A rare case of true carcinosarcoma of the breast

AbstractBackgroundTrue carcinosarcoma of the breast is an extremely rare condition, accounting for 0.08–0.2% of all breast malignancies.The correct definition of this tumor requires both a carcinomatous component and a malignant non-epithelial component of mesenchymal origin, without evidence of a transition zone between the two elements.Case presentationWe present a case of a 49-year-old woman presenting with a 4cm mass at the level of her left breast upper-outer quadrant with a histologic diagnosis of true carcinosarcoma of the breast.DiscussionThe most appropriate therapeutic regimens for breast carcinosarcoma are still unclear because of the rarity of this condition, but Breast Conserving Treatment (BCT) followed by adjuvant chemotherapy seems to provide a prognosis equalling that of usual Invasive Ductal Carcinoma of the breast

Rebound Tonometry in Cataract Surgery: Comparison with Goldmann Applanation Tonometry

Purpose: to compare the rebound tonometer ICare\uae (RT) with the Goldmann applanation tonometer (GAT) in cataract surgery and to assess the influence of central corneal thickness (CCT) on intraocular pressure (IOP) measurements. Design: retrospective, comparative study. Methods: a total of 472 patients underwent IOP measurement using RT (time 0 = RTa). GAT IOP measurement was performed 5 minutes later, followed by a second RT IOP measurement after other 5 minutes (RTa + 10 min = RTb). CCT was obtained by ultrasound pachymetry. In 106 patients IOP was measured by means of RT and GAT before clear corneal cataract surgery (RT1 and GAT1) and at one day postoperatively (RT2 and GAT2). Results: RT IOP values > 5 mmHg were overestimated, while RT IOP values < 15 mmHg were underestimated. Every 100 \ub5m of CCT an increase of 0.97 mmHg and 0.33 mmHg was found for RT and GAT respectively. The difference between RT1 and RT2, GAT1 and GAT2, RT1 and GAT1 was not statistically significant; while the difference between RT2 and GAT2 was statistically significant (p < 0.04). The difference between RTa and RTb was not statistically significant whereas the difference between RTa and GAT and RTb and GAT was statistically significant (p < 0.001). Conclusion: our results showed a good agreement between measurements obtained with RT and GAT in pre and postoperative cataract surgery, although a significant statistically difference was found between RT and GAT measurements performed postoperatively. Moreover, CCT is a parameter to be considered for the IOP measurement, especially for values obtained with RT

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Digitization and energy transition of the built environment - Redefining models of use in zero energy management of real estate assets

Thousands of years of progress in urban development led to complex urban environments that can be considered as complex systems. The management of complex systems must account for uncertainty, unpredictable future states and nonlinear behaviour. In this context, digitalisation can play a key role in the development of innovative tools to support strategic decisions and emergency management. In particular, the management of university building stocks can be facilitated with the creation of digital environments. In the Italian case, university campuses are often complex assets composed of widespread buildings and the management process is still based on fragmented databases handled by different administrative divisions resulting in a lack of information among stakeholders. The integration between Building Information Modeling (BIM) and Geographic Information System (GIS) is already making some steps towards the creation of a digital model of the city. The combination of BIM-GIS with a platform for the data management is the base to develop an Asset Management System to exploit Business Intelligence (BI) tools for Operation and Maintenance (O&amp;M) in smart campuses. This research aims to integrate BIM, GIS and BI tools in a digital framework for the development of an AMS and web-based application for the improvement of the experience among users and the optimal use of resources. A real case study is proposed for the development of the research project, namely the University of Turin building stock, in Italy