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The outbreak of the COVID-19 pandemic has led to a disruption of surgical care. The aim of this multi-centric, retrospective study was to evaluate the impact of the pandemic on surgical activity for thyroid disease among the Italian Units of Endocrine Surgery. Three phases of the pandemic were identified based on the epidemiological situation and the public measures adopted from the Italian Government (1st phase: from 9th March to 3rd May 2020; 2nd phase: from 4th May to 14th June; 3rd phase: from 15th June to 31st). The patients operated upon during these phases were compared to those who underwent surgery during the same period of the previous year. Overall, 3892 patients from 28 Italian endocrine surgical units were included in the study, 1478 (38%) operated upon during COVID-19 pandemic, and 2414 (62%) during the corresponding period of 2019. The decrease in the number of operations was by 64.8%, 44.7% and 5.1% during the three phases of COVID-19 pandemic, compared to 2019, respectively. During the first and the second phases, the surgical activity was dedicated mainly to oncological patients. No differences in post-operative complications were noted between the two periods. Oncological activity for thyroid cancer was adequately maintained during the COVID-19 pandemic.

Pheochromocytoma is a tumor arising from neuroectodermal chromaffin tissues in the adrenal gland or extra-adrenal paraganglia (paragangliomas). The prevalence of the tumor is 0.1%-0.6% in the hypertensive population, of which 10%-20% are malignant. Pheochromocytoma produces, stores, and secretes catecholamines, as well as leads to hypertensive crisis, arrhythmia, angina, and acute myocardial infarction without coronary artery diseases. We report a case of acute coronary syndrome (ACS) with a final diagnosis of multiple endocrine neoplasia with pheochromocytoma and medullary thyroid carcinoma (MTC).

The frequency of neuromonitoring during thyroid surgery is underreported in Italy. The present survey depicts and describes the patterns of use, management, documentation for IONM devices of IONM during thyroid surgery by surgeons in Italy. A point prevalence survey was undertaken. Source data were mixed from Italian surgeons attending the 2014 International Neuromonitoring Study Group (INMSG) meeting, four IONM manufacturers available in Italy and surgical units were identified from Company sales data. Qualitative and quantitative data were used to analyze. Questions probed IONM prevalence, surgeon background, hospital geographic practice locations, type of hospital, rationale for IONM use, sources of initial capital investment for IONM acquisition, type of equipment, use of continuous IONM, monitoring management, use of distinctive standards, and IONM documentation. IONM is currently delivered through 48 units in Italy. In 2013, the distribution of IONM by specialties included: general (50 %), ENT (46 %), and thoracic surgery (4 %). Overall, 12.853 IONM procedures were performed in the period from 2006 to 2013: 253 were performed in 2007 and about 5,100 in 2013. Distribution according to the type of hospital is: public 48 %, academic setting 37 %, and private maintenance 15 %. The use category of high volume thyroid hospitals represented 33 %. Initial capital investment for the acquisition of the monitoring equipment was 67 % public and 33 % with charitable/private funding. Audio plus graphic and EMG electrodes surface endotracheal tube-based monitoring systems accounted for the majority. Continuous IONM was introduced in 5 Academic Centers. Overall motivations expressed are legal (30 %), RLN confirmation (20 %), RLN identification (20 %), prognosis (10 %), helpful in difficult cases (10 %), decrease surgical time (5 %), and educational (5 %). The survey revealed that participants had few experience with the standardized approach of IONM technique (28 %). General IONM information to patients and/or subsequent specific IONM informed consent was initiated in 8 % of centers. EMG determinations were included in medical chart in 20 %. There were no significant associations found between all parameters considered. The present study describes an increased utilization of IONM in Italy. We highlighted areas for improvement in the management and documentation of IONM.

The fatigue behaviour of a microalloyed forging steel was analysed at two hot-forging temperature levels - one at1240°Ccorresponding to the ordinary heating parameters and the other at1060°Csuited to obtain a finer grain size. The resulting behaviour was then compared with a conventional hardened and tempered steel. Fatigue tests were carried out both on smooth and keyhole-type notched specimens. The fatigue test nucleation was studied on smooth test pieces, and the resulting experimental data were then used to predict the fatigue life of notched specimens.Contrarily to what happens with hardening and tempering steels, predictions for microalloyed steels are almost never conservative.

Mechanical and metallographic tests were run on surviving fragments of the late-19th-century Hone-Bard railway bridge demolished in the Sixties to assess the characteristics of the “agglomerated” (similar to «wrought») iron used in their construction. An explanation is also offered of the surprising discrepancy between the lab data for this iron and its brilliant service record.

I processi di produzione dei componenti meccanici spesso comportano l’insorgere di sforzi residuinel materiale. La causa di questi sforzi è da ricercarsi in una deformazione plastica non omogeneache può essere indotta da fenomeni meccanici, termici o chimici prodotti nel materiale durante le fasidi lavorazione sia per deformazione plastica sia per asportazione di truciolo.La geometria del componente, il rapporto di riduzione, il tipo di lubrificazione e le proprietàdel materiale determinano l’entità e la distribuzione degli sforzi residui prodotti nel caso delle operazioniper deformazione plastica. Nelle lavorazioni meccaniche per asportazione di truciolo, invece, gli effettimeccanici e termici sono influenzati dai parametri di processo e dal tipo di materiale.In entrambi i casi la conoscenza dei meccanismi e delle cause che generano gli sforzi residuiè importante per una buona progettazione del componente e del suo ciclo produttivo.

Gli acciai nitrurati sono spesso sottoposti al trattamento di post-ossidazione per migliorare la loro resistenza alla corrosione; tuttavia non è noto quale sia l’effetto di questo post-trattamento sulle proprietà meccaniche dei componenti così trattati, in particolare sulla resistenza a fatica. Il presente lavoro mostra i risultati di una serie di prove di corrosione, di fatica e di usura su un acciaio 42CrMo4 nitrurato e successivamente post-ossidato in differenti atmosfere. Le condizioni di prova analizzate sono state le seguenti: 1. nitrurazione controllata in gas (550° C per 6.5 ore) 2. come 1 seguito da un trattamento di post-ossidazione in H2O (525°C per 3 ore) 3. come 1 seguito da un trattamento di post-ossidazione in CO2 (525°C per 3 ore) 4. come 1 seguito da un trattamento di post-ossidazione in NOx (525°C per 3 ore) Le quattro condizioni sperimentali indicate sono state inizialmente analizzate secondo i metodi di studio classici dei trattamenti termochimici superficiali (esami metallografici, diffrazione a raggi x, prove di microdurezza). Successivamente è stata valutata la resistenza alla corrosione degli strati nitrurati e nitrurati-ossidati mediante curve potenziodinamiche in soluzione neutra contenente 35 g/L di NaCl a temperatura ambiente. Le prove di fatica sono state eseguite in flessione rotante determinando il limite di fatica dei campioni mediante il metodo stair case breve (metodo di Dixon). Il comportamento ad usura è stato studiato mediante una macchina di prova in configurazione pin-on-ring in condizione di strisciamento a secco (antagonista: WC-9%Co): tale prova ha permesso di determinare sia la perdita di peso in funzione della distanza “strisciata” sia il coefficiente di attrito. I provini post-ossidati, grazie alla presenza di nitruri di ferro (tipo Fe3N and Fe4N) e magnetite sulla parte più esterna dello strato indurito, mostrano un miglior comportamento a corrosione e ad usura rispetto ai provini solo nitrurati. La resistenza a fatica risulta essere identica per tutte le condizioni sperimentali analizzate, confermando che la post-ossidazione non peggiora il comportamento meccanico dei componenti così trattati.