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The influence of the timing of surgery in relation to the menstrual cycle on the survival of breast cancer patients has been both advocated and disputed. The records of 165 premenopausal M- breast cancer women consecutively operated from 1977 to 1991 were reviewed. All patients underwent modified radical mastectomies or quadrantectomies plus postoperative radiotherapy. Node-positive patients received adjuvant chemotherapy. Cox regression analysis was used to estimate the relative risk (RR) of death in three models including timing of surgery, age, histology, pT and pN. In each model, patients were divided into two groups according to the criteria proposed by Badwe, Hrushesky, and Senie. Multivariate analysis showed a significant association between pT and pN and survival, whereas no association with survival was observed for the timing of surgery according to either Badwe or Hrushesky or Senie (RR = 1.26, RR = 0.91 and RR = 0.88 respectively). Consensus on the menstrual phase related to the expected best prognosis is still required.

Thyroidectomy is one of the commonest surgical operations performed in endocrine surgery; results are generally excellent and morbidity and mortality usually are negligible. Total thyroidectomy's complication rates are low, with an overall incidence of 4.3% among experienced surgeons: the most frequent complications are vocal cord paresis or paralysis, hypoparathyroidism, hypocalcemia, haematoma and wound infection. Tracheal injury following thyroidectomy is even more rare. As reported from some authors, inadvertent tracheal injury has an incidence of 0-0.6% during thyroidectomy. Tracheal laceration (generally located in the posterolateral surface) is often recognized and repaired immediately, during the same intervention. Rarely, following a total thyroidectomy, a delayed tracheal rupture may occur secondary to an ischemic damage of the trachea. This has been described in few cases reported in literature. In this paper we report of a case in which delayed tracheal lacerations appeared 10 days after the patient underwent total thyroidectomy: a prompt surgical operation was efficient using both direct sutures of tracheal breaches and a patch of fibrinogen-thrombin coated collagen fleece covering the entire surface.

Surgery for breast cancer has changed in the last few decades in favor of more conservative approaches, without compromising loco‐regional control and survival. Common immediate complications fol ‐lowing breast surgery are hematoma, seroma, and wound infection.1Traditionally, surgeons have implemented the use of closed‐suction drains in this setting with the aim of preventing these complications, which can cause discomfort, morbidity, increased follow‐up visits,and possible delay in the beginning of adjuvant therapies.2 On the other hand, potential benefits of performing breast procedures without using a drain have been increasingly considered.3 There is lack of modern and official guidelines on use of drains in breast sur ‐gery, with no consensus regarding their management and the appro‐priate use of antibiotics in this setting. Almost all reports agree withthe use of drains after breast procedures, especially if they are asso‐ciated with reconstruction or axillar lymph node dissection (ALND), but an extreme variability is reported regarding practice patterns.4A national survey regarding the management of drains afterbreast cancer surgery was sent by email on January 2018 to all Breast Centers (BC) registered with Senonetwork Italia. Data col ‐lected by the administrative office of Senonetwork were de‐iden‐tified and exported for statistical analysis. A Steering Committeecomposed of general surgeons and plastic surgeons was appointedto coordinate the survey, which consisted of 22 multiple choicequestions, designed to inquire about surgeons' demographics, use of drains after breast procedures with and without reconstructionand/or ALND, antibiotic use and to characterize drain managementin their clinical practice.

To analyze the issue of cities-migrants interactions, as well as social-monetary values interactions, it is necessary to place it in a “higher” context, in order not to risk losing the necessary connection with universal ethical principles, and in a “broader” one, in which understanding complexity on a global scale interprets local conditions. The study of migration flows and urban dynamics, as well as housing markets, through theoretical paradigms and scientific tools from different disciplines provides an opportunity to learn and compare, dialogue and interface with new keys to understanding the problem, or with alternative interpretations and unprecedented perspectives in the path of multiculturalism, which has become an inescapable premise for the formation of an inclusive society. Despite different scientific and cultural backgrounds, many concepts emerge as cross-cutting, weaving a network of connections that transcends supposed disciplinary “boundaries” and, at the same time, highlights the possibility of expressing different visions and interpretations. This plurality of disciplinary expertise and cultural sensitivities, intellectual passion and willingness to confrontation can be represented by a chain of words—such as global, local, glocal, cities, territories, values, language, human dignity, human capital, citizenship, identity, cohabitation, public space, urban space—and constitutes the connotative trait of this volume in which the science of Appraisal and Valuation “measures” and compares itself with other social sciences.

Starting from the metaphor of the ethical conflict between dignity and rights in Antigone, the article reflects on the theme of human dignity for a critique of global inequalities. These theoretical assumptions are the basis for reflecting on the theme of contemporary international mobility of populations, which generates significant effects on the production of borders and the right to the city, highlighting new issues of social and spatial justice. In particular, with respect to the “newcomers”, claiming the “right to the city”, after claiming the “right to mobility”, very often coincides with the claim and protection of human rights, in order to build “spaces for survival”. On the one hand, the outcomes of these phenomena can be considered as a serious deterioration of problems, like an existential disadvantage of some individuals constantly claiming their rights, a condition that generates fragmented (individual or collective) identities; on the other hand, they contribute to the construction of the identity of places, generating new forms of city and citizenship, both at institutional level and, above all, in everyday practice.

This paper aims to examine the theme of energy retrofit within the circumscribed field of refurbishment interventions on load-bearing masonry buildings built in the early 20th century. These include a remarkable share of the fabric of many European cities and, in particular, they can be found in geographical areas characterized by a Mediterranean (mild) climate. The main objective is to increase the climate resilience of the buildings by verifying the economic feasibility and the environmental sustainability of the interventions at the same time observing the specific architectural features of the buildings. We put forward alternative retrofit solutions carrying out synoptic comparisons of several technological solutions and types of materials, assisted by the use of digital tools such as BIM. In order to increase the environmental compatibility of the intervention, this article carries out a closer examination of the comparison between the employment of nanostructured, conventional – of synthetic origin –, and natural materials. The selection of the best intervention solution required the elaboration of an iterative flexible integrated process of assessment of energy, technological, economic, environmental and architectural aspects. The methodology we propose here is applied to the case study of Palazzo Utveggio (Palermo, Italy).

The new Italian Procurement Code—L.D. n. 50, 2016—implementing the 2014 European Union Directive, introduced BIM (Building Information Modeling) as an innovative approach to digitalize the construction sector. The recent Decree n. 560 of December 1st 2017 defines the methods and schedule for the gradual introduction of the BIM for the design, execution and management of construction works. BIM procedures involve a radical change in the design approach that goes from the graphical representation to the simulation of a process, both in the field of new constructions and in the field of Cultural Heritage conservation. In this perspective the article shows the results of a survey carried out on historic buildings. It aimed at verifying how much the modeling has remained confined to a low level of development (LOD A, according to the UNI 11337 standard is linked to a merely symbolic level) and those who have gone further by integrating specific and detailed information that allow real time to evaluate the sustainability of different alternatives. The article, which represents a first step of an ongoing research, starting from the regulatory framework of the BIM in Italy, highlights its potential (Sect. 1); the issue of the evaluation is deepened (Sect. 2), with particular reference to the 5D-BIM Project cost management and to the Heritage Building Information Modeling (HBIM).