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Monitoramento Ambiental , Agricultura Florestal , Florestas , Monitoramento Ambiental/legislação & jurisprudência , Monitoramento Ambiental/métodos , Europa (Continente) , Árvores , Agricultura Florestal/métodos , Agricultura Florestal/organização & administração , Agricultura Florestal/tendênciasRESUMO
HERMES, a graphical user interface software tool, is presented, for pre-processing X-ray absorption spectroscopy (XAS) data from laboratory Rowland circle spectrometers, to meet the data handling needs of a growing community of practice. HERMES enables laboratory XAS data to be displayed for quality assessment, merging of data sets, polynomial fitting of smoothly varying data, and correction of data to the true energy scale and for dead-time and leakage effects. The software is written in Javaâ 15 programming language, and runs on major computer operating systems, with graphics implementation using the JFreeChart toolkit. HERMES is freely available and distributed under an open source licence.
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Laboratórios , Interface Usuário-Computador , Algoritmos , Software , Espectroscopia por Absorção de Raios XRESUMO
Bark beetle infestation is a major driver of tree mortality that may be critical for forest persistence under climate change and the forecasted increase of extreme heat and drought episodes. Under this context, the environmental position of host tree populations within the species' climatic niche (central vs. marginal populations) is expected to be a determinant in the dynamics of insect-host systems. Here, we analyzed the recent patterns of bark beetle disturbance and forest resistance across European coniferous forests during the 2010-2018 period. We obtained bark beetle attack and tree mortality data from successive continental-scale forest condition surveys on 130 plots including five host trees and five bark beetle species, and characterized the climatic niche of each species. Then, we analyzed the overall forest resistance and species-specific responses, in terms of bark beetle attack and induced tree mortality, in relation to the distance to the niche optimum of both host tree and beetle species, previous drought events, and plot characteristics. Regional patterns of recent disturbance revealed that forests in central, north, and east of Europe could be at risk under the attack of multivoltine bark beetle species. We found that overall forest resistance to beetle attack was determined by several driving factors, which varied among species responses. Particularly, the environmental position of the affected forest within the host and beetle species' climatic niche and plot characteristics mediated the influence of drought on the resistance to beetle attack. In turn, forest resistance to induced tree mortality was determined exclusively by the maximum intensity and duration of drought events. Our findings highlight the importance of disturbance interactions and suggest that the joint influence of drought events and bark beetle disturbance will threaten the persistence of European coniferous forests, even in those tree populations close to their species' climatic optimum.
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Besouros , Traqueófitas , Animais , Besouros/fisiologia , Cycadopsida , Florestas , Casca de Planta , ÁrvoresRESUMO
Forests play a major role in the global carbon cycle. Previous studies on the capacity of forests to sequester atmospheric CO2 have mostly focused on carbon uptake, but the roles of carbon turnover time and its spatiotemporal changes remain poorly understood. Here, we used long-term inventory data (1955 to 2018) from 695 mature forest plots to quantify temporal trends in living vegetation carbon turnover time across tropical, temperate, and cold climate zones, and compared plot data to 8 Earth system models (ESMs). Long-term plots consistently showed decreases in living vegetation carbon turnover time, likely driven by increased tree mortality across all major climate zones. Changes in living vegetation carbon turnover time were negatively correlated with CO2 enrichment in both forest plot data and ESM simulations. However, plot-based correlations between living vegetation carbon turnover time and climate drivers such as precipitation and temperature diverged from those of ESM simulations. Our analyses suggest that forest carbon sinks are likely to be constrained by a decrease in living vegetation carbon turnover time, and accurate projections of forest carbon sink dynamics will require an improved representation of tree mortality processes and their sensitivity to climate in ESMs.
Assuntos
Sequestro de Carbono/fisiologia , Ecologia/métodos , Florestas , Modelos Teóricos , Árvores/fisiologia , Atmosfera/análise , Dióxido de Carbono/análise , Mudança Climática , Ecologia/estatística & dados numéricos , Monitoramento Ambiental/estatística & dados numéricos , Análise Espaço-Temporal , Temperatura , IncertezaRESUMO
X-ray fluorescence spectroscopy is a non-destructive technique employed for elemental analysis of a wide range of materials. Its advantages are especially valued in archaeometry, where portable instruments are available. Considering ancient glass, such instruments allow for the detection of some major, minor, and trace elements linked to the deliberate addition of specific components or to impurities in the raw materials of the glass batch. Besides some undoubted advantages, portable XRF (p-XRF) has some limitations that are addressed in this study. The performance assessment of four different p-XRF units and the reconciling of their output were conducted. The results show the limitations in cross-referencing the data obtained from each unit and suggest procedures to overcome the issues. The p-XRF units were tested on the set of Corning reference glasses and on a small set of archaeological glasses with known composition. The compatibility of the output was assessed using multivariate statistical tools. Such a workflow allows us to consider data from multiple sources in the same frame of reference.
Assuntos
Oligoelementos , Arqueologia/métodos , Espectrometria por Raios X/métodosRESUMO
The response of forest productivity to climate extremes strongly depends on ambient environmental and site conditions. To better understand these relationships at a regional scale, we used nearly 800 observation years from 271 permanent long-term forest monitoring plots across Switzerland, obtained between 1980 and 2017. We assimilated these data into the 3-PG forest ecosystem model using Bayesian inference, reducing the bias of model predictions from 14% to 5% for forest stem carbon stocks and from 45% to 9% for stem carbon stock changes. We then estimated the productivity of forests dominated by Picea abies and Fagus sylvatica for the period of 1960-2018, and tested for productivity shifts in response to climate along elevational gradient and in extreme years. Simulated net primary productivity (NPP) decreased with elevation (2.86 ± 0.006 Mg C ha-1 year-1 km-1 for P. abies and 0.93 ± 0.010 Mg C ha-1 year-1 km-1 for F. sylvatica). During warm-dry extremes, simulated NPP for both species increased at higher and decreased at lower elevations, with reductions in NPP of more than 25% for up to 21% of the potential species distribution range in Switzerland. Reduced plant water availability had a stronger effect on NPP than temperature during warm-dry extremes. Importantly, cold-dry extremes had negative impacts on regional forest NPP comparable to warm-dry extremes. Overall, our calibrated model suggests that the response of forest productivity to climate extremes is more complex than simple shift toward higher elevation. Such robust estimates of NPP are key for increasing our understanding of forests ecosystems carbon dynamics under climate extremes.
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LHCII, the major light harvesting antenna from plants, plays a dual role in photosynthesis. In low light it is a light-harvester, while in high light it is a quencher that protects the organism from photodamage. The switching mechanism between these two orthogonal conditions is mediated by protein dynamic disorder and photoprotective energy dissipation. The latter in particular is thought to occur in part via spectroscopically 'dark' states. We searched for such states in LHCII trimers from spinach, at both room temperature and at 77 K. Using 2D electronic spectroscopy, we explored coherent interactions between chlorophylls absorbing on the low-energy side of LHCII, which is the region that is responsible for both light-harvesting and photoprotection. 2D beating frequency maps allow us to identify four frequencies with strong excitonic character. In particular, our results show the presence of a low-lying state that is coupled to a low-energy excitonic state. We assign this to a mixed excitonic-charge transfer state involving the state with charge separation within the Chl a603-b609 heterodimer, borrowing some dipole strength from the Chl a602-a603 excited states. Such a state may play a role in photoprotection, in conjunction with specific and environmentally controlled realizations of protein dynamic disorder. Our identification and assignment of the coherences observed in the 2D frequency maps suggests that the structure of exciton states as well as a mixing of the excited and charge-transfer states is affected by coupling of these states to resonant vibrations in LHCII.
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BACKGROUND: Improvement in healthcare, seeking the correct balance between quality and costs, is an ongoing concern in many countries. Many countries have developed and implemented improvement programmes in health care, particularly in emergency departments (ED), which play a key role in terms of hospital resources and planning. The regional government of Sicily implemented a project 2010-2012 to improve ED care quality and patient safety. PURPOSE: This paper aims to evaluate improvements implemented by the Regional Health Authority of Sicily in the 20 main EDs. METHOD: Performance analysis of EDs was conducted on three levels: care quality (standard Joint Commission International evaluation), efficiency in terms of resources and output (by way of interviews and document analysis) and the role of management in efficiently promoting change (presence of a performance monitoring system). FINDINGS: The results show improvements in all areas and improved performance in all EDs. There is, however, room for improvement in certain areas, and improvement was not uniformly distributed. PRACTICAL IMPLICATIONS: The quality of local policy and management are key aspects of efficient promotion of performance improvement. Copyright © 2015 John Wiley & Sons, Ltd.
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Serviço Hospitalar de Emergência/legislação & jurisprudência , Serviço Hospitalar de Emergência/organização & administração , Política de Saúde , Eficiência Organizacional , Liderança , Melhoria de Qualidade , SicíliaRESUMO
We studied forest monitoring data collected at permanent plots in Italy over the period 2000-2009 to identify the possible impact of nitrogen (N) deposition on soil chemistry, tree nutrition and growth. Average N throughfall (N-NO3 +N-NH4 ) ranged between 4 and 29 kg ha(-1) yr(-1) , with Critical Loads (CLs) for nutrient N exceeded at several sites. Evidence is consistent in pointing out effects of N deposition on soil and tree nutrition: topsoil exchangeable base cations (BCE) and pH decreased with increasing N deposition, and foliar nutrient N ratios (especially N : P and N : K) increased. Comparison between bulk openfield and throughfall data suggested possible canopy uptake of N, levelling out for bulk deposition >4-6 kg ha(-1) yr(-1) . Partial Least Square (PLS) regression revealed that - although stand and meteorological variables explained the largest portion of variance in relative basal area increment (BAIrel 2000-2009) - N-related predictors (topsoil BCE, C : N, pH; foliar N-ratios; N deposition) nearly always improved the BAIrel model in terms of variance explained (from 78.2 to 93.5%) and error (from 2.98 to 1.50%). N deposition was the strongest predictor even when stand, management and atmosphere-related variables (meteorology and tropospheric ozone) were accounted for. The maximal annual response of BAIrel was estimated at 0.074-0.085% for every additional kgN. This corresponds to an annual maximal relative increase of 0.13-0.14% of carbon sequestered in the above-ground woody biomass for every additional kgN, i.e. a median value of 159 kgC per kgN ha(-1) yr(-1) (range: 50-504 kgC per kgN, depending on the site). Positive growth response occurred also at sites where signals of possible, perhaps recent N saturation were detected. This may suggest a time lag for detrimental N effects, but also that, under continuous high N input, the reported positive growth response may be not sustainable in the long-term.
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Poluentes Atmosféricos/metabolismo , Florestas , Nitrogênio/metabolismo , Poluentes do Solo/metabolismo , Árvores/crescimento & desenvolvimento , Monitoramento Ambiental , ItáliaRESUMO
Roseobacter (Rsb.) denitrificans is a marine aerobic anoxygenic photosynthetic purple bacterium with an unusually high-800 nm absorption band. Ultrafast excited state processes have been intensively studied in the past in order to understand why the energy transfer efficiency between photosynthetic antennae approaches unity and recently it has been proved that the organization of the antennae proteins within the membranes plays an important role. Thanks to the development of genetic manipulation and to the capability of Rsb. denitrificans to grow anaerobically as well, it is possible to construct several mutants in order to compare the ultrafast dynamics between isolated complexes and complexes embedded in membrane environments. Time resolved fluorescence and transient absorption have been applied to isolate LH2, genetically modified membranes with LH2-only and wild type membranes with both LH2 and LH1 antennae of Rsb. denitrificans, in order to understand the effect of the membrane environment on the energy transfer efficiency. A global analysis is applied to calculate the lifetime of the excited states of LH2 and LH1, and although there is shortening of the relaxation lifetime of the LH2-only membranes with respect to the isolated LH2, we find an energy transfer efficiency from LH2 to LH1 of 95%, which still approaches unity.
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Proteínas de Bactérias/química , Membrana Celular/química , Teoria Quântica , Roseobacter/química , Proteínas de Bactérias/isolamento & purificação , Transferência de Energia , Roseobacter/citologiaRESUMO
Light-harvesting in photosynthesis is determined by the excitonic interactions in disordered antennae and the coupling of collective electronic excitations to fast nuclear motions, producing efficient energy transfer with a complicated interplay between exciton and vibrational coherences. Two-dimensional electronic spectroscopy (2DES) is a powerful tool to study the presence of these coherences in photosynthetic complexes. However, the unambiguous assignment of the nature of the observed coherences is still under debate. In this paper we apply 2DES to an excitonically coupled bacteriochlorophyll dimer, the B820 subunit of the light harvesting complex 1 (LH1-RC) of R. rubrum G9. Fourier analysis of the measured kinetics and modeling of the spectral responses in a complete basis of electronic and vibrational states allow us to distinguish between pure vibrational, mixed exciton-vibrational (vibronic), and predominantly exciton coherences. The mixed coherences have been found in a wide range of oscillation frequencies, whereas exciton coherences give the biggest contributions for the frequencies in the 400-550 cm(-1) range, corresponding to the exciton splitting energy of the B820 dimer. Significant exciton coherences are also present at higher frequencies, i.e., up to 800 cm(-1), which are determined by realizations of the disorder with a large energy gap between the two pigments (which increases the apparent value of the exciton splitting). Although the B820 dimer is a model system, the approach presented here represents a basis for further analyses of more complicated systems, providing a tool for studying the interplay between electronic and vibrational coherences in disordered photosynthetic antennae and reaction centres.
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Bacterioclorofilas/química , Análise Espectral/métodos , Dimerização , Modelos Químicos , Teoria Quântica , VibraçãoRESUMO
Forest soils harbor hyper-diverse microbial communities which fundamentally regulate carbon and nutrient cycling across the globe. Directly testing hypotheses on how microbiome diversity is linked to forest carbon storage has been difficult, due to a lack of paired data on microbiome diversity and in situ observations of forest carbon accumulation and storage. Here, we investigated the relationship between soil microbiomes and forest carbon across 238 forest inventory plots spanning 15 European countries. We show that the composition and diversity of fungal, but not bacterial, species is tightly coupled to both forest biotic conditions and a seven-fold variation in tree growth rates and biomass carbon stocks when controlling for the effects of dominant tree type, climate, and other environmental factors. This linkage is particularly strong for symbiotic endophytic and ectomycorrhizal fungi known to directly facilitate tree growth. Since tree growth rates in this system are closely and positively correlated with belowground soil carbon stocks, we conclude that fungal composition is a strong predictor of overall forest carbon storage across the European continent.
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Micobioma , Carbono , Microbiologia do Solo , Florestas , Árvores/microbiologia , SoloRESUMO
In the frame of a process aiming at harmonizing National Forest Inventory (NFI) and ICP Forests Level I Forest Condition Monitoring (FCM) in Italy, we investigated (a) the long-term consistency between FCM sample points (a subsample of the first NFI, 1985, NFI_1) and recent forest area estimates (after the second NFI, 2005, NFI_2) and (b) the effect of tree selection method (tree-based or plot-based) on sample composition and defoliation statistics. The two investigations were carried out on 261 and 252 FCM sites, respectively. Results show that some individual forest categories (larch and stone pine, Norway spruce, other coniferous, beech, temperate oaks and cork oak forests) are over-represented and others (hornbeam and hophornbeam, other deciduous broadleaved and holm oak forests) are under-represented in the FCM sample. This is probably due to a change in forest cover, which has increased by 1,559,200 ha from 1985 to 2005. In case of shift from a tree-based to a plot-based selection method, 3,130 (46.7%) of the original 6,703 sample trees will be abandoned, and 1,473 new trees will be selected. The balance between exclusion of former sample trees and inclusion of new ones will be particularly unfavourable for conifers (with only 16.4% of excluded trees replaced by new ones) and less for deciduous broadleaves (with 63.5% of excluded trees replaced). The total number of tree species surveyed will not be impacted, while the number of trees per species will, and the resulting (plot-based) sample composition will have a much larger frequency of deciduous broadleaved trees. The newly selected trees have-in general-smaller diameter at breast height (DBH) and defoliation scores. Given the larger rate of turnover, the deciduous broadleaved part of the sample will be more impacted. Our results suggest that both a revision of FCM network to account for forest area change and a plot-based approach to permit statistical inference and avoid bias in the tree sample composition in terms of DBH (and likely age and structure) are desirable in Italy. As the adoption of a plot-based approach will keep a large share of the trees formerly selected, direct tree-by-tree comparison will remain possible, thus limiting the impact on the time series comparability. In addition, the plot-based design will favour the integration with NFI_2.
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Ecossistema , Monitoramento Ambiental/métodos , Árvores/crescimento & desenvolvimento , Conservação dos Recursos Naturais/métodos , Agricultura Florestal/métodos , Itália , Estatística como Assunto , Árvores/classificaçãoRESUMO
A correct characterization of the status and trend of forest condition is essential to support reporting processes at national and international level. An international forest condition monitoring has been implemented in Europe since 1987 under the auspices of the International Co-operative Programme on Assessment and Monitoring of Air Pollution Effects on Forests (ICP Forests). The monitoring is based on harmonized methodologies, with individual countries being responsible for its implementation. Due to inconsistencies and problems in sampling design, however, the ICP Forests network is not able to produce reliable quantitative estimates of forest condition at European and sometimes at country level. This paper proposes (1) a set of requirements for status and change assessment and (2) a harmonized sampling strategy able to provide unbiased and consistent estimators of forest condition parameters and of their changes at both country and European level. Under the assumption that a common definition of forest holds among European countries, monitoring objectives, parameters of concern and accuracy indexes are stated. On the basis of fixed-area plot sampling performed independently in each country, an unbiased and consistent estimator of forest defoliation indexes is obtained at both country and European level, together with conservative estimators of their sampling variance and power in the detection of changes. The strategy adopts a probabilistic sampling scheme based on fixed-area plots selected by means of systematic or stratified schemes. Operative guidelines for its application are provided.
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Poluentes Atmosféricos/análise , Poluição do Ar/análise , Ecossistema , Monitoramento Ambiental/métodos , Árvores , Poluentes Atmosféricos/normas , Poluição do Ar/estatística & dados numéricos , Europa (Continente)RESUMO
BACKGROUND: Spontaneous coronary artery dissection (SCAD) often presents with acute coronary syndrome and underlying pathophysiology involves the interplay between predisposing factors and precipitating stressors, such as emotional and physical triggers. In our study we sought to compare clinical, angiographic and prognostic features in a cohort of patients with SCAD according to the presence and type of precipitating stressors. METHODS: Consecutive patients with angiographic evidence of SCAD were divided into three groups: patients with emotional stressors, patients with physical stressors and those without any stressor. Clinical, laboratoristic and angiographic features were collected for each patient. The incidence of major adverse cardiovascular events, recurrent SCAD and recurrent angina was assessed at follow-up. RESULTS: Among the total population (64 subjects), 41 [64.0%] patients presented with precipitating stressors, including emotional triggers (31 [48.4%] subjects) and physical efforts (10 [15.6%] subjects). As compared with the other groups, patients with emotional triggers were more frequently female (p = 0.009), had a lower prevalence of hypertension (p = 0.039] and dyslipidemia (p = 0.039), were more likely to suffer from chronic stress (p = 0.022) and presented with higher levels of C-reactive protein (p = 0.037) and circulating eosinophils cells (p = 0.012). At a median follow-up of 21 [7; 44] months, patients with emotional stressors experienced higher prevalence of recurrent angina (p = 0.025), as compared to the other groups. CONCLUSIONS: Our study shows that emotional stressors leading to SCAD may identify a SCAD subtype with specific features and a trend towards a worse clinical outcome.
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Anomalias dos Vasos Coronários , Doenças Vasculares , Humanos , Feminino , Prognóstico , Vasos Coronários , Fatores Desencadeantes , Doenças Vasculares/epidemiologia , Anomalias dos Vasos Coronários/epidemiologia , Angina Pectoris , Angiografia Coronária/efeitos adversos , Fatores de RiscoRESUMO
We investigated the Ubiquitin-Proteasome System (UPS), major nonlysosomal intracellular protein degradation system, in the genesis of experimental postsurgical peritoneal adhesions. We assayed the levels of UPS within the adhered tissue along with the development of peritoneal adhesions and used the specific UPS inhibitor bortezomib in order to assess the effect of the UPS blockade on the peritoneal adhesions. We found a number of severe postsurgical peritoneal adhesions at day 5 after surgery increasing until day 10. In the adhered tissue an increased values of ubiquitin and the 20S proteasome subunit, NFkB, IL-6, TNF-α and decreased values of IkB-beta were found. In contrast, bortezomib-treated rats showed a decreased number of peritoneal adhesions, decreased values of ubiquitin and the 20S proteasome, NFkB, IL-6, TNF-α, and increased levels of IkB-beta in the adhered peritoneal tissue. The UPS system, therefore, is primarily involved in the formation of post-surgical peritoneal adhesions in rats.
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Doenças Peritoneais/metabolismo , Complexo de Endopeptidases do Proteassoma/metabolismo , Aderências Teciduais/metabolismo , Ubiquitina/metabolismo , Animais , Ácidos Borônicos/uso terapêutico , Bortezomib , Interleucina-6/metabolismo , Masculino , NF-kappa B/metabolismo , Doenças Peritoneais/tratamento farmacológico , Doenças Peritoneais/etiologia , Pirazinas/uso terapêutico , Ratos , Ratos Sprague-Dawley , Aderências Teciduais/tratamento farmacológico , Fator de Necrose Tumoral alfa/metabolismoRESUMO
The finding of thyroid nodules is a very common occurrence in routine clinical practice. Approximately 5% to 7% of the entire population have thyroid nodules. Vascular lesions are one of the most controversial issues in thyroid pathology. These include benign lesions such as hemangiomas and, rarely, malignant tumors such as angiosarcomas or undifferentiated angiosarcomatoid carcinomas. In particular, angiosarcoma of the thyroid gland is a rare, highly aggressive malignant vascular tumor and in Italy the greatest geographical incidence of this lesion is witnessed near the Alps. Here, a case of thyroid angiosarcoma in a 71-year-old man with a history of goiter for about 20 years is described. The unusual localization of this lesion, the difficulties in reaching a definitive diagnosis for this particular histological type of primary tumor and a history of long-standing multinodular goiter in thyroid of an older man from outside the Alpine region prompted us to report this case of thyroid angiosarcoma mainly to discuss surgical, histopathological and immunohistochemical features.
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Hemangiossarcoma/patologia , Neoplasias da Glândula Tireoide/patologia , Evolução Fatal , Hemangiossarcoma/cirurgia , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
A rapid, empirical method is described for estimating weekly AOT40 from ozone concentrations measured with passive samplers at forest sites. The method is based on linear regression and was developed after three years of measurements in Trentino (northern Italy). It was tested against an independent set of data from passive sampler sites across Italy. It provides good weekly estimates compared with those measured by conventional monitors (0.85 ≤R(2)≤ 0.970; 97 ≤ RMSE ≤ 302). Estimates obtained using passive sampling at forest sites are comparable to those obtained by another estimation method based on modelling hourly concentrations (R(2) = 0.94; 131 ≤ RMSE ≤ 351). Regression coefficients of passive sampling are similar to those obtained with conventional monitors at forest sites. Testing against an independent dataset generated by passive sampling provided similar results (0.86 ≤R(2)≤ 0.99; 65 ≤ RMSE ≤ 478). Errors tend to accumulate when weekly AOT40 estimates are summed to obtain the total AOT40 over the May-July period, and the median deviation between the two estimation methods based on passive sampling is 11%. The method proposed does not require any assumptions, complex calculation or modelling technique, and can be useful when other estimation methods are not feasible, either in principle or in practice. However, the method is not useful when estimates of hourly concentrations are of interest.
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Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Modelos Lineares , Modelos Químicos , Ozônio/análise , Monitoramento Ambiental/métodos , ItáliaRESUMO
AIM: The ductal carcinoma in situ is a malignant proliferation of mammary ductal epithelial cells without invasion beyond the basement membrane. The management of patients with DCIS is complex, controversial and has undergone changes over time. MATERIAL OF STUDY: We treated 65 patients diagnosed with DCIS between 2002 and 2005. We surveyed women aged between 28 and 71 years (average age 51.4), the DCIS in 16 patients appeared as a palpable mass (about 2.2 cm) - group I and in 49 patients as microcalcifications detected on mammography - group II. RESULTS: The most frequent histological type was found to be the comedocarcinoma. After 3 years of follow-up, we had 3 cases of recurrence (4.6%) in patients undergoing conservative surgery, with Van Nuys Prognostic Index between 3 and 4. DISCUSSION: 15-25% of cases of breast cancer are DCIS. Most of these are comedocarcinomas. Comedo form DCIS is an insidious cancer. Surgical treatment ranges from mastectomy to excision of the lesion, often the latter, followed by radiotherapy. CONCLUSION: We prefer, with regard to surgical treatment, quadrantectomy with systematic control of the free margins. The search for the axillary sentinel node represents for us, too, the gold standard.
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Neoplasias da Mama/terapia , Carcinoma Intraductal não Infiltrante/terapia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
AIM: It presents a clinical case of undifferentiated retroperitoneal liposarcoma with 5 years' recurrence from the first operation for the rarity of the occurrence, the problems related to surgery and complementary therapeutic approach. MATERIAL OF STUDY: Male patient aged 73 was operated for removal of retroperitoneal mass with involvement of the right kidney at the Second University of Naples in the 2003. In accordance with the interdisciplinary board, complementary therapy is not indicated and follow-up program. The successive controls were negative until at least 2007. Reoperation for recurrence in 2008 for the presence of massive bone formation occupying a large part in the right half of the abdomen at the sub-hepatic level. In both cases histological examination showed undifferentiated liposarcoma. DISCUSSION: It is of unknown etiology and only 25% occurs in well-differentiated cells are also more than 100 histological subtypes, 85% are malignant. The most affected is the male sex and from the beginning looks like malignancy. The trend of growth in general is slow, and in most cases tends to recur over time. The role of chemotherapy and radiation therapy is controversial. CONCLUSIONS: The peculiarity of our case is higher than the average survival despite advanced age and presence of recurrence. This confirms the importance of surgical treatment, thus offering the patient a chance of better long-term survival.