Sentinel node biopsy for breast cancer: is it already a standard of care? A survey of current practice in an Italian region

BACKGROUND: Although sentinel node biopsy (SNB) is becoming the standard approach for axillary staging in patients with small breast cancer, criteria for patient selection and some technical aspects of the procedure have yet to be clearly defined. The aim of the present survey was therefore to investigate the way in which SNB is used by general surgeons working in the Veneto region, Italy. METHODS: A 29-item questionnaire regarding various aspects of SNB practice was mailed to surgeons in charge of breast surgery in all the 56 surgical centres of the region. RESULTS: The rate of response to the questionnaire was 82.1% (n = 46); 69.6% (n = 32) of the respondents routinely perform SNB in their clinical practice. Most of the interviewed surgeons (93.5%) expressed the belief that the acceptable false negative rate should be ≤5%. However, among the surgeons who perform SNB, only 34.4% performed more than 20 SNB during the learning phase. Indications are limited to tumours of ≤1 cm by 31.2% (n = 10) of respondents, ≤2 cm by 46.9% (n = 15) and ≤3 cm by 21.9% (n = 7). Almost all respondents (93.7%) agreed that a clinically positive axilla is a contraindication to SNB, while opinions differed widely concerning other potential contraindications. In most of the centres considered, SN identification is undertaken on the day before surgery using a subdermal injection of 30–50 MBq of 99mTc-albumin-nanocolloid followed by lymphoscintigraphy. CONCLUSIONS: SNB is currently performed in the majority of hospitals in the Veneto region. However, the training phase and criteria used for patient selection differ from centre to centre. Certified training courses and shared guidelines are therefore highly desirable

Verso un'economia a basso impatto ambientale: una nuova sfida anche per l'agricoltura locale?

CARBON.CARE nasce all’interno di un programma comunitario più ampio, ovvero il progetto Lo.Ca.Re, finanziato dal Fondo Europeo di Sviluppo Regionale attraverso il Programma INTERREG IVC, nel corso del quale sei Regioni europee hanno unito le proprie forze per realizzare una iniziativa comune volta a ridurre le emissioni di CO2 nei propri territori. La comparazione di diverse modalità di gestione agronomica e forestale per giungere a tecniche più efficaci di fissazione del carbonio è stato il cuore pulsante delle iniziative intraprese dai tre partner nelle tre aree di progetto. A seguito dei risultati raggiunti dalle analisi effettuate nella provincia di Ferrara, questa pubblicazione esprime alcune riflessioni di carattere tecnico-scientifico sull’opportunità e sui vantaggi potenziali derivanti dall’effettiva applicazione di modelli energetici a basso impatto di CO2 su scala regionale nel settore primario

Ground Source Heat Pumps. An overview on the potential in Adriatic area and the Balkans

The Handbook resumes all the activities developed within LEGEND Project in the framework of low enthalpy geothermal applications to existent public buildings in the Adriatic area. The activities have focused on many different aspects, such as geological and geotheraml potential, awareness raising, supply chain, environmental life cycle aspects and administrative barriers. The volume has been presented at LEGEND Final Conference, held in Ferrara on December 12th, 2014

How to boost shallow geothermal energy exploitation in the adriatic area: The LEGEND project experience

The evaluation, monitoring and reduction of the heating and cooling consumptions are topics of increasing importance. One promising technology is the geothermal heat pump. Despite its undoubted advantages compared to fossil fuels in terms of RES production, CO2 reduction and primary energy savings, there are still significant barriers for the creation of sustainable local markets. Many regions present similar conditions in terms of climate, geology, hydrogeology, infrastructure and political conditions. Because of the context-driven nature of shallow geothermal systems, similarities should be taken into account and strategies shared across borders to foster the introduction and exploitation of shallow geothermal energy. Focusing on the results of the LEGEND Project, this paper presents an attempt at creating an interregional strategy for the widespread introduction of geothermal heat pumps in the Adriatic area, which includes EU and non-EU countries. The multi-level approach adopted (a combination of desk studies on the transferability potential, pilot plants across the regions and programs to involve, educate and train stakeholders) allowed to set up the strategy. Therefore, different actions are proposed to stimulate the development of the market, whose interconnection across the Adriatic can accelerate the achievement of the main energy and climate targets for all the countries involved