Performing Advanced Trauma Life Support (ATLS) across Borders: Midterm Follow-Up of the Aeromedical Evacuation after Civilian Bus Accident at Madeira.

On 17 April 2019, a coach with tourists from Germany crashed in Madeira, requiring repatriation by the German Air Force. The Advanced Trauma Life Support (ATLS) concept was the central component of patient care. Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany, all available medical data sheets were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short Form Health Survey (SF-12). Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany, in total 82 radiological images and 9 operations were performed. Hospital stay lasted 11 days (median, IQR 10-18). Median follow-up (14 of 15 patients) was 16 months (IQR 16-21). Eighty percent (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, and media coverage. Those findings may improve AE missions in the future, e.g., when required after armed conflicts.

Projeto de monitoria do laboratório de habilidades médicas do departamento de ginecologia e obstetrícia do curso de medicina do Centro Universitário Padre Albino / Monitoring project of the laboratory of medical skills of the department of gynecology and obstetrics of the medicine course of the Centro Universitário Padre Albino / Proyecto de monitoría del laboratorio de habilidades médicas del departamento de ginecología y obstetrícia del curso de medicina del Centro Universitario Padre Albino

Introdução: O projeto de Monitoria do Laboratório de Habilidades em Emergências Médicas da disciplina de Ginecologia e Obstetrícia visa propiciar uma formação acadêmica mais ampla e aprofundada ao aluno universitário, incentivar o estudante para o interesse à docência e à pesquisa; além de possibilitar uma maior integração dos segmentos da instituição. Alternativa de apoio pedagógico é atividade antecipatória das práticas de treinamento de habilidades com o paciente, preparando o estudante para o exercício técnico e intelectual de sua futura profissão, pautado nos preceitos da bioética...(AU)

Introduction: The Monitoring Project of the Laboratory of Medical Emergency Skills of the discipline of Gynecology and Obstetrics aims to provide a broader and deeper academic education to the university student, to encourage the student for the interest of teaching and research; besides enabling a greater integration of the institution's segments. Alternative pedagogical support is anticipatory activity of skills training practices with the patient, preparing the student for the technical and intellectual exercise of his future profession, based on the precepts of bioethics ... (AU)

Introducción: El Proyecto de Monitoreo del Laboratorio de Habilidades de Emergencia Médica de la disciplina de Ginecología y Obstetricia tiene como objetivo proporcionar una educación académica más amplia y profunda al estudiante universitario, para alentar al estudiante a interesar la enseñanza y la investigación; además de permitir una mayor integración de los segmentos de la institución. El apoyo pedagógico alternativo es la actividad anticipatoria de las prácticas de capacitación de habilidades con el paciente, preparando al estudiante para el ejercicio técnico e intelectual de su futura profesión, basado en los preceptos de la bioética ... (AU)

Cutaneous leiomyosarcoma on the trunk.

Cutaneous leiomyosarcoma is a relatively uncommon tumor that accounts for 7% of all soft tissue sarcomas. It occurs more frequently in males between 50-70 years and only 10-15% of cases are located on the trunk. Radiotherapy and previous trauma have been implied as risk factors. We report the case of a 57 year-old male with an eight-month history of a hard painless erythematous-violaceous tumor on the presternal region. Histopathology evidenced a malignant spindle cell tumor, "cigar" shaped, with pleomorphic nuclei and a high mitotic index that occupied the entire dermal thickness. Immunohistochemical staining of the tumor cells was positive for smooth muscle actin, desmin and vimentin and negative for S-100 protein and pan-cytokeratin, which supported the diagnosis of dermal leiomyosarcoma. Radical surgery was performed to remove the tumor.

Leiomiossarcoma cutâneo no tronco / Cutaneous leiomyosarcoma on the trunk

O Leiomiossarcoma cutâneo é um tumor maligno que representa 7 por cento dos sarcomas dos tecidos moles, afetando, mais frequentemente, homens entre os 50-70 anos. A localização, no tronco, é atípica, constituindo 10 a 15 por cento dos casos. A radioterapia e o traumatismo prévio têm sido referidos como fatores de risco. Descrevemos um homem de 57 anos, com tumor eritemato-violáceo, indolor, de consistência dura, localizado na região pré-esternal, com cerca de oito meses de evolução. A histopatologia evidenciou tumor maligno de células fusiformes, com núcleos em forma de "charuto", pleomórficos, com alto índice mitótico, ocupando toda a espessura da derme. Estas células expressaram actina do músculo liso, desmina e vimentina e foram negativas para proteína S-100 e pancitoqueratina. Foi efetuada a exérese cirúrgica radical do tumor.

Cutaneous leiomyosarcoma is a relatively uncommon tumor that accounts for 7 percent of all soft tissue sarcomas. It occurs more frequently in males between 50-70 years and only 10-15 percent of cases are located on the trunk. Radiotherapy and previous trauma have been implied as risk factors. We report the case of a 57 year-old male with an eight-month history of a hard painless erythematous-violaceous tumor on the presternal region. Histopathology evidenced a malignant spindle cell tumor, "cigar" shaped, with pleomorphic nuclei and a high mitotic index that occupied the entire dermal thickness. Immunohistochemical staining of the tumor cells was positive for smooth muscle actin, desmin and vimentin and negative for S-100 protein and pan-cytokeratin, which supported the diagnosis of dermal leiomyosarcoma. Radical surgery was performed to remove the tumor.

Erythema multiforme on exposed and non-exposed skin following polymorphic light eruption: a case report.

We report a 35-year-old caucasian female with a history of polymorphic light eruption (PLE) who, after the outbreak of pruritic papules following the first sun exposure of the year, developed target lesions in two different bouts, the first on sun-exposed skin and the second on sun-protected sites. A diagnosis of erythema multiforme (EM) developing as a result of PLE was made. As far as we were able to search in the literature, EM occurring in two bouts has not been described previously. We discuss the differential diagnosis.