Variability in Forest Visit Numbers in Different Regions and Population Segments before and during the COVID-19 Pandemic.

In view of the prevailing preferences for health and recreation revealed by previous studies as the main expected benefits of forest visits, the research presented herein focuses on whether such expectations would translate into a significant increase in the number of forest visits (NFV) following pandemic outbreaks. In this context, a Slovak nationwide survey on forests was conducted, with the main objective of casting light on possible changes in NFV as a coping mechanism or behavioral response to the discomfort and severe restrictions stemming from coronavirus disease 2019 (COVID-19) and the related measures. The survey was administered on a statistically representative sample after the pandemic's first wave ebbed and restrictions were eased in the summer months of 2020. Collected data were assessed using ANOVA, the results of which supported the importance of forests as places providing opportunities for restoration of mental and physical resources. Forest accessibility as represented by forest coverage and settlement size emerged as a paramount factor affecting NFV rates both before and during the COVID-19 pandemic. The pandemic and its accompanying measures affected the relationships between NFV and average per capita income, type of employment, and most importantly age, highlighting possible vulnerabilities and disadvantages in certain population segments.

Malignant phyllodes tumour presenting as a massive fungating breast mass and silent thrombo-embolism.

INTRODUCTION: We report an unusual case of a massive malignant phyllodes tumour that had almost replaced the entire breast presenting with severe chronic blood loss, extensive deep venous thrombosis (DVT) and a silent pulmonary embolus. PRESENTATION: Long-standing neglected massive fungating ulcerative mass larger than the left haemothorax. DISCUSSION: Phyllodes tumours are rare fibro-epithelial breast lesions that have the propensity to grow rapidly to a large size if neglected. Larger tumours are more likely to be malignant with an overall metastatic rate around 10%. An incidental pulmonary embolus arising from extensive silent lower limb deep vein thrombosis requiring an IVC filter complicated the surgical management. CONCLUSION: Phyllodes tumours are rare and account for approximately 0.3-0.5% of all breast tumours [1]. They have the propensity to be fast growing. However, tumours reaching a massive size (>10cm) are rare with few reports in the literature.