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Surgery for breast cancer has changed in the last few decades in favor of more conservative approaches, without compromising loco‐regional control and survival. Common immediate complications fol ‐lowing breast surgery are hematoma, seroma, and wound infection.1Traditionally, surgeons have implemented the use of closed‐suction drains in this setting with the aim of preventing these complications, which can cause discomfort, morbidity, increased follow‐up visits,and possible delay in the beginning of adjuvant therapies.2 On the other hand, potential benefits of performing breast procedures without using a drain have been increasingly considered.3 There is lack of modern and official guidelines on use of drains in breast sur ‐gery, with no consensus regarding their management and the appro‐priate use of antibiotics in this setting. Almost all reports agree withthe use of drains after breast procedures, especially if they are asso‐ciated with reconstruction or axillar lymph node dissection (ALND), but an extreme variability is reported regarding practice patterns.4A national survey regarding the management of drains afterbreast cancer surgery was sent by email on January 2018 to all Breast Centers (BC) registered with Senonetwork Italia. Data col ‐lected by the administrative office of Senonetwork were de‐iden‐tified and exported for statistical analysis. A Steering Committeecomposed of general surgeons and plastic surgeons was appointedto coordinate the survey, which consisted of 22 multiple choicequestions, designed to inquire about surgeons' demographics, use of drains after breast procedures with and without reconstructionand/or ALND, antibiotic use and to characterize drain managementin their clinical practice.

As we prepare to emerge from an extensive and unprecedented lockdown period, due to the COVID-19 virus infection that hit the Northern regions of Italy with the Europe&rsquo, s highest death toll, it becomes clear that what has gone wrong rests upon a combination of demographic, healthcare, political, business, organizational, and climatic factors that are out of our scientific scope. Nonetheless, looking at this problem from a patient&rsquo, s perspective, it is indisputable that risk factors, considered as associated with the development of the virus disease, include older age, history of smoking, hypertension and heart disease. While several studies have already shown that many of these diseases can also be favored by a protracted exposure to air pollution, there has been recently an insurgence of negative commentary against authors who have correlated the fatal consequences of COVID-19 (also) to the exposition of specific air pollutants. Well aware that understanding the real connection between the spread of this fatal virus and air pollutants would require many other investigations at a level appropriate to the scale of this phenomenon (e.g., biological, chemical, and physical), we propose the results of a study, where a series of the measures of the daily values of PM2.5, PM10, and NO2 were considered over time, while the Granger causality statistical hypothesis test was used for determining the presence of a possible correlation with the series of the new daily COVID19 infections, in the period February&ndash, April 2020, in Emilia-Romagna. Results taken both before and after the governmental lockdown decisions show a clear correlation, although strictly seen from a Granger causality perspective. Moving beyond the relevance of our results towards the real extent of such a correlation, our scientific efforts aim at reinvigorating the debate on a relevant case, that should not remain unsolved or no longer investigated.

Purpose: To assess the contribution of Italian radiation oncologists in the current management of recurrent high-grade gliomas (HGG), focusing on a reirradiation (reRT) approach. Methods: In 2015, the Reirradiation and the Central Nervous System Study Groups on behalf of the Italian Association of Radiation Oncology (AIRO) proposed a survey. All Italian radiation oncologists were individually invited to complete an online questionnaire regarding their clinical management of recurrent HGG, focusing on a reRT approach. Results: A total of 37 of 210 questionnaires were returned (18% of all centers): 16 (43%) from nonacademic hospitals, 14 (38%) from academic hospitals, 5 (13%) from private institutions, and 2 (6%) from hadron therapy centers. The majority of responding centers (59%) treated ≤5 cases per year. Performance status at the time of recurrence, along with a target diameter Conclusions: Although there were wide variations in the clinical practice of reRT across the 37 centers, the core activities were reasonably consistent. These findings provide a basis for encouraging a national collaborative study to develop, implement, and monitor the use of reRT in this challenging clinical setting.

Objective: Different perfusion metrics were investigated to determine the accuracy of Perfusion CT (PCT) in differentiating recurrence of brain metastases from radiation necrosis in patients who previously underwent stereotactic radiation therapy (SRT). Patients and Methods: Twenty patients previously treated with SRT underwent PCT examination of the brain. Normalized Cerebral Blood Volume (nCBV) values within the region of interest (ROI) were calculated. Fractional volumes at nCBV values between 1.0 and 2.25, defined as V 1.0-V 2.25, were derived as alternative metrics and compared to the conventional method based on the mean CBV value within the lesion (nCBV mean). The Mann-Whitney test was used to compare the two patient's groups with recurrence and radiation necrosis with respect to the different nCBV metrics. Predictive powers and optimal thresholds for both the nCBV mean and the V 1.0-V 2.25 were evaluated using the Receiver Operating Characteristic Curves. The gold standard was represented either by the histopathological examination or the Magnetic Resonance (MR) imaging follow-up longer than six months. Results and Conclusion: The differences between the patient's group with recurrence and that with radiation necrosis resulted statistically significant for all the metrics, showing the lowest p-value for V 1.75 and V 2. The metrics based on the fractional volumes were found to show higher predictive powers, with the highest value of 0.96 for V 2.0. Quantitative analysis of the CBV map deriving different metrics may potentially improve the diagnostic accuracy of PCT in differentiating brain metastasis recurrence from radiation necrosis. © 2011 Elsevier Ireland Ltd. All rights reserved

To report on the clinical outcome of hypofractionated conformal radiotherapy (HCRT) for medically inoperable stage I non-small cell lung carcinoma (NSCLC) or limited pulmonary metastases/= 5 cm in diameter.: From June 2003 to March 2007, 40 patients (42 lesions) underwent HCRT consisting of 40 Gy in five fractions over 2.5 weeks received by at least 95% of planning target volume. All patients underwent CT simulation and treatment under free shallow breathing. To evaluate target displacement under respiratory activity, two additional CT scans were performed with breath-holding during the expiratory and inspiratory phases. Of all patients enrolled, those with a follow-upor = 4 months were considered suitable for analysis. Local response was evaluated with CT imaging 4 months after the end of HCRT and every 3 months thereafter. Local relapse-free survival (LRFS) and overall survival (OS) were calculated with the Kaplan-Meier method.: Local response to the treatment was complete response, partial response, no change, and progressive disease as seen in 29%, 43%, 14%, and 7% of tumors, respectively. LRFS at 1 year and 3 years was 76% and 63%, respectively. Lung toxicitiesor = grade 2 were observed in 4/40 patients, but no grade 4. Pericardial effusion occurred in one patient. In stage I NSCLC patients (n = 15) with a median follow-up of 25 months, the 1-year LRFS and OS rates were 88% and 81%, respectively, and the 3-year rates 72% and 61%, respectively.: HCRT is an effective and low-toxic treatment for medically inoperable early-stage lung cancers and pulmonary metastases for all clinicians lacking the aid of a dedicated stereotactic system.

Il contributo si svolge a partire dalla intuizione dello pseudo-Dionigi Areopagita circa la salvezza dal nulla offerta a quanti sono "ontos onta": non le cose, ma i pensanti. Inoltre, pone la questione del senso metafisico della "Lux" e della sua originaria regalità.