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Purpose: Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy. Methods: A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA), surgical procedures, and drugs for hypo- or hyperthyroidism were extracted from regional health databases. Proportions and rates of selected examinations were calculated from 2010 to 2017, overall and by sex, calendar years, age, and region. Results: Between 2010 and 2017 in North-eastern Italy, 24.5% of women and 9.8% of men received at least one TSH test yearly. In 2017, 7.1% of women and 1.5% of men were prescribed drugs for thyroid dysfunction, 94.6% of whom for hypothyroidism. Neck ultrasound examinations were performed yearly in 6.9% of women and 4.6% of men, with a nearly two-fold variation between areas. Thyroid FNA and thyroidectomies were three-fold more frequent in women (394 and 85 per 100,000) than in men (128 and 29 per 100,000) with a marked variation between areas. Both procedures decreased consistently after 2013. Conclusions: The results of this population-based study describe recent variations over time and between surrounding areas of indicators of ‘diagnostic pressure’ on thyroid in North-eastern Italy. These results emphasize the need to harmonize practices and to reduce some procedures (e.g., neck ultrasound and total thyroidectomies) in certain areas.

SummaryRadiofrequency thermal ablation (RFA) is a new, minimally invasive technique offered in the treatment of various neoplasms. RFA produces ionic agitation within the area to be treated, resulting in the heating of neoplastic tissue using a radiofrequency generator. Well defined areas of coagulative necrosis are formed, thereby destroying the tumor.Percutaneous CT-guided RFA was performed in 34 patients with 69 lung neoplasms. Six patients were affected by primary Non-Small Cell Lung Cancer (NSCLC), and 28 patients presented with metastatic lung nodules originating in various solid tumors. Patients were considered ineligible for surgery for the following reasons: medical comorbidities; technical reasons; severe respiratory insufficiency; refusal of surgery.Adequacy of treatment was assessed by CT-Scan and Nuclear Magnetic Resonance (NMR) with gadolinium. A median follow-up of 9 months (3-25 months) resulted in 30 patients evaluable for response with a total of 63 nodules to be treated, 58 of which achieved complete necrotic response. Relapse occurred in 5/63 treated nodules. In 2 of these patients, relapse occurred exclusively in the treated nodules, whereas in the other 3 patients, relapse occurred in the treated nodules as well as at distant sites. 9 patients are alive and disease free. Pneumothorax requiring pleural drainage was the main complication, observed in 16% of the treatment sessions. Lung RFA has shown itself to be a safe and feasible option in the treatment of lung neoplasms in patients otherwise ineligible for surgery.The high rate of complete responses obtained in our study (92%) suggests that further investigation of lung RFA, combined with chemotherapy and/or radiation therapy is warranted with the objective of improving local disease control and survival rates.

SummaryVascular endothelial growth factor (VEGF) is known to play a central role in tumour angiogenesis. However, no data have been published with regard to the clinical-biological significance of serum (S)-VEGF in hepatocellular cancer (HCC) patients undergoing to percutaneously radiofrequency thermal ablation (PRFA). The aim of this study was to assess the modifications of S-VEGF levels in a series of 28 HCC patients in hepatitis C virus-positive cirrhosis before and after PRFA, respectively. Samples of S were taken before, 2 and 5 days after PRFA respectively and VEGF levels were assessed by ELISA. No significant difference was found between pre- and post-VEGF levels (p= n.s.; by Wilcoxon test). We suggest that S-VEGF level is not useful as early predictive marker of response to PRFA.

SummaryA new mineral species, vigezzite (Ca,Ce) (Nb,Ta,Ti)2O6, was found near Orcesco, Valle Vigezzo, Prov. Novara, Northern Italy. It forms fiat prismatic crystals up to 2–3 mm length of an orange-yellow colour. The crystals are elongated along the a-axis and flattened on (010). Cleavage at right angles to the prism axis is distinct, fracture conchoidal. Vickers hardness VHN = 396 kp/mm2, corresponding to -5 in the Mohs scale. Refraction indices are high: a = 2.14, ? = 2.315 (NaD, 589 µm), birefringence is 0.175. Optic angle 2V?is large. Though intensively yellow coloured, the mineral shows no pleochroism. a = c, ß = b, ? = a; optic axial plane is parallel to (010).Vigezzite is orthorhombie with space group Pmnbor P21nb; a= 7.559±0.01, b= 11.028±0.01, c= 5.360± 0.004 Å, Z = 4. The six strongest lines of the X-ray powder pattern are 4.821 (9) (011), 3.784 (8) (200), 3.036 (10) (031), 2.974 (10) (211), 1.7129 (6) (242), 1.6018 (7) (431).Electron microprobe analyses lead to the empirical formula (Ca0.82Ce0.24)S1.06(Nb0.9Ta0.62Ti0.5)S2.02O6. The mineral is not completely homogenous, the ratio Nb/(Nb+Ta) varies from 0.55–0.62. Rynersonite Ca (Ta,Nb)2O6, may represent the Ta-dominant equivalent of vigezzite. Vigezzite occurs together with several other Nb-minerals such as pyrochlore, columbite and fersmite, whose crystallographical and chemical data are reported, in an albitic rock of presumably pegmatitic origin.