ObjectivesTo survey medical students on their ideas of future work-life balance and discuss topics for next-generation medical education. MethodsFirst-year (n=372, 34.9% female) and sixth-year medical students (n=311, 44.1% female) responded to a questionnaire on future self, marriage and childcare, and gender differences at the workplace. Responses were compared between academic years and gender. Responses were evaluated by gender and academic year using the Mann-Whitney U test.  Significance was set at p<0.01. ResultsThe first-year and sixth-year students, regardless of gender, had different views on gender-related favorable treatment at workplaces {U=13464, p=0.000 (first-year), U=10407, p=0.000 (sixth-year)}. A greater percentage of female students would choose career options based on the possibility of marriage and childbirth {U=10689, p=0.000 (first-year), U=10930, p=0.000 (sixth-year)}. Among first-year students, a greater percentage of female students expected to work part-time. Also among first-year students, greater percentages of female students expected to work part-time or leave their jobs temporarily while raising their children. Compared with first-year male students, first-year female students expected to undertake larger portions of the childcare and housework burden than their partners. However, gender differences in work-life balance and childcare leave vanished in the sixth-year students. ConclusionsFemale medical students accepted childcare and housework burdens as inevitable; the work environment they choose might affect their career development. While support from male partners and institutions must be increased, voluntary actions and change in mentality of female students need to be promoted through medical education to prevent them from waiting passively for the situation to change.

RESUMO: Os traumas sobre a coluna resultantes de projetil de arma de fogo (PAF) são lesões geralmente graves e muitas vezes com baixo potencial para recuperação neurológica. A indicação cirúrgica destas lesões ainda é motivo de controvérsia. O objetivo deste artigo é identificar fatores no pré e trans-operatório que irão influenciar na recuperação neurológica destes pacientes. Realizamos estudo retrospectivo de 45 pacientes submetidos a laminectomia para trauma raquimedular por PAF, avaliando os seguintes fatores: nível da lesão, apresentação clínica, uso de glicocorticóide no pré-operatório, presença de lesão dural, momento cirúrgico e relação entre escala de Frankel pré e pós-operatória. Observamos que os fatores mais importantes para a recuperação neurológica foram o nível da lesão (53% dos pacientes com lesão lombar melhoraram após a cirurgia) e a apresentação clínica pré-operatória (pacientes com síndrome de cauda equina obtiveram melhora em 60% dos casos), sendo que as demais variáveis não apresentaram significância estatística. Em 71% dos casos, a dor pré-operatória foi aliviada com o procedimento cirúrgico. PALAVRAS-CHAVE: trauma raquimedular, projetil de arma de fogo, prognóstico.Prognostic factors related to gunshot wounds to the spine in patients submited to laminectomy ABSTRACT -The spinal trauma related to civilian gunshot missile still remains a serious neurological event that carries a dismal prognosis almost in all cases. Its surgical indication also is a mather of discution. Our goal is to identify the aspects that could influence the prognosis after surgery to this kind of lesions. We conducted a retrospective study of 45 consecutive patients submitted to laminectomy at Hospital de Base do Distrito Federal (Brasília, Brazil), testing the following aspects: initial neurological status, level of the deficit, surgical timing, use of methilprednisolone and presence of dural tearing. Among those, the initial clinical presentation and the level of the lesion (60% of the patients with cauda equina syndrome and 53% of that with lesions in the lombar region improved their neurological status after laminectomy) were the most important factors affecting the outcome. Seventy percent of the patients experienced a pain relief after the surgical procedure.KEY-WORDS: spinal trauma, gunshot wound, prognosis.O traumatismo raquimedular (TRM) penetrante, seja ele provocado por projetil de arma de fogo (PAF) ou objetos perfurantes constitui lesão grave e geralmente associada a mau prognóstico neurológico 1 . Quando um projetil atinge a coluna vertebral provoca lesões primárias devido ao trauma mecânico direto e trauma térmico sobre as estruturas neurais e vasculares. Posteriormente pode desencadear lesões secundárias, tanto por alterações isquêmicas como hiperêmicas sobre o

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Background: The effect of second-line chemotherapy in patients with non-small cell lung cancer (NSCLC) who received first-line chemotherapy at the age of ≥ 75 years is unclear.

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