Community gardens vary enormously in what they offer, according to local needs and circumstance.This article reports on research and experience from the USA. The context in which these findings are discussed is the implementation of Local Agenda and sustainable development policies. In particular, emphasis is given to exploring the social dimension of sustainable development policies by linking issues of health, education, community development and food security with the use of green space in towns and cities. The article concludes that the use of urban open spaces for parks and gardens is closely associated with environmental justice and equity.
Localization methods for breast lesions including cancers have changed and advanced since their inception. Currently, the most widely used technique in the United Kingdom is the image‐guided hook wire localizer developed in the 1970s. It remains as the gold standard for localization of impalpable breast tumors. Besides its advantages, there are some disadvantages associated with this technique. In recent years, novel wire‐free techniques (eg, Magseed®, SCOUT®, and LOCalizer™) have been developed to not only localize impalpable breast lesions but also negate the disadvantages of wire localization. This article reviews the variety of techniques from their origins to the most recent advancements that are used to localize breast lesions. The future is heading toward non‐wire technology and wire localization may then be reserved for special cases.
Aims
Prior to March 2020, at Princess Royal University Hospital (PRUH), Kings College NHS Foundation Trust, almost daily face to face benign/malignant breast clinic follow ups occurred. On March 23rd 2020 the UK went into official COVID-19 pandemic lockdown. The effect on elective follow up practice was swift with cancellation, triaging and replacement of face-to-face by telephonic/virtual consultations.
We compared the change of follow up pattern, pre and post COVID-19. Could this effect the future of consultations at PRUH?
Methods
A comparison of all patients attending PRUH breast unit outpatients in January 2020 (preCOVID-19) for follow up, with those attending in April 2020 (postCOVID-19).
Data collection from clinic lists and electronic patient records, with Excel version 16 analysis.
Results
343 patient follow up consultations 01/2020. 53 patient follow up consultations 04/2020.
Malignant cases: January 65%, April 60%
Benign/B3 cases: January 35%, April 20%
Summary follow up types.
Conclusions
Impact of COVID has been widespread in our practice. Our results show a significant reduction in face-to-face appointments, to allow social distancing. Further evaluation of this model will show its sustainability. Patient satisfaction will have to be assessed, with a view to a full move to video/telephone consultation where indicated.
Background
ADM (Acellular Dermal Matrix) assisted implant-based immediate breast reconstruction (IBR) is a common technique worldwide. Various ADMs are available manufactured from different sources. The Surgimend ADM (fetal bovine dermis) is fenestrated and rich in type I/III collagen; it is claimed to reduce fluid accumulation and promote healing.
Methods
Retrospective observational analysis exploring safety profile using combination of SurgiMend MacroPorous (MP)/SurgiMend PRS and Mentor CPG/Mentor Siltex implants between January 2018 to December 2019. Patients with unilateral/bilateral IBR following Nipple sparing (NSM) or Skin sparing mastectomy (SSM) were included. The primary outcome was minor complications (seroma (>100ml on USS), hematoma, wound infection and infected seromas). Secondary outcome was major complications (flap necrosis, capsular contracture, implant explantation and Red Breast Syndrome).
Results
Six (16.2%) bilateral and 31 (83.8%) unilateral IBR were performed in 37 patients. Mean age was 53.78 years.
No major complications were recorded.
Conclusions
The Surgimend ADM and Mentor implant combination demonstrate a good safety profile. Higher rates of seroma in this study could be explained by overdiagnosis and treatment at our unit, which in turn might imply as a result that no major complications were detected and no implant loss.
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