Resumo O uso da internet tem aumentado exponencialmente a nível mundial. Ainda que ele não seja por si só negativo, já que integra benefícios vários, alguns indivíduos parecem exibir problemas relacionados com o seu uso excessivo, descontrolado e disfuncional. Consequentemente, tem sido crescente, particularmente nas últimas duas décadas, o interesse dos investigadores em explorar este uso, quando excessivo e pouco saudável. Porém, e sendo um tema/constructo tratado por diferentes autores com quadros teóricos também diferentes, são vários os termos usados na literatura para descrever este fenómeno. Neste sentido, este artigo propõe-se a apresentar o trabalho uma revisão de literatura de dois dos conceitos mais usados e espartilhados na literatura científica, ou seja, adição à internet e uso problemático da internet.

The Portuguese Severe Asthma Registry (Registo de Asma Grave Portugal, RAG) was developed by an open collaborative network of asthma specialists. RAG collects data from adults and pediatric severe asthma patients that despite treatment optimization and adequate management of comorbidities require step 4/5 treatment according to GINA recommendations. In this paper, we describe the development and implementation of RAG, its features, and data sharing policies. The contents and structure of RAG were defined in a multistep consensus process. A pilot version was pretested and iteratively improved. The selection of data elements for RAG considered other severe asthma registries, aiming at characterizing the patient's clinical status whilst avoiding overloading the standard workflow of the clinical appointment. Features of RAG include automatic assessment of eligibility, easy data input, and exportable data in natural language that can be pasted directly in patients' electronic health record and security features to enable data sharing (among researchers and with other international databases) without compromising patients' confidentiality. RAG is a national web-based disease registry of severe asthma patients, available at asmagrave.pt. It allows prospective clinical data collection, promotes standardized care and collaborative clinical research, and may contribute to inform evidence-based healthcare policies for severe asthma.

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Pulmonary agenesis is defined as the complete absence of one or both lungs, including the bronchi, bronchioles, vasculature and lung parenchyma. Most of these malformations are detected in early childhood. A residual number remains asymptomatic and undiagnosed until adulthood. The clinical presentation is wide, ranging from asymptomatic to respiratory complaints like dyspnoea, respiratory distress and a history of recurrent lung infections. This case presents a 54-year-old woman with complaints of coughing, dyspnoea for medium exertion and wheezing for a couple of months. Based on the results of complementary diagnosis methods, right pulmonary agenesis was diagnosed without other malformations. Simultaneously, an asthma diagnosis was also performed. The treatment of pulmonary agenesis is symptomatic. Simultaneous cardiovascular malformations could require surgical interventions. This case demonstrates that pulmonary agenesis may remain undiagnosed, be identified incidentally, and have a good and long prognosis.

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Dear Editor,We report the case of a 68-year-old man who presented at the emergency department with abdominal pain, vomiting, and constipation that progressively became worse over a 1-month period. His social history was notable for a remote phase of smoking. On physical examination, the patient was found to be hemodynamically stable, and his abdomen was tender with diffuse periumbilical pain on palpation. His laboratory results showed hemoglobin of 12.4 g/dL (normal, >13 g/dL), white blood count of 13000/ uL (normal, 4000-11000/uL), and C-reactive protein level of 96.4 mg/L (normal, <2.9 mg/L). Abdominal computerized tomography (CT) scan revealed focal thickening of the ileal segment ( Figure 1a). Additional thoracic CT revealed a left upper lobe mass (50×55 mm) ( Figure 1b). The patient underwent bronchofibroscopy and an exploratory laparoscopy with enterectomy. The cytology of the bronchial aspirate and histology of the ileal enterectomy were consistent with squamous cell carcinoma of the lung with intestinal metastasis, respectively (Figure 2a, 2b, respectively). The neoplasia was completely staged as squamous cell carcinoma of the lung, stage IV cT2b-N2M1b (mediastinal and left hilar lymph nodes and liver metastases) according to the 7th edition of TNM classification (1). The patient was treated with palliative chemotherapy with carboplatin and gemcitabine (6 cycles) and died 6 months after the diagnosis.Lung cancer is one of the most common cancers worldwide and is the leading cause of cancer-related deaths with a 5-year survival of 10%-25% (2). In non-small-cell lung cancers (NSCLC), approximately 40% of the patients have metastatic disease at the time of presen-tation (1). NSCLC can metastasize to nearly any organ, but it usually spreads to the brain, liver, adrenal glands, bone, and lung. Clinically significant small bowel metastases are rare (frequency of 0.5%) (2), and its diagnosis is usually based on post-mortem examination [12% of prevalence of gastrointestinal (GI) metastases and 8.1% in small bowel] (3). Small bowel, especially ileum, is the most commonly reported site for GI-tract metastasis of lung cancer. Small bowel metastases may occur in every cell type of primary lung cancer. The pathogenesis of small bowel metastases has been thought to be due to tumor cell spread via the hematogenous and lymphatic routes. Tumor invasion of the bowel wall results in perforation, obstruction, and bleeding. It appears that perforation or hemorrhage can also occur in patients under chemotherapy because chemotherapy may lead to tumor necrosis and acute ulceration (4). The difficulty in early detection of GI metastases leads to a delay in diagnosis until presenting with life-threatening complications that frequently require emergency surgeries (4). The time between the diagnosis of squamous cell carcinoma of the lung and the discovery of GI metastases is extremely variable, occurring more often in the first 12 months (2,4).In this case report, small bowel obstruction was the initial clinical symptom for this pat...