The accuracy of sentinel lymph-node biopsy in breast cancer after previous excisional biopsy

Scopo: La biopsia del linfonodo sentinella (BLS) nel carcinoma della mammella con linfonodi ascellari clinicamente negativi \ue8 considerato la migliore scelta per stadiare il cavo ascellare. Inizialmente una precedente biopsia escissionale del carcinoma era considerata una controindicazione. Esaminiamo il tasso di successo della BLS e la incidenza della recidiva a livello ascellare in pazienti con carcinoma della mammella precedentemente sottoposti a biopsia escissionale del tumore. Pazienti e metodi: 858 pazienti con carcinoma della mammella sono stati sottoposti a BLS e i pazienti con linfonodi sentinella metastatici a svuotamento del cavo ascellare; 82 pazienti erano stati sottoposti precedentemente a biopsia escissionale del tumore. Risultati: Il linfonodo sentinella \ue8 stato identificato nel 100% dei casi, \ue8 risultato indenne nel 74,4% e metastatico nel 23,1%. La dissezione del cavo ascellare \ue8 stata effettuata in tutti i casi con linfonodi sentinella metastatici e nel 74% dei casi non si sono ritrovati altri linfonodi ascellari metastatici. Il follow-up mediano \ue8 stato di 63,5 mesi e non si sono osservate recidive ascellari. Conclusioni: L\u2019accuratezza del BLS in pazienti con carcinoma della mammella sottoposte precedentemente a biopsia escissionale \ue8 uguale a quella dei pazienti non sottoposti a biopsia.Aim: Sentinel node biopsy (SLNB) is considered to be the standard of care for staging the axilla in clinically node-negative women with breast cancer. A previous breast excisional biopsy has been considered a contraindication to the use of SLNB.We examined the success rate of SLN localization and then the evaluation of the incidence of axillary relapse in patients with breast cancer undergoing excisional biopsy. Patients and Methods: 858 patients with breast carcinoma underwent a SLNB and only positive sentinel nodes were submitted to axillary dissection; 82 patients had undergone an excisional biopsy before. Results: The sentinel node was identified in 100% of cases, it was negative in 74.4% and positive in 23.1%. Complete axillary dissection was performed in all positive cases, and in 74% of cases no other positive nodes were found. The follow-up median was 63.5 months and no axillary recurrence was observed. Conclusions: SLNB accuracy in breast cancer patients who have previously undergone excisional biopsy is comparable with that in patients undergoing no excisional biopsy, so that it may be considered a standard procedure

A probabilistic approach to stormwater runoff control through permeable pavements beneath urban trees

: One of the most current and urgent challenges is making cities sustainable and resilient to climate change. From this perspective, Nature-Based Solutions (NBSs) are well-recognized strategies for stormwater control and water cycle restoration. Urban trees are an example of NBS. However, the high degree of soil sealing typically found in urban environments limits natural processes such as infiltration and hinders the water and nutrient supply for proper root development, which weakens tree stability. Permeable pavements at the base of urban trees, on the one hand, facilitate infiltration, which helps runoff control, and on the other hand, improve stormwater retention and soil humidity, which enhance root feeding. This paper proposes an analytical-probabilistic approach to estimate the contribution of permeable pavements to stormwater management. The equations developed in this study relate the runoff probability to the storage volume, the infiltration rate into the underlying soil, and the average values of the hydrological variables in the input. The model allows us to select different runoff thresholds and considers the possibility that residual volume from previous rainfall events prefills the storage capacity. An application to a case study in Sao Paulo (Brazil) has been presented. It investigates the influence of the different parameters used in the model on the results. The comparison of the outcomes obtained using the developed equations with those obtained from the continuous simulation of measured data confirmed the effectiveness of the proposed analytical-probabilistic approach and the suitability of using permeable pavements at the base of urban trees for improving stormwater retention

Molecular characterization of the autochthonous grape cultivars of the region Friuli Venezia Giulia – North-Eastern Italy

A sample of 48 accessions belonging to important autochthonous grapevine varieties from Friuli Venezia Giulia (North-Eastern Italy) was analyzed using two sets of microsatellite markers. One marker set, based on di-nucleotide core repeats, was compared with a recently developed set of markers based on tri-, tetra-, and penta-nucleotide repeats in order to determine genetic identities, estimate genetic diversity, and establish the power of discrimination of the two sets. A total of 20 di-nucleotide SSR markers and 19 tri-, tetra-, and penta-nucleotide SSR markers were used to screen the accessions.All 39 primers produced PCR amplicons that were polymorphic and easily scorable in all of the accessions studied. Both datasets allowed the discrimination of all cultivars but two ('Refosco di Runcis' and 'Refoscone'). The observed heterozygosity ranged from 0.21 to 1.0 for the di-nucleotide markers, and from 0.21 to 0.88 for the tri-, tetra-, and penta-nucleotide repeat motif microsatellites, respectively.The population structure of the 48 autochthonous accessions was evaluated, together with 8 international cultivars included as references, providing evidence for significant population structure within the sample. Microsatellites composed of tri-, tetra-, and penta-nucleotide repeats, characterized by low ‘stuttering’ and larger relative size differences between incremental alleles, are now available for grape fingerprinting.

Borderline personality in patients with poly-diagnoses treated for a Bipolar Disorder

Some patients with dysphoria, explosive behaviour, or suicidal ideation, may receive a diagnosis of, and treatment for Bipolar Disorder (BD) and, not infrequently. The coexistence of these two diagnoses has been explained in different ways. Some authors include the BPD in the bipolar spectrum; others are sceptical about the existence of real comorbidity, suggesting a misdiagnosis. This study aimed to assess the personality of this group of poly-diagnosed patients (PolyD) and hypothesised they had a pathological borderline organisation. Via the administration of the Schedler Westen Assessment Procedure (SWAP-200), we compared PolyD patients with those suffering from BPD or BD only. We performed two different MANCOVAs to test PolyD, BPD and BD patients' differences in PD-factors, Q-traits and age. The sample comprised 45 patients (Mean age=43.3, SD=15.7; Females 57.7%, N=26). BD patients (N=15) did not present any personality disorder, they had a higher functioning and Obsessive Q-traits, and a lower Histrionic PD-factor than both PolyD (N=20) and BPD (N=10) patients. Compared to PolyD patients, BD had inferior PD-Borderline, PD-Antisocial factor and Dependent-Masochistic Q-traits, but there were no other differences with BPD patients. PolyD did not differ from BPD patients in any of the PD-factors and Q-traits. Our results suggest that PolyD patients are different from BD patients and propose to consider the pathological borderline personality as a central core of their disease

A new in situ test for the assessment of the rock-burst alarm threshold during tunnelling

Rock-burst is one of the most serious risks associated with hard rock tunnelling and mining at high depths. Monitoring of acoustic emissions emitted by the rock-mass during excavation and their interpretation now permits the early assessment of failure events and makes the safe management of the construction works possible. A reliable set-up of the alarm threshold is thus fundamental for the correct implementation of the procedures planned to minimise rock-burst related risk. This paper focuses on a novel in situ test specifically developed to provide an experimental basis for a more accurate assessment of the alarm threshold during tunnelling, representative of the local geomechanical conditions. The test, thanks to the compression induced by two flat jacks at the tunnel side wall, produces an artificial failure process during which acoustic emissions are measured and correlated to the mechanical response of the rock-mass, without the typical limitations of scale that characterised the laboratory experiments. The new methodology, named the Mules method, was successfully tested during the excavation of some stretches of the Brenner Base Tunnel in the Brixner granite, affected by mild spalling episodes. The case-history is fully described in the paper to illustrate the practical application of the proposed approach

1-Phenyl-3-azabicyclo[3.1.0]hexane derivatives as new ligands for sigma receptors

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ILEUS FOLLOWING SPONTANEOUS JEJUNUM INTRAMURAL HEMATOMA: CASE REPORT AND REVIEW OF THE LITERATURE

Anticoagulant therapy may cause the onset of a spontaneous intramural hema- toma of the small bowel, in the jejunum, ileum or duodenum. A 53-year-old woman on therapy with heparin for previous pulmonary embolism was admitted for abdominal pain and vomit. Computed tomography scan visualized an intramural hematoma of the jejunum causing subtotal obstruction of the intestinal lumen. The patient underwent resection of a part of the jejunum, securing intestinal continuity by a mechanical side-to-side anastomosis. The postoperative course was regular, but the initial anticoagulant therapy was reduced to prevent recurrence. In conclusion, spontaneous hema- toma of small bowel can occur as a complication of anticoagulant therapy. The clinical picture and rapid diagnosis indicate medical or surgical therapy

Proteomic profiling of 13 paired ductal infiltrating breast carcinomas and non-tumoral adjacent counterparts.

According to recent statistics, breast cancer remains one of the leading causes of death among women in Western countries. Breast cancer is a complex and heterogeneous disease, presently classified into several subtypes according to their cellular origin. Among breast cancer histotypes, infiltrating ductal carcinoma represents the most common and potentially aggressive form. Despite the current progress achieved in early cancer detection and treatment, including the new generation of molecular therapies, there is still need for identification of multiparametric biomarkers capable of discriminating between cancer subtypes and predicting cancer progression for personalized therapies. One established step in this direction is the proteomic strategy, expected to provide enough information on breast cancer profiling. To this aim, in the present study we analyzed 13 breast cancer tissues and their matched non-tumoral tissues by 2-DE. Collectively, we identified 51 protein spots, corresponding to 34 differentially expressed proteins, which may represent promising candidate biomarkers for molecular-based diagnosis of breast cancer and for pattern discovery. The relevance of these proteins as factors contributing to breast carcinogenesis is discussed