Logistic Red Flags in Mass-Casualty Incidents and Disasters: A Problem-Based Approach.

BACKGROUND: Mass-casualty incidents (MCIs) and disasters are characterized by a high heterogeneity of effects and may pose important logistic challenges that could hamper the emergency rescue operations.The main objective of this study was to establish the most frequent logistic challenges (red flags) observed in a series of Italian disasters with a problem-based approach and to verify if the 80-20 rule of the Pareto principle is respected. METHODS: A series of 138 major events from 1944 through 2020 with a Disaster Severity Score (DSS) ≥ four and five or more victims were analyzed for the presence of twelve pre-determined red flags.A Pareto graph was built considering the most frequently observed red flags, and eventual correlations between the number of red flags and the components of the DSS were investigated. RESULTS: Eight out of twelve red flags covered 80% of the events, therefore not respecting the 80-20 rule; the number of red flags showed a low positive correlation with most of the components of the DSS score. The Pareto analysis showed that potential hazards, casualty nest area > 2.5km2, number of victims over 50, evacuation noria over 20km, number of nests > five, need for extrication, complex access to victims, and complex nest development were the most frequently observed red flags. CONCLUSIONS: Logistic problems observed in MCIs and disaster scenarios do not follow the 80-20 Pareto rule; this demands for careful and early evaluation of different logistic red flags to appropriately tailor the rescue response.

Teachers' health and lifestyle considering the level of leisure-time physical activity during the COVID-19 pandemic / Salud y estilo de vida de los docentes considerando el nivel de actividad física en el tiempo libre durante la pandemia de COVID-19 / Saúde e estilo de vida de docentes considerando o nível de atividade física no lazer durante a pandemia de COVID-19

In the context of COVID-19's Pandemic, and the need for social distance, teachers started to work remotely and had changes in their work routines. This paper sought to investigate the influence of Physical Activity on the Profile of Lifestyle and Teaching Health of elementary school teachers - 1st cycle, in a medium-sized municipality in Paraná in the context of the social distance from the Pandemic of COVID-19. 201 teachers from the Municipal Education Network participated. The instruments used were: sociodemographic questionnaire; International Physical Activity Questionnaire - long version; Individual Lifestyle Profile (PEVI); Teacher Health Questionnaire (QSD). Non-parametric statistical tests were used: Pearson's Chi-square, Yates' Continuity Correction and Fisher's Exact Test, Mann Whitney U Test. The results show that Physically Active teachers have lower breakdown rates than inactive teachers, as well as a more positive lifestyle profile. However, the dimension of Physical Activity is not the determinant for the promotion of a more positive Individual Lifestyle, nor central to better levels of Teaching Health, as the dimensions of Relationship and Self-efficacy are decisive in the construction of a Positive Lifestyle and Excellent Teaching Health, respectively.

En el contexto de la pandemia de COVID-19 y la necesidad de distancia social, los profesores comenzaron a trabajar de forma remota y tuvieron cambios en sus rutinas de trabajo. Este trabajo buscó investigar la influencia de la Actividad Física en el Perfil de Estilo de Vida y Salud Docente de docentes de primaria - 1er ciclo, de un municipio mediano de Paraná en el contexto de la distancia social con la Pandemia de COVID-19. Participaron 201 docentes de la Red Municipal de Educación. Los instrumentos utilizados fueron: cuestionario sociodemográfico; Cuestionario internacional de actividad física - versión larga; Perfil de estilo de vida individual (PEVI); Cuestionario de salud para maestros (QSD). Se utilizaron pruebas estadísticas no paramétricas: Chi-cuadrado de Pearson, Corrección de continuidad de Yates y Prueba Exacta de Fisher, Prueba U de Mann Whitney. Los resultados muestran que los profesores físicamente activos tienen tasas de agotamiento más bajas que los profesores inactivos, así como un perfil de estilo de vida más positivo. Sin embargo, la dimensión de Actividad Física no es determinante para la promoción de un Estilo de Vida Individual más positivo, ni central para mejores niveles de la Salud Docente, ya que las dimensiones de Relación y Autoeficacia son determinantes en la construcción de un Estilo de Vida Positivo y una excelente salud docente, respectivamente.

No contexto de Pandemia da COVID-19, e necessidade de distanciamento social, professores passaram a trabalhar remotamente e tiveram mudanças nas rotinas laborais. Este trabalho buscou investigar a influência da Atividade Física no Perfil de Estilo de Vida e na Saúde Docente de professores do Ensino Fundamental - I ciclo, de um município de médio porte do Paraná no contexto do distanciamento social da Pandemia de COVID-19. Participaram 201 professores da Rede Municipal de Educação. Os instrumentos utilizados foram: questionário sociodemográfico; Questionário Internacional de Atividade Física ­ versão longa; Perfil de Estilo de Vida Individual (PEVI); Questionário de Saúde Docente (QSD). Foram utilizados os testes estatísticos não-paramétricos: Qui-quadrado de Pearson, Correção de Continuidade de Yates e Exato de Fisher, Prova U de Mann Whitney. Os resultados evidenciam que professores Ativos Fisicamente apresentam menores índices de esgotamento que professores inativos, bem como um perfil de estilo de vida mais positivo. Entretanto, a dimensão de Atividade Física não é o determinante para a promoção de um Estilo de Vida Individual mais positivo, nem central para melhores níveis de Saúde Docente sendo que, as dimensões de Relacionamento e Autoeficácia são determinantes na construção de um Estilo de Vida Positivo e uma Saúde Docente excelente, respectivamente.

The use of drugs and medical students: a literature review.

INTRODUCTION: The consumption and abuse of alcohol and other drugs are increasingly present in the lives of university students and may already be considered a public health problem because of the direct impacts on the physical and mental health of these individuals. The requirements of the medical program play a vital role in the increasing rate of drug users. OBJECTIVES: To carry out a systematic review of the literature on the use of drugs, licit or not, in Brazilian medical students. METHODS: A descriptive-exploratory study, in which the SciELO and MEDLINE databases were used. A total of 99 articles were found, of which 16 were selected for this review. RESULTS: Alcohol and tobacco were the most frequently used licit drugs among medical students. The most consumed illicit drugs were marijuana, solvents, "lança-perfume" (ether spray), and anxiolytics. The male genre presented a tendency of consuming more significant amounts of all kinds of drugs, with the exception of tranquilizers. It was found an increasing prevalence of drug consumption in medical students, as the program progressed, which may result from the intrinsic stress from medical school activities. Students who do not use psychoactive drugs are more likely to live with their parents, to disapprove drugs consumption, to practice religious beliefs and to be employed. CONCLUSION: The prevalence of licit and illicit drug use among medical students is high, even though they understand the injuries it may cause.

PRIMARY LYMPH NODE HEMANGIOMA IN A PATIENT WITH INVASIVE DUCTAL CARCINOMA / Hemangioma linfonodal primário em paciente com carcinoma ductal invasivo

Primary lymph node hemangioma is a rare entity with only a few cases having been reported in the literature. This article describes a case of a 68-year-old female patient with breast cancer who underwent modified radical mastectomy with a subsequent histopathological evaluation that revealed invasive ductal carcinoma histological grade III according to Nottingham's Combined Classification. Among the 14 resected lymph nodes, the presence of vascular proliferation (intranodal) was observed in one of them, consistent with primary nodal hemangioma. Thus, knowledge about this clinical entity is important in order to establish the correct differential diagnosis with malignant primary neoplasms and metastasis, in which therapeutics and prognosis are very different

Hemangioma linfonodal primário é uma entidade rara, sendo que poucos casos foram descritos na literatura. Neste artigo foi relatado o caso de uma paciente de 68 anos com neoplasia mamária à direita e que foi submetida à mastectomia radical modificada com posterior avaliação histopatológica, que evidenciou carcinoma ductal invasor de grau histológico III, conforme Classificação Combinada de Nottingham. Dentre os 14 linfonodos ressecados, foi observada em 1 deles a presença de proliferação vascular (intranodal) consistente com hemangioma nodal primário. Dessa forma, o reconhecimento dessa entidade clínica torna-se imprescindível para a realização de diagnóstico diferencial de neoplasias malignas primárias ou metastáticas, que apresentam terapêuticas e prognósticos totalmente distintos

The use of drugs and medical students: a literature review

SUMMARY INTRODUCTION The consumption and abuse of alcohol and other drugs are increasingly present in the lives of university students and may already be considered a public health problem because of the direct impacts on the physical and mental health of these individuals. The requirements of the medical program play a vital role in the increasing rate of drug users. OBJECTIVES To carry out a systematic review of the literature on the use of drugs, licit or not, in Brazilian medical students. METHODS A descriptive-exploratory study, in which the SciELO and MEDLINE databases were used. A total of 99 articles were found, of which 16 were selected for this review. RESULTS Alcohol and tobacco were the most frequently used licit drugs among medical students. The most consumed illicit drugs were marijuana, solvents, "lança-perfume" (ether spray), and anxiolytics. The male genre presented a tendency of consuming more significant amounts of all kinds of drugs, with the exception of tranquilizers. It was found an increasing prevalence of drug consumption in medical students, as the program progressed, which may result from the intrinsic stress from medical school activities. Students who do not use psychoactive drugs are more likely to live with their parents, to disapprove drugs consumption, to practice religious beliefs and to be employed. Conclusion The prevalence of licit and illicit drug use among medical students is high, even though they understand the injuries it may cause.

RESUMO INTRODUÇÃO O consumo e o abuso de álcool e outras drogas estão cada vez mais presentes na vida dos estudantes universitários, e podem ser considerados problemas de saúde pública pelos potenciais prejuízos acarretados na saúde física e mental. No curso de medicina, as exigências acadêmicas e o estresse têm papel fundamental no aumento do uso de drogas entre os estudantes. OBJETIVO Realizar uma revisão sistemática da literatura sobre o uso de drogas, lícitas e ilícitas, em estudantes de medicina brasileiros. MÉTODOS Estudo de revisão de literatura, cuja fonte bibliográfica foram os portais de periódicos SciELO e Medline. No total, 99 artigos foram encontrados, dos quais 16 foram selecionados para esta revisão. RESULTADOS O álcool e o tabaco foram as drogas mais consumidas por estudantes de medicina. Dentre as drogas ilícitas, as mais frequentemente utilizadas incluem maconha, solventes, lança-perfume e ansiolíticos. O sexo masculino apresentou maior proporção de consumo de todos os tipos de drogas, com exceção de tranquilizantes. Foi encontrado um aumento da prevalência de consumo de drogas ao longo do curso de medicina, o que pode ser resultante do estresse próprio das atividades do curso. Estudantes que fazem menos uso de substâncias psicoativas tendem a viver com os pais, não possuir vínculos próximos com usuários de drogas, desaprovar o consumo de drogas, possuir e praticar crenças religiosas e trabalhar. CONCLUSÃO A prevalência de consumo de drogas lícitas e ilícitas entre estudantes de medicina é alta, mesmo eles tendo conhecimento sobre os malefícios que o uso pode causar.

Metástasis ileal de melanoma de origen desconocido / Ileal metastasis from melanoma of unknown origin

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