Disaster coordination and management: summary and action plans.

INTRODUCTION: Disaster is a collective responsibility requiring coordinated response from all parts of society. This theme focused on coordination and management issues in a diverse range of scenarios. METHODS: Details of the methods used are provided in the preceding paper. The chairs moderated all presentations and produced a summary that was presented to an assembly of all of the delegates. Although the main points developed in Themes 1 and 4 were different from each other (as reported in the Results section), their implementation was similar. Therefore, the chairs of both groups presided over one workshop that resulted in the generation of a set of Action Plans that then were reported to the collective group of all delegates. RESULTS: The main points developed during the presentations and discussions included: (1) the need for evidence-based assessments and planning, (2) the need for a shift in focus to health-sector readiness, (3) empowerment of survivors, (4) provision of relief for the caregivers, (5) address the incentives and disincentives to attain readiness, (6) engage in joint preparation, response, and training, (7) focus on prevention and mitigation of the damage from events, and (8) improve media relations. There exists a need for institutionalization of processes for learning from experiences obtained from disasters. DISCUSSION: Action plans presented include: (1) creation of an Information and Data Clearinghouse on Disaster Management, (2) identification of incentives and disincentives for readiness and develop strategies and interventions, and (3) act on lessons learned from evidence-based research and practical experience. CONCLUSIONS: There is an urgent need to proactively establish coordination and management procedures in advance of any crisis. A number of important insights for improvement in coordination and management during disasters emerged.

[Rare association of a mixed tumor of the skin with a carcinoma of low grade malignancy. Clinical case]. / Rara associazione di un tumore misto della cute con un carcinoma a basso grado di malignità. Caso clinico.

Chondroid syringoma, previously called mixed tumor of the skin is a fairly uncommon type of sweat gland tumor, most often diagnosed in the sixth and seventh decade of life. It presents as a well encapsulated dermal or subcutaneous module and it is most frequently found in the skin of the head and neck. The neoplasm is asymptomatic and is featured by a slow rate of growth. At histopathological examination, the tumor consists of an epithelial component, with glandular or ductal differentiation, either eccrine or apocrine, and a stromal component with myxoid or chondroid elements. Surgical removal is the treatment of choice and recurrence may occur. Malignant chondroid syringoma has been reported rarely, most frequently arising in previously benign lesions. They behave as lethal tumors and often metastasize to the regional lymph nodes and lung. We report a most unusual case of a mixed tumor of the skin localized in the sacral area associated with a peripheral low grade malignant component of the adenocystic type. Association of these two types of sweat gland tumors has never been previously described, to our knowledge.