Repositório RCAAP

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Esta dissertação descreve o trabalho que teve como objectivo estudar a actividade citotóxica e contribuir para o conhecimento do mecanismo de acção de compostos conjugados de ferroceno com aminoácidos (triptofano, prolina e metionina) e complexos de ouro (N-Au-PPh3, N-Au-PPh2py, S-Au-PPh3, S-Au- (C6F5)3) em linhas tumorais. Fez-se uso de duas linhas tumorais humanas, HeLa (células endoteliais do cancro do colo do útero) e MCF-7 (células epiteliais do cancro da mama) e de uma linha tumoral não-humana, N1E-115 (células isoladas a partir do clone adrenérgico derivado de neuroblastoma C-1300 de murganho). No que diz respeito à citotoxicidade, seis dos nove compostos testados apresentaram valores de IC50 promissores, entre os 10 - 88 μM. Observaram-se diferenças de actividade anti-proliferativa para os diferentes tipos celulares. O conjugado de ferroceno mais eficaz está associado ao aminoácido metionina e ao complexo de Ouro, S-Au-PPh3. Foram levados a cabo estudos biológicos e de interacção dos compostos com a molécula de DNA, com o intuito de obter informações sobre o mecanismo de acção destes potenciais fármacos. Dos primeiros estudos concluiu-se que a apoptose é, provavelmente, um dos mecanismos de morte celular que decorre da actividade destes e que a produção de espécies reactivas de oxigénio poderá estar na sua origem. A interacção dos compostos com a molécula de DNA não parece ser por intercalação.

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Este trabalho envolveu um estudo quantitativo por espectroscopia de Ressonância Magnética Nuclear (NMR) de 1H em amostras biológicas e um estudo de NMR de 29Si e 95Mo para caracterização de materiais e compostos organometálicos. No primeiro capítulo fez-se uma introdução à técnica de NMR. No segundo capítulo descreveu-se a quantificação de citrato em secreções prostáticas por 1H NMR e fez-se a sua comparação com níveis de PSA e biopsias. Foram analisadas doze amostras com volumes entre 10 e 450 L e as concentrações de citrato determinadas variaram entre 7 e 237 mmol/L. Os resultados obtidos estão de acordo com estudos publicados segundo os quais baixas concentrações de citrato estão, geralmente, associadas ao adenocarcinoma da próstata, e sugerem que a quantificação do citrato em secreções prostáticas constitui um método de diagnóstico mais fiável do que a determinação dos níveis de PSA. O terceiro capítulo envolveu o estudo de NMR de 29Si e 95Mo em materiais e compostos organometalicos. Verificou-se que o núcleo de silício em derivados (EtO)3Si(CH2)3X é sensível à alteração do substituinte X nos sistemas estudados. Os espectros de 95Mo dos derivados de fórmula geral [Mo(CO)2(3-C3H5)(Br)LL] (L=ligandos com átomos doadores de azoto), apresentam diferentes sinais de ressonância entre -600 e -800 ppm que correspondem aos vários isómeros (exo/equatorial, exo/axial, endo/equatorial) habitualmente detectados nos respectivos espectros NMR de 1H. No quarto capítulo descrevem-se os detalhes experimentais.

The construction of a new Museu Nacional dos Coches, Belem, in January 2013, and the subsequent transfer and instillation of all museum content, has created new challenges and renewed ways of looking at the vast potential of all assets as well as encouraged countless initiatives in the areas of conservation, study and communication of the different collections. As commonly happens when preparing a change, enthusiasm connected to “starting anew” and trying to do better were strongly felt. A closer look at questions concerning the Museum’s history, in particular questions related to the foundress Queen, D. Amélia’s, life experiences and the history of the collections, was both necessary and essential in order to obtain a more clarified understanding of the various nuclei. It consequently generated the motivation for a new investigation based on documental sources and direct observation which would allow for a more assertive and validated analysis of the physical condition of the assets themselves. This complex logistical journey, managing and organizing the collections, was supported by the available human and financial resources and created new strategies, procedures and operational methods which should be analysed, correlated, and gathered for future memory. The singular character of this patrimony, its undeniable historical significance, and the great prestige obtained among visitors as well as national and international investigators would certainly maintain the position of this Museum as the most visited among all national museums. With this study we intend to offer the public a new point of interest in these peculiar assets, most of which are installed on wheels. At the same time, we are confident that we can stimulate the imagination, bring back distant memories and turn important data about collection management, often left inside institutional and scientific limits, public. We hope to contribute to the developing studies and preservation of Museu Nacional dos Coches’ collections. We also hope that these facts serve as a guideline for emphasizing the importance of the preservation of this heritage, which is recognized all over the world, and help build multidisciplinary teams with specialized knowledge concerning maintenance and preservation of all different collections in the future.

Significant resources and efforts have been devoted, especially in the U.S.A., to develop predictive policing programs. Predictive policing is, at the same time, one of the drivers of the birth, and the ultimate material enactment of, the anticipatory logics that are central to the smart city discourse. Quite surprisingly, however, critical analyses of the smart city have remained divorced from critical criminology and police studies. To fill this gap, this article sets out the first critical, in-depth empirical discussion of Blue CRUSH, a predictive policing program developed in Memphis (TN, U.S.A.), where its implementation intersects long-term austerity for urban policy. The article, first, shows that there is no evidence of Blue CRUSH’s capacity to prevent crime, thus adding empirical material to skepticism over the role of predictive policing as a policy solution in the first place. And, second, it argues that, rather than making crime a matter of technological solutions, predictive policing shifts the politics therein—in short, it contributes to the expansion of policing into the field of urban policy at the same time as it disrupts present police work. These takeaways allow to further the critique of the salvific promises implicit in the smart city discourse.

This dissertation describes the genesis of the idea of femicide in a period of English and American Letters, the last decade of the eighteenth century and the first half of the nineteenth century, in which patriarchal values and constructions were entering a crisis which resulted in the revision of the idea of gender—in a way, that was the period in which the concept of gender was coded. In the first chapter, I look at the way the term femicide was first given currency in the English language in 1827 through Robert Macnish’s The Confessions of an Unexecuted Femicide, a fiction disguised as a true story, and how it spawned a short-lived literary sub-genre. In the second chapter, I examine Poe’s reworking of the femicide story, and to the ways in which he has drawn attention to its Gothic roots. Finally, in the third chapter, I offer a reading of Memoirs of the Author of ‘A Vindication of the Rights of Woman,’ in which I argue that Godwin’s “sentimentalised” portrait of Mary Wollstonecraft, and by extension of the female intellectual, constitutes an implicit refutation of her ideas, and therefore can be profitably compared to the portraits Poe’s femicide narrators make of Morella and Ligeia in the tales named after them.

This report presents the results of the study ‘Financialization of housing in Southern Europe: policy analysis and recommendations’, carried out between August and November of 2020. The study, which focuses on Portugal, Spain, Italy and Greece, is based on a comprehensive review of the scholarly literature on the financialization of housing and on a systematic collection of relevant legislation produced in the four countries. The study identifies six modes of housing financialization and several cross-cutting dimensions: 1) mortgage debt, which links the access to homeownership to finance; 2) mortgage securitization, the use of mortgage portfolios as securities/assets; 3) financialization of social rented housing; 4) financialization of market rental housing; 5) transformation of public or not-for-profit housing companies into financialized companies; 6) financialization of ‘not-for-housing housing’ (NFHH) (Donald and Roling 2019), and in particular short-term rentals (STRs) and empty housing used as investment. 7) cross-cutting issues, that is, regulations, practices and programmes that intersect the previous modes, easing the attraction and penetration of financial capital into housing systems and real estate markets. Based on this framework, the study systematizes the role of the state in housing financialization in Southern Europe, observing a number of ‘waves’ of housing financialization.

Este trabalho aborda o tema dos ossículos de equinodermes do Miocénico da Bacia Neogénica do Tejo-Sado, a partir de amostras provenientes da arriba costeira da Península de Setúbal, nomeadamente Foz do Rego, Fonte da Telha, Olhos d’Água e Lagoa de Albufeira. Complementarmente, foram observadas associações de Nanofósseis calcários dos níveis amostrados para maior precisão biostratigráfica. Foram recolhidas 11 amostras que foram crivadas por via húmida e posteriormente tríadas. Da fracção fina daquelas amostras foram feitas lâminas delgadas para o estudo das associações de Nanofósseis calcários, e para a amostra LAAM4 também para o estudo da possível existência de ossículos de holoturóides de dimensão nanométrica. Em todas as amostras estudadas, a Helicospahera stalis e H. walbersdorfensis estão presentes indicando uma idade Tortoniano Inferior. Apenas as amostras provenientes da Lagoa de Albufeira possuíram conteúdo relevante em Equinodermes. Vários ossículos dos representantes fósseis deste Filo foram encontrados naquela localidade, nomeadamente de equinóides, asteróides, ofiuróides, crinóides e holoturóides. Vários fragmentos de carapaças de Equinodermes irregulares espatangóides foram encontrados, juntamente com dois tipos dos seus espinhos. O seu elevado estado de fragmentação não possibilitou uma identificação específica. Fragmentos de equinóides regulares foram também descobertos. Alguns desses fragmentos foram identificados como pertencendo aos géneros Psammechinus e Genocidaris. Os ossículos de equinodermes asteróides dos géneros Luidia e Astropecten encontram-se presentes, nomeadamente ossículos marginais e ambulacrais. Espinhos e outros ossículos de asteróides não identificados foram também encontrados, não tendo sido possível uma classificação sistemática. O género Ophiura encontra-se representado no sedimento estudado, por diversos dos seus ossículos. Foi também possível fazer a distinção de outros ossículos de ofiuróides, não tendo sido possível saber qual a sua espécie. A análise dos cálices de crinóides descobertos possibilitou afirmar que pertencem ao género Palaoantedon. Outros ossículos de crinóides estão também presentes, nomeadamente ossículos dos cirrais e braquiais, englobado-os dentro daquele género.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motor neurons (MN) with currently limited targets and biomarkers. Neuroinflammation is a key player for disease onset/progression and the relationship between MN dysfunction and microglial activation represents a major hallmark. Our recent data demonstrated overactivation of the N9-microglia exposed to exosomes from NSC-34-MNs carrying the SOD1G93A mutation (SOD1G93A-MNs). These mutated MNs and their exosomes were enriched in microRNA(miR)-124. After internalizing these exosomes, N9-microglia exhibited time-dependent polarization and upregulated miR-124. Likewise, soluble factors released by SOD1G93A-MNs produced harmful effects on N9-microglia (upregulation of pro-inflammatory mediators/alarmins and reduced phagocytosis). Considering the paracrine effects that upregulated neuronal miR-124 may have on microglia functional properties through the influence of MN-derived secretome, we anticipate that miR-124 can be an active player for microglia immune-deregulation. We aimed to investigate whether the immune balance/function of spinal microglia is modified by wild-type (WT) or SOD1G93A-MN secretome and if it relates with MN miR-124 upregulation. As miRNAs have been progressively associated to deregulated pathways in ALS, we explored how the modulation of miR-124 in WT/diseased MNs modifies the secretome signature of inflammatory-associated miRNA content. Next, we aimed to clarify differences in microglia feedback to the secretome from WT/mutated MNs to better understand their immunoregulatory action. Since our preliminary data showed the anti-inflammatory benefits of miR-124 modulation in SOD1G93A-MNs in the murine N9-microglia cell line, our ultimate goal was to validate such data in the mice spinal cord (SC) microglia cultures, which better resemble in vivo conditions. We used mixed glial cultures isolated from the SC of 8-day-old WT and SOD1G93A mice, that were maintained for 21 days in vitro (DIV). Microglia were then isolated and used after 2 DIV. Additionally, WT and SOD1G93A-MNs were plated and differentiated for 1 day, when SOD1G93A-MNs were transfected with anti-miR-124 for 12 h and maintained for additional 48 h. Secretomes from WT/SOD1G93A/SOD1G93A anti-miR-124 MNs were collected at 4 DIV, incubated in microglia for 4/24 h and inflammatory/functional mediators were evaluated. We demonstrated that SOD1G93A-MNs have a specific miRNA profile (increased miR-124/miR-125b, decreased miR-146a/miR-21), which was fully recapitulated in mutated MNs secretome, except for miR-125b, probably due to its intracellular retention. These effects were reversed in SOD1G93A anti-miR-124-MNs and reflected in their secretome, validating miR-124 as a driver of such deregulation. Relatively to the influence exerted by the neuronal secretome, both spinal microglia responded similarly to WT MNs secretome, displaying decreased inflammatory-associated markers upon 24 h incubation, suggesting the immunosuppressive action of this secretome. Moreover, we proved that SOD1G93A-MNs secretome has an acute and immunostimulant impact on WT microglia by increasing pro-inflammatory-associated genes and also reducing the expression of markers involved in phagocytosis and intercellular communication. In contrast, these inflammatory-associated markers were decreased in SOD1G93A microglia exposed to SOD1G93A-MN secretome, indicating their inability to mount a reparative response. As we anticipated that miR-124 elevation in SOD1G93A-MNs is partially associated with a secretome exerting microglial phenotypic aberrancies, our next results were directed to assess the microglia regenerative effects after incubation with SOD1G93A-anti-miR-124 MN secretome. Such modulation was able to prevent the upregulation of iNOS/IL-1β/IL-18/HMGB1, observed in WT microglia incubated with mutated MNs-secretome. Overall, this work highlights the impact that MNs and their secretome have in ALS microglia immune balance and dysfunction. Our findings also point out, for the first time, the benefits of downregulating miR-124 in SOD1G93A-MNs as a strategy to prevent paracrine microglia activation and ALS-associated neuroinflammation, using the SOD1G93A mice. Future studies will be performed to validate these data in MNs and microglia generated from ALS patients with familiar and sporadic forms of the disease.

The introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) for children in Portugal resulted in significant changes in the serotype distribution of the pneumococcal population responsible for invasive pneumococcal disease (IPD) not only in children, but also in adults, consistent with herd protection. A 23-valent pneumococcal polysaccharide vaccine (PPV23) is also available in Portugal since 1996, although adult uptake is believed to be low. The effect of broader PCV13 uptake in children in adult IPD is currently unknown. We aimed to characterize the pneumococcal population causing adult IPD (≥18 years old) in Portugal after the introduction of PCV13 in the Nacional Immunization Plan for children, in 2015. A total of 1608 Streptococcus pneumoniae isolates were recovered from adult IPD in 61 hospitals in Portugal between 2015 and 2017. These strains were characterized phenotypically (serotyping and antimicrobial susceptibility testing) and by molecular methods (MLST). The results obtained were compared with those from previous studies to assess the effect of PCV13 introduction in Nacional Immunization Plan in the studied population. Among the 1608 isolates, 56 different serotypes were found. The most common serotypes were serotype 8 (17.8%, n=287), 3 (14.7%, n=236), 22F (7.4%, n=119), 14 (6.9%, n=111), 19A (6.2%, n=100) and 9N (4.1%, n=66). Most of the cases corresponded to serotypes exclusively found in the PPV23 (42.4%, n=681). The PCV13 serotypes were responsible for 37.6% (n=605) of the cases, and 7-valent pneumococcal conjugate vaccine (PCV7) serotypes accounted for a small fraction of the cases (14.0%, n=225). Penicillin and erythromycin non-susceptibility were detected in 14.9% (n=239) and 16.4% (n=263) of the bacterial isolates, respectively. PCV7 and serotypes exclusively found in PCV13 were responsible for 51.0% (n=122) and 15.5% (n=37) of the penicillin non-susceptible isolates and 37.6% (n=99) and 19.0% (n=50) of the erythromycin resistant isolates, respectively. Regarding all collection, 31.2% (n=501) of the strains were non-susceptible to at least one of the tested antibiotics, where serotypes 14 and 19A were the most common. MLST analysis was performed in 726 strains, where 56 different clonal complexes were found. PCV13 serotypes presented a high genetic diversity, while serotypes exclusively found in PPV23 and non-vaccine serotypes (NVT) presented a lower genetic diversity. Thirteen major clonal complexes (CC) were defined in this study that accounted for 86.4% (n=627) of the isolates: CC156, CC180, CC433, CC378, CC97, CC235, CC439, CC199, CC260, CC315, CC994, CC30 and CC191. Eleven of the 43 PMEN clones were at least double-locus-variant of 33.6% (n=244) of the isolates, however no significant association was established between clonal complexes and penicillin and erythromycin non-susceptible isolates. Serotyping was also performed using in silico methods, where both approaches (SeroBa and PneumoCAT) were found to be good alternatives to conventional methods for the determination of S. pneumoniae serotypes. Comparison with previous studies revealed an increase in the proportion of serotypes 8 and 12F, while serotypes 1, 12B and 7F decreased. Non-susceptible serotypes 8 and 22F isolates increased, whereas non-susceptible 19A isolates decreased. Although not significant, serotype 3 also presented an increase in the proportion of non-susceptible isolates to some of the antimicrobials tested. Regarding genetic lineages, sequence type (ST) 53 (serotype 8) increased, while ST191 (serotype 7F) and ST276 (serotype 19A) decreased. Even with the introduction of PCV13 in the National Immunization Plan, serotype 3 is still one of the dominant serotypes in adult IPD in Portugal, along with serotypes 14 and 19A (all serotypes present in PCV13). The increase in serotypes that do not belong to PCV13, especially serotype 8, 22F and 9N is also of concern, particularly serotypes 8 and 22F where antimicrobial non-susceptible isolates increased. With these, our data suggests that, in a situation of higher vaccination coverage, PCV13 serotypes are still significant causes of adult IPD, especially serotypes 3. However, serotypes not present in PCV13 have been showing to be an important cause of adult IPD, particularly serotypes 8 and 22F, reinforcing the continuous need for surveillance studies.

A maioria das mortes ocorre após um período longo de doença crónica. Desta forma, é expectável que estes doentes experienciem um período ímpar na sua vida, frequentemente previsível e gradual, composto por verdadeiras alterações, conhecido por morte iminente. A capacidade de identificar os sinais e sintomas que caracterizam esta fase pode ajudar não só a entender melhor a fisiopatologia do processo de morte, mas também ajudar os clínicos a tomar as melhores decisões, de forma a garantir a dignidade e a qualidade de vida que estes doentes necessitam, facilitar a comunicação com as suas famílias e também permitir uma melhor gestão de recursos de saúde. O objetivo deste trabalho foi estudar os sinais e sintomas que ocorrem nos últimos dias de vida num doente crónico. Uma pesquisa de revisão realizada em diferentes bases de dados médicas (PubMed, Cochrane Library e European Journal of Palliative Care) revelou 46 sinais e sintomas que caracterizam o doente perto da morte e as suas prevalências relativamente às últimas 24 horas, 2 dias, 3 dias, 7 dias e 14 dias de vida. Em geral, os resultados obtidos encontram-se em conformidade com estudos anteriores. Contudo, tendo em conta que a definição temporal de morte iminente ainda não se encontra bem estabelecida, é difícil conseguir chegar a uma conclusão definitiva. São necessários mais estudos para ajudar os clínicos a reconhecer o doente na sua fase final de vida.

Introdução: O cancro da mama é a neoplasia maligna mais comum entre as mulheres. A evolução na terapêutica do carcinoma da mama tem ocorrido no sentido do alcance da menor invasividade sem que, no entanto, haja o compromisso da eficácia. Alguns estudos evidenciaram a baixa probabilidade da extensão microscópica das células malignas superior a 1cm da loca tumoral, o que desafia a noção da imperatividade da radioterapia adjuvante convencional associada a cirurgia conservadora, particularmente para as doentes em estádio inicial. A Radioterapia Intraoperatória (RT-IO) corresponde a uma das técnicas de Irradiação parcial acelerada da mama (APBI) que se tem apresentado como uma das possíveis alternativas no tratamento das doentes em estádio inicial. Esta revisão tem como objetivo proceder a revisão da literatura relativa a eficácia do uso terapêutico da RT-IO em substituição a Radioterapia adjuvante convencional na abordagem conservadora do cancro da mama em estádio inicial. Metodologia: Realizou-se uma revisão não sistemática da literatura, com recurso a base de dados Pubmed com os termos Breast cancer, Early stage, Treatmen, Intraoperative radiotherapy. Resultados: Obteve-se um conjunto de 31 artigos potencialmente relevantes, dos quais se incluíram 9, duas Revisões Sistemáticas, dois Ensaios Clínicos de Fase III, dois Ensaios Clínicos de Fase II, dois Estudo Coorte Prospetivo e um Estudo Retrospetivo. Discussão: As evidencias mostram que a RT-IO é equiparável a radioterapia convencional quanto a sobrevida global. A sua eficácia no tratamento do cancro da mama em estádio inicial não é inferior ao tratamento convencional no que se refere ao controlo da doença local. É, no entanto, necessária uma escolha cuidadosa das doentes no sentido de serem selecionadas as de baixo risco. É também importante realçar a necessidade de mais estudos, com maior duração, para a identificação mais precisa deste grupo de doentes.

O choque séptico é das principais causas de doença grave e mortalidade em todo o mundo. É um tipo de choque distributivo que cursa com alterações circulatórias que culminam na hipotensão. Um dos objectivos primários do tratamento do choque séptico é restabelecer a pressão de perfusão de órgão através do início de suporte vasopressor, quando esta não é atingida apenas com a reposição volémica. A noradrenalina é, atualmente, o vasopressor de primeira-linha embora se reconheça a existência de casos de hipossensibilidade adrenérgica ou efeitos adversos com doses mais elevadas. A terlipressina é um pro-fármaco sintético, análogo da vasopressina, com elevada afinidade para os recetores de vasopressina-1, com potencial vasopressor. Neste trabalho tenta-se avaliar o quão eficaz e segura a terlipressina é para tratar o choque séptico. Pesquisaram-se as bases de dados da PUBMED e selecionaram-se ensaios clínicos aleatorizados que utilizaram terlipressina em associação com vasopressores adrenérgicos ou isoladamente em doentes com choque séptico. Nos 5 estudos selecionados não se observou diferença significativa na mortalidade ou no tempo de internamento. A terlipressina foi em todos pelo menos tão eficaz como a noradrenalina a manter a pressão arterial média acima dos 65 mmHg. Os doentes a quem foi administrada terlipressina tiveram menor necessidade de noradrenalina relativamente aos que não receberam terlipressina. Alguns estudos mostram redução dos lactatos séricos e da creatinina sérica. O efeito adverso mais frequentemente reportoado foi isquémia digitial. A terlipressina é um vasopressor não adrenérgico aparentemente tão eficaz a corrigir a hipotensão associada ao choque séptico como a noradrenalina, e com potencial benefício na perfusão de tecidos e função de órgão.

Strokes represent a major cause of morbidity and mortality worldwide. Hypertension is the risk factor with the greatest impact in stroke incidence. Blood pressure (BP) control, as a secondary prevention measure, has a substantial effect on diminishing recurrence of vascular events (stroke included). The optimal BP target in secondary stroke prevention is still controversial and different guidelines from diverse organizations recommend different targets. Data available on risk factors control in European countries is limited and, at least, 5 years old. This study’s objective was to assess in a cohort study whether, in Portugal, patients who recently suffered a stroke have controlled BP. Methods: Adult patients (age >18 years) admitted with a diagnosis of stroke (imagological confirmed), included in the PRECISE-Stroke study online database between January 2017 and May 2020. Patients had their BP assessed on discharge, 3 months and 12 months post-stroke. Posteriorly, we conducted a comparative study of BP control throughout the 12-month follow-up period. Results: 357 patients (42,3% female) were included in this study, mean age of 66 years old. 75,4% of them had controlled BP at discharge. 3- and 12-month post-stroke BP control rate drops down to 52,9 and 51%, respectively. In terms of evolution, only 32,6% of patients had controlled BP in every assessment. One limitation to this work was the loss of follow-up through the 12-month post-stroke period, with just 56% of patients attending both medical appointments. Conclusion: The percentage of patients with controlled BP was higher than previously reported, but it is still not ideal.

The first episode psychosis is a variable syndrome defined by the presence of positive and negative symptoms with a continuous duration of at least one week. Typically it begins in adolescence or young adulthood. The prevalence of tobacco use in patients with first episode psychosis is markedly high, about 59%, higher than in the general population. Most of the existing studies currently refer to patients with chronic psychotic disorders. Thus, there has been crescent interest in understanding the concrete origin of the relationship between tobacco and the first psychotic episode. This systematic review reunites the studies published until March 2018, through a search in Pubmed and Web of Knowledge databases, in order to study three main aims that could contribute to the existence of the relationship between tobacco and first psychotic episode: 1)Tobacco smoking as a potential risk factor to first episode psychosis; 2)Nicotine use in the form of tobacco smoking in first episode psychosis: the self-medication hypothesis; and 3)Tobacco use as a marker of greater illness severity in first episode psychosis. Ten original articles were included, of which: one studied the first topic mentioned above; four studied the second; and the remaining five studied the third hypothesis. This review concludes that the relationship between tobacco and the first psychotic episode is undeniable, and, in spite of being difficult to reach the nature of this association, there was a trend towards a greater contribution of the hypothesis “Tobacco smoking as a potential risk factor to first episode psychosis” comparative to the “Nicotine use in the form of tobacco smoking in first episode psychosis: the self-medication hypotheses”. The last hypothesis "Tobacco as a marker of disease severity" was the one that was most corroborated, with four of the five studies included in this topic supporting this hypothesis. In one study, it is suggested that poor adherence to medication may be a causal factor that mediates the association between smoking and increased severity of the disease. It was found that, although further studies on this associations are necessary, if fully tested, it may be very useful in clinical practice, primarily in a view of prevention and also in the staging of the disease.