RESUMO
In this article, we have reviewed available evidence for diagnosis, treatment, and follow-up in female breast cancer (BC). Into daily clinical practice some controversies are occurred. Especially, in the diagnosis field, despite the fact that the optimal age in which screening mammography should start is a subject of intense controversy, there is a shift toward the beginning at the age of 40 although it is suggested that the net benefit is small for women aged 40 to 49 years. In addition, a promising tool in BC screening seems to be breast tomosynthesis. Other tools such as 3D ultrasound and shear wave elastography (SWE) are full of optimism in BC screening although ultrasonography is not yet a first-line screening method and there is insufficient evidence to recommend the systemic use of the SWE for BC screening. As for breast magnetic resonance imaging (MRI), even if it is useful in BC detection in women who have a strong family history of BC, it is not generally recommended as a screening tool. Moreover, based on the lack of randomized clinical trials showing a benefit of presurgical breast MRI in overall survival, it's integration into breast surgical operations remains debatable. Interestingly, in contrast to fine needle aspiration, core biopsy has gained popularity in presurgical diagnosis. Furthermore, after conservative surgery in patients with positive sentinel lymph nodes, the recent tendency is the shift from axillary dissection to axillary conserving strategies. While the accuracy of sentinel lymph node after neoadjuvant chemotherapy and second BC surgery remains controversial, more time is needed for evaluation and for determining the optimal interval between the two surgeries. Additionally, in the decision between immediate or delayed breast reconstruction, there is a tendency in the immediate use. In the prevention of BC, the controversial issue between tamoxifen and raloxifene becomes clear with raloxifene be more profitable through the toxicities of tamoxifen. However, the prevention of bone metastasis with bisphosphonates is still conflicting. Last but not least, in the follow-up of BC survivors, mammography, history and physical examination are the means of an early detection of BC recurrence. ed.
RESUMO
The paper presents a comprehensive, thought simple, methodology, for forecasting the annual hydrological drought, based on meteorological drought indications available early during the hydrological year. The meteorological drought of 3, 6 and 9 months is estimated using the reconnaissance drought index (RDI), whereas the annual hydrological drought is represented by the streamflow drought index (SDI). Regression equations are derived between RDI and SDI, forecasting the level of hydrological drought for the entire year in real time. Further, using a wide range of scenarios representing possible climatic changes and drought events of varying severity, nomographs are devised for estimating the annual streamflow change. The Medbasin rainfall-runoff model is used to link meteorological data to streamflow. The later approach can be useful for developing preparedness plans to combat the consequences of drought and climate change. As a case study, the area of N. Peloponnese (Greece) was selected, incorporating several small river basins.
RESUMO
We report the generation of few-cycle multiterawatt light pulses with a temporal contrast of 10(10), when measured as close as 2 ps to the pulse's peak. Tens of picoseconds before the main pulse, the contrast value is expected to spread much beyond the measurement limit. Separate measurements of contrast improvement factors at different stages of the laser system indicate that real contrast values may reach 10(19) and 10(14), when measured 50 and 25 ps before the pulse's peak, respectively. The combination of the shortest pulse duration and the highest contrast renders our system a promising front-end architecture for future multipetawatt laser facilities.
