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Background: Patients with active cancer have a 4–sevenfold increased risk for venous thromboembolism (VTE) especially during systematic anticancer treatment. Simultaneously, surgery is an additional risk factor. Methods: The Metaxas’s Hospital THromboprophylaxis program in Oncological & Surgical Patients (MeTHOS) is a prospective, phase IV, observational, non-interventional cohort study, aiming to record the thromboprophylaxis practice patterns in high-risk active cancer patients undergoing surgical and/or chemotherapy treatment. Results: We are reporting results from 291 ambulatory patients (median age: 67 years, Q1–Q3: 59–73 years, 54.6% males) who received anti-neoplastic treatment and administered thromboprophylaxis. 59.8% had cardiovascular disease (mostly hypertension), 76.6% were reported as having at least one comorbidity, while 27.5% and 15.8% accumulated two and three comorbidities, respectively. 94.9% of the patients were receiving highly thrombogenic agents such as platinum-based agents, 5-FU, immunotherapy, antiangiogenics/anti-VEGF, or erythropoietin. 26.5% of the patients were initially surgically treated. In terms of anticoagulation, all patients were treated with tinzaparin (fixed dose, 10,000 Anti-Xa IU, OD). The median anticoagulation duration was 6.2 months. Six thrombotic events were observed (2.06%, 95% CI: 0.76–4.43%): 5 were DVT, and one PE. With respect to safety, 7 bleeding events occurred (2.6%, 95% CI: 1.0–5.3%); 6 of them were minor. Conclusions: Thromboprophylaxis with LMWH in patients with active cancer and high thrombotic burden was safe and effective. Intermediate dose of tinzaparin seems to be an appropriate agent for cancer-associated thromboprophylaxis management. Clinical trial registration: ClinicalTrials.gov: NCT04248348. © 2022, The Author(s).

Trastuzumab emtansine (T-DM1) is a human epidermal growth factor receptor 2 (Her2) - targeted antibody-drug conjugate that is approved for patients previously treated with trastuzumab and a taxane for Her2-positive advanced breast cancer and those who have progressed within 6 months of completion of adjuvant chemotherapy, as well as for patients with residual invasive Her2-positive disease after the completion of adjuvant chemotherapy. Peripheral neuropathy is a common adverse event; however, ocular events have also been described. With the current report we present the case of a 67-year old woman who developed transient grade 2-3 blurred vision after the first T-DM1 infusion, which was complicated with grade 2 diplopia causing vertigo after the second infusion. After extended investigation, this symptomatology was attributed to central neurotoxicity, and gradually resolved after T-DM1 discontinuation. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

BACKGROUND The differences in histopathology and molecular biology between right colon cancer (RCC) and left colon cancer (LCC) were first reported in the literature by Bufill in 1990. Since then, a large number of studies have confirmed their differences in epidemiology, clinical presentation, comorbidities and biological behaviours, which may be related to the difference in prognosis and overall survival (OS) between the two groups. AIM To investigate statistically significant differences between Greek patients with LCC and RCC. METHODS The present observational study included 144 patients diagnosed with colon cancer of any stage who received chemotherapy in a Greek tertiary oncology hospital during a 2.5-year period. Clinical information, comorbidities, histopathologic characteristics and molecular biomarkers were collected from the patients' medical records retrospectively, while administered chemotherapy regimens, targeted agents, progression-free survival (PFS) periods with first-and second-line chemotherapy and OS were recorded retroactively and prospectively. Data analysis was performed with the SPSS statistical package. RESULTS Eighty-six males and 58 females participated in the study. One hundred (69.4%) patients had a primary lesion in the left colon, and 44 (30.6%) patients had a primary lesion in the right colon. Patients with RCC were more likely to display anaemia than patients with LCC [odds ratio (OR) = 3.09], while LCC patients were more likely to develop rectal bleeding (OR = 3.37) and a feeling of incomplete evacuation (OR = 2.78) than RCC patients. Considering comorbidities, RCC patients were more likely to suffer from diabetes (OR = 3.31) and coronary artery disease (P = 0.056) than LCC patients. The mucinous differentiation rate was higher in the right-sided group than in the left-sided group (OR = 4.49), as was the number of infiltrated lymph nodes (P = 0.039), while the percentage of high-grade differentiation was higher in the group of patients with left-sided colon cancer than in RCC patients (OR = 2.78). RAS wild-type patients who received anti-epidermal growth factor receptor (EGFR): Treatment experienced greater benefit (PFS: 16.5 mo) than those who received anti-vascular endothelial growth factor treatment (PFS: 13.7 mo) (P = 0.05), while among RAS wild-type patients who received anti-EGFR treatment, LCC patients experienced greater benefit (PFS: 15.8 mo) than the RCC subgroup (PFS: 5.5 mo) in the first-line chemotherapy setting (P = 0.034). BRAF-mutant patients had shorter PFS (9.3 mo) than BRAF wild-type patients (14.5 mo) (P = 0.033). RCC patients showed a shorter tumour recurrence period (7.7 mo) than those with LCC (14.5 mo) (P < 0.001), as well as shorter (OS) (58.4 mo for RCC patients; 82.4 mo for LCC patients) (P = 0.018). CONCLUSION RCC patients present more comorbidities, worse histological and molecular characteristics and a consequently higher probability of tumour recurrence, poor response to targeted therapy and shorter OS than LCC patients. © The Author(s) 2020.

This paper presents the methodological approach adopted to prioritize and comparatively assess alternative design solutions aimed to retain the Byzantine antiquities that were found during the construction works of the new city Metro main line, without cancelling the construction and operation at the Venizelou station in which they were found during excavation. It is shown, on the basis of cost over the respective benefit, that such a challenging engineering task is indeed feasible from both a technical and a financial viewpoint through a pragmatic compromise between the infrastructure logistics and the priceless nature of the archaeological findings. The particular feasibility study was the first of its kind made at a city and national level, it is deemed as a significant contribution to the public debate between the local and governmental authorities that essentially paved the way towards complex engineering solutions, innovative ideas and fruitful interactions, which are currently at the heart of the public debate. Even though it is not seen by any means as the unique solution to the particular problem, it is considered as a useful contribution to the present state-of-the art of potential strategies that can be adopted by decision-makers in resolving a multiple-objective, dual engineering and archaeological problem.

Trabajo presentado en TERRAenVISION Environmental Issues Today: Scientific Solutions for Societal Issues, celebrado en Barcelona (España) del 27 de enero al 2 de febrero de 2018, This contribution results from international collaborative efforts of different research groups around the Mediterranean basin focusing on soil conservation and water management. We will present the most complete database of runoff and soil erosion information and analyze the records from 68 locations, including more than 22458 detail events between 1985-2015. Soil conservation and water planning are two of the most challenging problems around the Mediterranean basin due to climate conditions and human activity. We believe that future advances on understanding soil degradation by water should be developed under global approaches. In this contribution, we will present an analysis of atmospheric conditions, expressed by weather types and the resulted rainfall, runoff, and erosion and sediment yield around the Mediterranean basin. The weather types compile daily information about the different air masses responsible for rainfall, runoff and eventually erosion and sediment yield, and their analyses let us know the synchrony of the response at different sites around the Mediterranean basin. The analyses of the global dataset display different spatial patterns for rainfall, runoff, and sediment yield, related to different atmospheric patterns. This research will be a valuable tool for understanding the evolution of these environmental variables, and therefore it will allow future planning to design regional water management and soil conservation measures

This paper presents the results of an experimental program concerning the efficiency of a specific strengthening technique which utilizes a small steel link element connected to the R/C frame through bracing elements. Brittle types of failure, especially at the connections between steel and concrete elements, can be avoided by appropriate design of the local details. Five single storey one bay R/C frames scaled 1:3 were constructed according to older codes with substandard details. The first one was a typical bare reference frame. The other four were identical to the first one, strengthened by steel bracing elements. The behavior of the strengthened frames is described with respect to the reference bare frame. The concrete frames were constructed according to older code provisions by the use of smooth steel bars, low strength concrete, sparsely spaced stirrups and substandard details. The strengthening scheme aimed to the increase of both strength and deformation capacity of the original R/C frame. The inelastic deformations are purposely concentrated to a short steel link element connecting the steel bracing to the R/C frame. The results show that the steel link element can increase considerably the strength and the energy dissipation capacity of the frame.

There are two alternative strategies that a designer may adopt and combine when faced with the retrofitting of a bridge: (a) the increase in the capacity or (b) the reduction in the actions of the structure. In this article, a new scheme, based on the second strategy, is proposed for the retrofit of existing multi-span simply supported (MSSS) bridges. The reduction in the actions of the bridge was mainly achieved by utilising an external restraining system consisting of I-shaped steel piles driven in the backfill soil and a slab that is the pile-cap of the piles. The restraining system was preliminarily designed and assessed in an existing MSSS bridge system, whose deck slab was made continuous. The existing and the retrofitted bridge were analysed by means of non-linear dynamic time history analysis and their response was compared in terms of serviceability and earthquake resistance performance. The study showed that the retrofitting scheme enhanced effectively the earthquake resistance of the existing b...

The design of structural systems depends on a wide range of compliance criteria. More specifically, with respect to earthquake resistant bridges, the issue of economy, i.e. the cost-effectiveness, is mostly influenced by the design concept, that is the selection of the optimum structural system, which is related to specific conditions and requirements. The study presents part of the results of an extended investigation program, conducted for Egnatia Odos SA, which manages the major and longest motorway in Northern Greece. The scope of the investigation program was to assess the range of cost of different bridge systems, designed to low and high seismic actions. The present paper focuses on the cost-effectiveness of four different bridge earthquake resisting systems: (a) a seismically isolated bridge, whose deck is supported on all the piers and abutments through low damping rubber bearings, (b) a “semi-integral” bridge, (c) a “quasi-integral” bridge, which was the “reference” bridge, and (d) a “fully integral” bridge, with full-height abutments, which are rigidly connected to the deck. The accommodation of both serviceability and earthquake resistance of bridge systems was studied with the objective of minimizing their structural and final costs.

The aim of this article is to present a computer-aided comprehensive strategy for the rapid visual inspection of buildings and the optimal prioritization of strengthening and remedial actions that are necessary prior to, and after, a major earthquake event, respectively. Based on the visual screening procedures used in the United States and past experience in seismic assessment of buildings in Greece and Turkey (the two countries with the highest seismic risk in Europe), a building inventory is first compiled; then a vulnerability ranking procedure that is specifically tailored to the prevailing construction practice in Southeast Europe is implemented into a multi-functional, georeferenced computer tool, that accommodates the management, evaluation, processing and archiving of the data stock gathered during the pre- and post-earthquake assessment process, and the visualization of its spatial distribution. The methodology proposed and the computer system developed is then applied to the city of Duzce, Turkey, a city strongly damaged during the devastating 1999 earthquake.