Sentinel Node Biopsy for Breast Cancer Patients: Issues for Discussion and Our Practice

Sentinel node biopsy has been established for several years now as a standard procedure of breast cancer surgery, but there are several variations of the indications and the technique used. This paper provides information regarding several issues of debate for its application as are the selection criteria, the application to patients with multifocal/multicentric breast cancer or DCIS, postneoadjuvant chemotherapy, the necessary number of nodes to be biopsied, the need for lymphoscintigraphy, the technique for frozen section, the factors that may predict nonsentinel nodes (NSNs) involvement, the value of micrometastasis and isolated tumour cells, the internal mammary chain sentinel nodes, and finally the axillary recurrence after SLNB. Our view for these issues is included together with our experience of 430 SLNBs

Reviewing 15 years of research on neoliberal conservation:towards a decolonial, interdisciplinary, intersectional and community-engaged research agenda

In this paper, we undertake an extensive review of the neoliberal conservation literature with the aim to explore and substantiate the principal ways in which conservation is neoliberalized in practice as well as who has studied these processes and through which collaborative patterns. Using descriptive statistics and thematic content analysis, we explore selected characteristics of the peer-reviewed scholarship, including most commonly used concepts, methods and topics, geographical and co-authorship patterns, critical readings of key processes of neoliberalization, including commodification, privatization, dispossession, governance rescaling, governmentalities, and its engagement with the economic crisis, austerity politics, and social struggles. Our analysis shows the breadth of the literature in unraveling the unequal social, spatial and environmental impacts of neoliberal conservation policies as well as a significant degree of novelty in terms of topics and theories. Nonetheless, it also unravels some key gaps, including a limited engagement with quantitative methods and community-engaged social sciences and humanities approaches, a lack of focus on urban areas and urbanization, some important gaps in the theorization of the commodification of nature, a domination of Global North scholarship that contradicts the clear empirical focus of the field on the Global South, a limited engagement with social movements and grassroots activism, and a conspicuous lack of attention to the dynamics of class, gender and race. We conclude by identifying key directions for future research to address current gaps in the literature, and initiate a shift towards a decolonial, interdisciplinary, intersectional, community-engaged approach and an in-depth encounter with everyday practices of resistance

Reviewing 15 years of research on neoliberal conservation: towards a decolonial, interdisciplinary, intersectional and community-engaged research agenda

In this paper, we undertake an extensive review of the neoliberal conservation literature with the aim to explore and substantiate the principal ways in which conservation is neoliberalized in practice as well as who has studied these processes and through which collaborative patterns. Using descriptive statistics and thematic content analysis, we explore selected characteristics of the peer-reviewed scholarship, including most commonly used concepts, methods and topics, geographical and co-authorship patterns, critical readings of key processes of neoliberalization, including commodification, privatization, dispossession, governance rescaling, governmentalities, and its engagement with the economic crisis, austerity politics, and social struggles. Our analysis shows the breadth of the literature in unraveling the unequal social, spatial and environmental impacts of neoliberal conservation policies as well as a significant degree of novelty in terms of topics and theories. Nonetheless, it also unravels some key gaps, including a limited engagement with quantitative methods and community-engaged social sciences and humanities approaches, a lack of focus on urban areas and urbanization, some important gaps in the theorization of the commodification of nature, a domination of Global North scholarship that contradicts the clear empirical focus of the field on the Global South, a limited engagement with social movements and grassroots activism, and a conspicuous lack of attention to the dynamics of class, gender and race. We conclude by identifying key directions for future research to address current gaps in the literature, and initiate a shift towards a decolonial, interdisciplinary, intersectional, community-engaged approach and an in-depth encounter with everyday practices of resistance

Trends of Bloodstream Infections in a University Greek Hospital during a Three-Year Period: Incidence of Multidrug-Resistant Bacteria and Seasonality in Gram-negative Predominance

The aim of the study was to assess the epidemiology, the incidence of multidrug-resistant bacteria and bloodstream infections’ (BSIs) seasonality in a university hospital. This retrospective study was carried out in the University General Hospital of Patras, Greece, during 2011–13 y. Blood cultures from patients with clinical presentation suggestive of bloodstream infection were performed by the BacT/ALERT System. Isolates were identified by Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the disk diffusion method and E-test. Resistance genes (mecA in staphylococci; vanA/vanB/vanC in enterococci; blaKPC/blaVIM/blaNDM in Klebsiella spp.) were detected by PCR. In total, 4607 (9.7%) blood cultures were positive from 47451 sets sent to Department of Microbiology, represent­ing 1732 BSIs. Gram-negative bacteria (52.3%) were the most commonly isolated, followed by Gram-positive (39.5%), fungi (6.6%) and anaerobes bacteria (1.8%). The highest contamination rate was observed among Gram-positive bacteria (42.3%). Among 330 CNS and 150 Staphylococcus aureus, 281 (85.2%) and 60 (40.0%) were mecA-positive, respectively. From 113 enterococci, eight were vanA, two vanB and two vanC-positives. Of the total 207 carbapenem-resistant Klebsiella pneumoniae (73.4%), 202 carried blaKPC, four blaKPC and blaVIM and one blaVIM. A significant increase in monthly BSIs’ incidence was shown (R2: 0.449), which may be attributed to a rise of Gram-positive BSIs (R2: 0.337). Gram-positive BSIs were less frequent in spring (P < 0.001), summer (P < 0.001), and autumn (P < 0.001), as compared to winter months, while Gram-negative bacteria (P < 0.001) and fungi (P < 0.001) were more frequent in summer months. BSIs due to methicillin resistant S. aureus and carbapenem-resistant Gram-negative bacteria increased during the study period. The increasing incidence of BSIs can be attributed to an increase of Gram-positive BSI incidence, even though Gram-negative bacteria remained the predominant ones. Seasonality may play a role in the predominance of Gram-negative’s BSI

Trends of Bloodstream Infections in a University Greek Hospital during a Three-Year Period: Incidence of Multidrug-Resistant Bacteria and Seasonality in Gram-negative Predominance

The aim of the study was to assess the epidemiology, the incidence of multidrug-resistant bacteria and bloodstream infections’ (BSIs) seasonality in a university hospital. This retrospective study was carried out in the University General Hospital of Patras, Greece, during 2011–13 y. Blood cultures from patients with clinical presentation suggestive of bloodstream infection were performed by the BacT/ALERT System. Isolates were identified by Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the disk diffusion method and E-test. Resistance genes (mecA in staphylococci; vanA/vanB/vanC in enterococci; blaKPC/blaVIM/blaNDM in Klebsiella spp.) were detected by PCR. In total, 4607 (9.7%) blood cultures were positive from 47451 sets sent to Department of Microbiology, represent­ing 1732 BSIs. Gram-negative bacteria (52.3%) were the most commonly isolated, followed by Gram-positive (39.5%), fungi (6.6%) and anaerobes bacteria (1.8%). The highest contamination rate was observed among Gram-positive bacteria (42.3%). Among 330 CNS and 150 Staphylococcus aureus, 281 (85.2%) and 60 (40.0%) were mecA-positive, respectively. From 113 enterococci, eight were vanA, two vanB and two vanC-positives. Of the total 207 carbapenem-resistant Klebsiella pneumoniae (73.4%), 202 carried blaKPC, four blaKPC and blaVIM and one blaVIM. A significant increase in monthly BSIs’ incidence was shown (R2: 0.449), which may be attributed to a rise of Gram-positive BSIs (R2: 0.337). Gram-positive BSIs were less frequent in spring (P < 0.001), summer (P < 0.001), and autumn (P < 0.001), as compared to winter months, while Gram-negative bacteria (P < 0.001) and fungi (P < 0.001) were more frequent in summer months. BSIs due to methicillin resistant S. aureus and carbapenem-resistant Gram-negative bacteria increased during the study period. The increasing incidence of BSIs can be attributed to an increase of Gram-positive BSI incidence, even though Gram-negative bacteria remained the predominant ones. Seasonality may play a role in the predominance of Gram-negative’s BSI

Πρόταση πολεοδομικής αναδιοργάνωσης: η περίπτωση της Κισσάμου

Μη διαθέσιμη περίληψηNot available summarizatio

Μετασχηματίζοντας βιομηχανικές γειτονιές: ο ρόλος των αναπλάσεων

Μη διαθέσιμη περίληψηNot available summarizationPresented on

Rationale and design of a prospective, observational, multicentre study on the safety and efficacy of apixaban for the prevention of thromboembolism in adults with congenital heart disease and atrial arrhythmias: the PROTECT-AR study

Introduction The risk for stroke in adults with congenital heart disease (ACHD) is increased, especially in the setting of commonly ensuing atrial arrhythmias (AA), namely atrial fibrillation, atrial flutter or intra-atrial re-entrant tachycardia. Data are limited regarding treatment with non-vitamin K oral anticoagulants in long-term studies involving patients with ACHD and AA.Methods and analysis PReventiOn of ThromboEmbolism in Adults with Congenital HearΤ disease and Atrial aRrhythmias is a prospective, multicenter, single-arm, non-interventional cohort study designed to investigate the safety and efficacy of apixaban for the prevention of thromboembolism in ACHD with AA in a ‘real-world’ setting. Eligible patients will be evaluated by the means of available registries and clinical counter. The study aims to accumulate approximately 500 patient-years of exposure to apixaban as part of routine care. Enrolment will take place at four ACHD centres in Greece. The first patient was enrolled in July 2019. The primary efficacy endpoint is a composite of stroke, systemic or pulmonary embolism and intracardiac thrombosis. The primary safety endpoint is major bleeding, according to the International Society on Thrombosis and Haemostasis bleeding criteria.Ethics and dissemination The study protocol has been approved by the institutional review board/independent ethics committee at each site prior to study commencement. All patients will provide written informed consent. Results will be disseminated at scientific meetings and published in peer-reviewed journals.Trial registration number NCT03854149; Pre-results