complaints we don’t conduct further tests to assess the surrounding toxicity. With regard to chronic cardiac toxicity, several international recommendations are being developed for the follow-up of patients irradiated for left-sided breast cancer.

Do patients stick to the recommendations they are given?
Vera Mendonça: In most cases; in the summer it’s a bit more difficult.

In the summer? Why?
Vera Mendonça: It has to do with clothes, because it’s not advisable to wear a bra directly on skin that is being irradiated on a daily basis. You should always wear a cotton sweater under your bra to minimise the risk of wound; elastics, lace, all of these can increase the risk of wound. With warmth patients feel more reluctant to adhere to this recommendation and therefore we see more grade-2 toxicity, perhaps because they’re less careful. In the winter we see mostly grade-1 toxicity, which is the same as an erythema, oedema, or pruritus on the breast.

Can you trace the profile of a woman with breast cancer?
Vera Mendonça: That’s an interesting question because this is an issued we discuss with oncologists. Of course there are exceptions, but I think that all cancer patients have a certain psychological profile; breast cancer patients also have a profile, and they are usually more anxious, some more depressed, generally more stressed women. Please note that this is not a label, and it doesn’t rely on any established evidence, but rather our perception of the sample we treat annually.

Can this speed up the disease process?
Vera Mendonça: In women who have experienced traumatic situations and were left with emotional damage, these can affect the disease, because they affect their immune system. On the other hand, each of us has a specific genetic profile, and that makes us more prone to certain diseases. And when all these intrinsic and extrinsic factors come together, “get in tune” and combine themselves, that’s when the disease reveals itself. So, I believe that in some cases the disease may actually be triggered by a life event. All these women often mention this, you know, the fact that they believe they experienced stressful situations at home or at work, which may have been responsible for triggering the disease. And many of them – some who are still very young, they are 30/40 years old and have breast cancer – say “I’ve always been healthy, I don’t smoke, I don’t drink, I even exercise, why did this happen to me?”

And why did it happen to them?
Vera Mendonça: I don’t think anyone can answer that. Because there’s genetic cancer and non-genetic cancer, and most of the cancer is not genetic; the disease happens when all the factors, both extrinsic and intrinsic, come together in the same person. According to literature, it’s a multifactorial question.

If it’s not genetic, is it worth investing in prevention?
Vera Mendonça: Of course, because the earlier we find it, the better the prognosis. There’s a difference in finding a stage-1 tumour or a stage-3 tumour, because that has a great impact on survival.

But, in preventive exams, don’t you receive signs from the body saying “hold on, there might be a disease here?”
Vera Mendonça: No, we don’t. We can’t predict it.

Is breast cancer as aggressive in an 80-year-old woman as in a 40-year-old woman? In other words, do cancer cells slow down as metabolism slows down?
Vera Mendonça: It depends on the biology of the tumour. We’ve had cases of patients over 80 whose breast cancer had an aggressive biological profile. The problem is that, because many of them have several co-morbidities (quantification of various diseases), that forces us to exclude some therapeutic modalities. As treatment we have radiotherapy, surgery and hormone therapy (chemotherapy and immunotherapy are used in selected cases), for women who are hormone-dependent and have a better prognosis; for the triple negative profile we have fewer therapeutic options. We have to adjust the treatment to the patient we have before us.

I know that you’re a doctor and you’re used to dealing with this reality every day, but you’re also a woman. Do you struggle with this disease as a woman, or can you filter this reality and don’t allow these issues to affect you?
Vera Mendonça As time goes by, we manage to stand more and more on the side, but at the same time we have a different bond with the patient. I’m able to see past the disease but, at the same time, I try walking in the patient’s shoes. I try to understand what she’s feeling and establish an emotional relationship. To get more of them, we also have to give them more. Breast cancer patients need to be emotionally touched in order to better correspond to what we ask of them next. Radiation frightens them, but when their doubts have been cleared, they are calmer and less afraid of toxicity.

Is there still room for advancements in radiotherapy?
Vera Mendonça: Of course, imaging techniques are constantly evolving and each time they do we can offer more possibilities to the patients. Planning associated with the technological evolution of the treatment has been amazing.

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After all, walking across the corridors of a Hospital as huge as Santa Maria may not be as terrifying as we’d imagined, as if we were terrified children in the dark, facing the unknown.
Trusting in the physician we have before us and in therapeutic and technological progress may be the second most important tool to overcome a disease such as breast cancer.
Because the first of all is the inner confidence that every woman must grasp and never want to give up.
And if, along the rockiest road, you receive the news that you have cancer, when you find a physician like Vera Mendonça you can be sure that the odds are more in your favour.

A propósito da conferência “Mais inovação, mais saúde“, realizada no passado dia 15 de junho na Fundação Calouste Gulbenkian, o Diário de Notícias publicou um artigo com grande interesse e actualidade, “Médicos em privação de sono podem cometer mais erros”.

«”O stress, a fadiga e o sono constituem três factores que influenciam negativamente a actividade dos profissionais de saúde, interagindo entre eles”. O alerta é feito por Paula Pinto, coordenadora da unidade de sono e ventilação não invasiva do serviço de Pneumologia do Centro Hospitalar Lisboa (…).

«[T]endo em conta a actividade profissional inerente à prática da medicina, os profissionais de saúde estão sujeitos à realização de turnos que condicionam uma alteração ao nível do desempenho das suas actividades diárias, apresentando privação crónica de sono“.

«Em causa está o estilo de vida das sociedades modernas, aliado à exigência profissional, que “resultam numa redução do número de horas de sono, que levam a fadiga, cansaço e hipersonolência diurna, com um aumento do risco de acidentes de trabalho, podendo resultar inclusivamente em erros médicos“.

«De acordo com a também professora da Faculdade de Medicina de Lisboa, “a privação crónica do sono funciona para o organismo como um estado de stress contínuo“, o que aumenta o risco de doenças cardiovasculares, diabetes e perturbações mentais, nomeadamente estados de ansiedade e depressão. Além disso, explica, quando o profissional de saúde está sujeito a situações de stresse, “não tem capacidade de resposta adequada”, o que pode prejudicar o seu desempenho.»

Leia notícia completa aqui.

André Rodrigues

Equipa Editorial

Teachers Sara e Diana

Paediatrics at Santa Maria Hospital has a School since 2002, which was born of a protocol between PT, the National Association of Cystic Fibrosis of HSM, the Ministry of Education and CANTIC (Organism of this Ministry), because there were children who were hospitalised for more than a week and in need of continued treatment, which meant they were losing much of what was taught in class. At a time when the use of technology systems was scarce and knowledge was less universal, the use of video-conferences or remote classes was an oasis, an innovative system, but with a great need for IT and technical support.

Sara Costa and Diana Guerreiro are teachers assigned by the Ministry of Education to the Santa Maria Hospital. Hospitalized children are grateful for them. “We’re school employees out there, but our classrooms are in here”.

Sara (secondary school teacher) and Diana (primary school teacher) arrived with the intention of accompanying the children with cystic fibrosis, but their action quickly extended to all the others within Paediatrics who stayed for longer. Nowadays, they are able to guarantee a more personalised teaching activity from the 1st to the 9th year of schooling. “With students of grades 10, 11 and 12, I am able to teach Mathematics, which is my area. Otherwise, we contact the school and we serve as intermediaries for the adolescent’s school.” Life continues outside the doors of Santa Maria, as it does for these students, so one of them even took the exams to access higher education and got in with “an excellent mark”.

Usually, it is through the hands of the Paediatrics educators that Sara and Diana arrive at their students, but when they become chronically ill or stay for prolonged hospitalisation, they also become chronic students, and the educators call the teachers to warn them that the students are coming. But it is deceiving to think that because they are hospitalised, these kids refuse to learn.

Do most children who spend time in the hospital ask for classes?

Sara Costa: The majority does, but there are some who at the start don’t want to learn from us. Then, time goes on and that initial good feeling of free time starts to tire them. The suspicious looks become interactions, and then they ask us to get in touch with the schools to ask for activities and tasks.

Is there any trick to reach these students?

Sara Costa: There isn’t one… Perhaps they change when they understand that everything they’re going to do here will help them when they leave. Because the outside world goes on, even though they are closed off here. When they leave and go back to school, they won’t be able to rewind classes, they will have to pick up the pace. So we just make them understand the rhythm of things. If on one hand older people are more difficult to captivate, on the other hand, they adhere more because they realise the importance of not missing out.

And how is your communication with the Schools?

Sara Costa: We always start by probing the child or young person’s interest and involve the family. Only then do we contact the school through the Class Director and introduced the School of the Department of Paediatrics. We ask that the students do tasks whilst they’re here. Then it depends a lot on the schools. Some collaborate a lot and some less. But there is a reason for collaborating less, which is never due to unwillingness. Sometimes, they think that because the student is hospitalised, he/she should not be bothered with school work, as he/she is sick and should only try to get better. We try to show them that this position is wrong, because the more they focus on the disease, the less they are able to help themselves. We want the child to continue to be what he or she really is, a student, because this child is no longer anything else. The child is lying in bed and cannot play football or go for a walk. And we try to bring them some normality. Other times, the interaction fails because, as time goes by, the school forgets that he is a student there. But, in general, they cooperate a lot. The chronically ill patients already started to bring their homework. They are very autonomous, they exchange e-mails with their teachers and make arrangements with them. Then, we create reports and send them to the school to provide them with feedback on the student’s performance. Sometimes, we are invited to take part in the class council of the students who spend a lot of time with us. We are the mediators between the two parties.

But there is also a very interesting concept, the remote class. Where does it get included?

Sara Costa: The remote class was the main project of our School, which has become diluted, because schools are not able to create the level of interaction we expected. Let me explain that. There used to be a subject called “Project Area”, in which students worked on a common topic together with us, and this was then interactively shared in remote class sessions. But that subject does not exist anymore and there is no more room for this project in schools. Therefore, at the moment, we are only doing it with the School of the Paediatric Services at the Lisbon Oncology Institute. Actually, we also maintain a great interaction with the Estefânia and Alcoitão schools, and we work together in a network as schools of the Lisbon Hospitals. We set a common topic every year, and this year we chose “Living the heritage”, which we have been posting on the shared website. The last remote class we did with the Oncology Institute School was on the heritage of Lisbon, through which we discovered several city sites.
It was interesting because among the hospitals we had students from five different nationalities and the great majority of the students did not know these sites, because what they know of Portugal and Lisbon is the Santa Maria Hospital.

Curtain of friendship that was born of a large blanket of solidaritybetween institutions

Are those children from the PALOP (Portuguese-speaking African countries)?

Sara Costa: Yes, mostly.

And when they leave the hospital, do they return to their country?

Sara Costa: No. Many of them have to stay for longer, because they require treatment. They stay in a guest house or with relatives. And, in fact, these virtual classes allow them to take virtual tours around the city. Did you know that some of the children become sad when they are discharged, because they would rather stay at the hospital? They would rather stay here instead of going to a guest house, where they do not receive this kind of support.

But we have other projects. One of them is called “The robot helps!”, which has the participation of Professor Paulo Torcato, who comes to the hospital in his free afternoon and gives lectures on programming and robotics. The kids love it!

We also promote another project together with the Pavilion of Knowledge, which is called “Science is good for your health”. They come here and we perform experiences, or they bring some experts to talk about relevant topics (ants, dinosaurs, etc.). But we also visit them, through our computer, and use video-conferences.

Not being ill yourself, how do you adapt to the perspective of those who are? I imagine that teaching in a regular classroom is not the same as teaching in an isolation ward?

Sara Costa: We are a different kind of teachers. While teaching in a regular classroom, I see my class twice a week and for ninety minutes per day, and no matter how much interest I have for their lives, I have thirty students in front of me. Here, we spend time with them and their families on a daily basis, we get closer to them. Family members often come to us to talk. Doctor and nurses need to split their attention between many other children, and this is something they understand quite well, but with us it is different, they get the feeling that they can spend a little more time with us. We have room for them.

Sara Costa feels that they are being able to accomplish what they set out initially as they get contacted by external people who make themselves available to be teachers for one day. Francisco Silva is one such teacher for one day, and he brought the sea to the hospital and explained many interesting facts, namely the Nazaré canyon. It was our school’s Facebook page (Escola Departamento de Pediatria do HSM) that allow them to open this door to the world and promote their mission.

When they’re attending a remote class, children need to go to school on the 8th floor of the hospital, which has a classroom. But there are children in isolation that cannot leave their rooms. In those cases, Sara and Diana try to use their laptops to take the school to them. And if at the 8th floor classroom they do not need special clothing, Sara and Diana are not worse teachers when they go into the isolation ward and wear a hospital gown. They need very little apart from the spiritual strength, a few laptops and some ink cartridges.

The classes are very dynamic and every day they try to convey different messages, or the same message conveyed in a different way, by changing places and resources, so that no one ever loses interest or the sense of novelty.

The main message passed on to us by professor Sara Costa is the spirit of this small physical school, which entails a great commitment: “I see a student, not a patient”.

Joana Sousa

Equipa Editorial

Coffee has an unjustifiably bad reputation. There are in-depth studies that prove that people who drink more coffee have less coronary disease, less Alzheimer’s or Parkinson’s disease.

But talking about coffee is not talking about caffeine. Of the thousands of substances found in coffee, some have a beneficial impact.

That’s the opinion of António Vaz Carneiro, professor at the Faculty of Medicine of the University of Lisbon, based on scientific evidence.

Source and Image credits: Saúde Online

Auto-retrato de Craig Finn, doente com Esquizofrenia e que representa a sua percepção individual da doença

The study on “The Cost and Burden of Schizophrenia in Portugal” by the Centre for Evidence-Based Medicine of the Faculty of Medicine of the University of Lisbon is warning of the high numbers of patients with schizophrenia.

This study was based on data relating to 2015 and aims at giving a perspective on both the number of patients and the costs incurred by the country, while drawing attention to the fact that there is a large number of patients who are not being treated neither in the private, nor in the public system.

To learn more about the study, read the full article, here.

O médico francês René Laennec foi o inventor do estetoscópio, que na sua forma primitiva consistia num pequeno tubo monoaural, aparentemente, por razões que podemos talvez atribuir ao decoro e pudor da época. Desconfortável por ter de encostar o ouvido ao peito das mulheres para ouvir os batimentos cardíacos, Laennec desenvolveu aquele que é provavlemnte o mais conhecido de todos os instrumentos médicos quando trabalhava no Hôpital Necker-Enfants malades. 

Um dos primeiros estetoscópios fabricados por Laennec.  Imagem da Wikimedia Commons.

André Silva
Equipa Editorial
news@medicina.ulisboa.pt

Sabia que…?

Os sintomas da Doença de Alzheimer, considerada enquanto entidade patológica distinta, foram inicialmente identificados e propostos pelo alemão Emil Kraepelin, um dos fundadores da moderna Psiquiatria? E que, por seu turno, a neuropatologia característica foi observada e descrita pelo seu colega Alois Alzheimer em 1906?

Podemos também ler a este respeito, na Wikipédia, que “… Because of the overwhelming importance Kraepelin attached to finding the neuropathological basis of psychiatric disorders, [he] made the generous decision that the disease would bear Alzheimer’s name.”

Em cima, Auguste Deter, primeiro paciente diagnosticado com a Doença de Alzheimer, em de 1901.

Fonte: Wikipédia, Wikimedia Commons, para a imagem

Com uma série de antecedentes incontornáveis, nomeadamente o 25 de Abril de 1974 e a consequente Constituição da República de 1976, a Lei n.º 56/79, de 15 de Setembro de 1979 instituiu uma rede de serviços de cuidados de saúde acessíveis a toda a população, financiada através de impostos.

De acordo com a página do SNS (https://www.sns.gov.pt), “A organização dos serviços de saúde sofreu, ao longo dos tempos, a influência de conceitos políticos, económicos, sociais e religiosos de cada época e foi-se concretizando para dar resposta aos problemas de saúde então identificados, mas também para “conservar” – isto é, promover – a saúde dos povos, na expressão utilizada por Pedro Hispano e Ribeiro Sanches.

“Nos séculos XIX e XX, até à criação do SNS, a assistência médica competia às famílias, a instituições privadas e aos serviços médico-sociais da Previdência.”

Fonte: https://www.sns.gov.pt/sns/servico-nacional-de-saude/

Sir Arthur Conan Doyle (1859-1930), escritor britânico, criador do imortal Sherlock Holmes, era médico, tendo obtido a sua formação na Universidade de Edimburgo, especializando-se, mais tarde, em Oftalmologia.

Como tantos outros escritores, foi difícil encontrar um editor para as histórias que escrevia, inicialmente nos intervalos das consultas, enquanto aguardava pelos seus pacientes, e noutros tempos livres.

A profissão de médico e a sua formação científica moldaram em grande parte o estilo do autor, considerado um dos grandes nomes da ficção britânica da época vitoriana.

Uma das marcas distintivas da ficção de Conan Doyle é a forma como, sem se afastar da fantasia e da especulação, procura e consegue de facto atribuir à sua personagem principal as características de um verdadeiro cientista, seja através dos métodos de investigação criminal, quer das descrições pormenorizadas de cada caso, tal como nos é contado, desde as etapas iniciais ao surpreendente desfecho, por um médico, o não menos célebre Dr. John H. Watson, provavelmente inspirado num dos colegas de Doyle, de nome James Watson.

Conan Doyle escreveu, a propósito da criação de Holmes: “…in later life I tried to build up a scientific detective who solved cases on his own merits and not through the folly of the criminal“.

Uma característica peculiar de Sherlock Holmes, imaginável para muitos leitores de hoje, é que o famoso detective era um cocainómano. Tal facto, não sendo estranho para o contexto da época, merece a forte oposição do seu amigo e colega Dr. Watson.  Uma das mais famosas adaptações à televisão, com Jeremy Brett no papel de Sherlock Holmes, retratou justamente essa característica, numa cena notável.

Gravura da autoria de Sydney Paget para “A Scandal in Bohemia”, que começou por aparecer na revista The Strand Magazine, em Julho de 1891. Sherlock Holmes está sentado, de costas, as pontas dos dedos das suas mãos unidos, num gesto característico do detective, muitas vezes replicado nas diversas adaptações ao cinema e à televisão. (Fonte: Wikipédia)

André Silva

É de crer que a raiz etimológica de “medicina” esteja na fonte Indo-Europeia ‘med‘, com o sentido de “avaliar” ou “medir”.
O termo “medicina” chegou ao português através do latim medicina, com o mesmo sentido global.
A Ars Medicinae era, como a própria designação faz supor, concebida como uma arte e uma técnica (o termo latino ‘ars’ corresponde mais ou menos ao grego ‘techné’).
Medicina pode referir-se tanto à prática como ao remédio (medicamento).

À esquerda, busto de Hipócrates (Museu Pushkin, Moscovo), pai da Medicina, figura incontornável da história da medicina no Ocidente.

Embora quase nada saibamos da sua vida, exceptuando dados espúrios de origem mitológica, a verdade é que os autores do chamado corpus hipocrático fundaram as bases de um racionalismo médico, com textos seminais, como o seu famosoJuramento (ainda hoje os estudantes de medicina, ao chegarem à universidade, lêem uma versão adaptada deste Juramento) ou os Aforismos

Proveniência da imagem: http://www.wikiwand.com

Para o texto: http://www.dicionarioetimologico.com.br/medicina/

A Escola Médico-Cirúrgica de Lisboa, criada em 1836 pelo governo presidido por Passos Manuel, foi a instituição que sucedeu à Real Escola de Cirurgia, fundada em 1825, funcionando no Hospital de S. José. Antecedeu por sua vez as actuais Faculdade de Medicina e Faculdade de Farmácia da Universidade de Lisboa, fundadas em 1911, logo a seguir à Implantação da República.

Na Escola Médico-Cirúrgica de Lisboa agregou-se o ensino das ciências médicas e farmacêuticas, que se manteve na Faculdade de Medicina até 1918.

Existiram instituições análogas no Porto (antecessora dos actuais Instituto de Ciências Biomédicas Abel Salazar e Faculdade de Medicina do Porto) e em Goa.

Na imagem acima, o atual edifício da Faculdade de Ciências Médicas da Universidade Nova de Lisboa (a partir de 1977), que começou por ser da Escola Médico-Cirúrgica de Lisboa, depois, a partir de 1911, Faculdade de Medicina da Universidade de Lisboa. O edifício foi inaugurado em 1906, como uma das exigências de Miguel Bombarda para a realização, nesse ano, em Lisboa, do XV Congresso Internacional de Medicina.

Na imagem, o edifício do Hospital de Santa Maria, projecto do arquitecto  alemão Hermann Distel, inaugurado em 1953, para onde transitou a Faculdade de Medicina da Universidade de Lisboa, fazendo deste um dos dois maiores hospitais universitários do país.

André Rodrigues
andresilva@medicina.ulisboa.pt