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At CERN-ISOLDE, high-purity radioactive ion beams of 219Fr and 221RaF were investigated with α-decay spectroscopy at the CRIS and ASET experiments in the course of three different experimental campaigns. The half-life of 215At, α-decay daughter of 219Fr, is measured to be 36.3(3)[9]µs, and that of 221Ra was determined to be 26.2(1)[6]s, both of which are well in line with the trends in this region of the nuclear landscape but at odds with some of the reported literature.
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AIM: To assess pain relief and local tumour control retrospectively in spinal metastases undergoing cryoablation. MATERIALS AND METHODS: Between May 2008 and September 2020, 46 metastases in 41 consecutive patients (mean age 59.7±4.4 [SD] years; range 27-84) were treated with cryoablation in 42 interventional sessions. Patient demographics, procedural data, complications, pain, and local tumour control were analysed retrospectively. RESULTS: Thirty-one patients (36 spine metastases; 32 sessions) were treated for pain relief and 10 (10 metastases; 10 sessions) for local tumour control. Clinical success was reached in 30/32 (93.8%) interventional palliative sessions. Mean pre-procedural numerical pain rate scale was 6.2±1.7 (SD), and dropped significantly to 3.5±1.8 (SD), 1.9±1.7 (SD), and 1.9±1.8 (SD) at 24-h, 1-month and at the last available follow-up (median 16.5±23.2 [SD] months), respectively. For patients requiring local tumour control, primary clinical success was reached in 6/10 (60%) spinal metastases at median 25-months follow-up. The overall complication rate was 8%, with no secondary fractures or iatrogenic thermal-mediated nerve injuries reported. CONCLUSION: Percutaneous image-guided cryoablation of spinal metastases is safe and effective in achieving pain relief and local tumour control.
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Criocirugía/métodos , Manejo del Dolor/métodos , Dolor/cirugía , Radiología Intervencionista/métodos , Neoplasias de la Columna Vertebral/secundario , Neoplasias de la Columna Vertebral/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/etiología , Estudios Retrospectivos , Neoplasias de la Columna Vertebral/complicaciones , Resultado del TratamientoRESUMEN
PURPOSE: To investigate the safety and clinical efficacy of bipolar radiofrequency ablation (b-RFA) with increased (>70°C) target temperature for the treatment of spine metastases with the intent of achieving pain relief or local tumor control. MATERIALS AND METHODS: Thirty-one patients with a total of 37 metastases who were treated with b-RFA with increased temperature and vertebroplasty from January 2016 to May 2019 were retrospectively included. There were 20 women and 11 men with a mean age of 62.4±10.5 (SD) years (range: 40-78years). Patients and metastases characteristics, procedure details and clinical outcomes were analyzed. RESULTS: Metastases were predominantly located in lumbar (22/37; 59.5%) or thoracic spine (13/37; 35.1%). Mean target temperature was 88.4±3.5 (SD) °C (range: 70-90°C). Technical success was 100% (37/37 metastases). One (1/37; 2.7%) major complication unrelated to b-RFA was reported. One (1/37; 2.7%) metastasis was lost to follow-up. Favorable outcome was noted in patients receiving b-RFA for pain management (16/20 metastases; 80%; mean follow-up, 3.4±2.9 [SD] months) or with oligometastatic/oligoprogressive disease (6/6 metastases; 100%; mean follow-up, 5.0±4.6 [SD] months). In patients receiving b-RFA to prevent complications, favorable outcome was noted in 6/10 metastases (60%; mean follow-up, 3.8±4.8 [SD] months). CONCLUSIONS: B-RFA with increased target temperature has an excellent safety profile and results in high rates of pain relief and local metastasis control in patients with oligometastatic/oligoprogressive disease. Suboptimal results are achieved in patients receiving b-RFA to prevent complications related to the growth of the index tumor.
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Ablación por Catéter , Ablación por Radiofrecuencia , Neoplasias de la Columna Vertebral , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Manejo del Dolor , Estudios Retrospectivos , Neoplasias de la Columna Vertebral/cirugía , Temperatura , Resultado del TratamientoRESUMEN
Reliable neutron-induced-reaction cross sections of unstable nuclei are essential for nuclear astrophysics and applications but their direct measurement is often impossible. The surrogate-reaction method is one of the most promising alternatives to access these cross sections. In this work, we successfully applied the surrogate-reaction method to infer for the first time both the neutron-induced fission and radiative capture cross sections of ^{239}Pu in a consistent manner from a single measurement. This was achieved by combining simultaneously measured fission and γ-emission probabilities for the ^{240}Pu(^{4}He,^{4}He^{'}) surrogate reaction with a calculation of the angular-momentum and parity distributions populated in this reaction. While other experiments measure the probabilities for some selected γ-ray transitions, we measure the γ-emission probability. This enlarges the applicability of the surrogate-reaction method.
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AIM: To report the technique of percutaneous double oblique anterior access to the acetabulum and evaluate its feasibility and safety. MATERIALS AND METHODS: Pelvic computed tomography (CT) examinations of 60 patients (30 men and 30 women; mean age 62.6±13.2 years) were retrieved randomly from the picture archiving and communication system (PACS). A virtual intraosseous trajectory was defined on both sides on the axial CT images with the entry point marked 1 cm above the anterosuperior iliac spine and the endpoint defined just above the level of the ischial spine at the midpoint of the posterior acetabulum. Patient age, sagittal oblique angulation, axial oblique angulation, length of intraosseous trajectory, distance from the hip joint, thickness of the iliac bone cortex, and intervening structure(s) between the skin and the bone entry points were recorded. RESULTS: The mean sagittal and axial oblique angulations were 34.2±4.5° and 31.5±6.7°, respectively, and mean length of the intraosseous trajectory was 11.8±0.9 cm. The axial oblique angle and length of the intraosseous trajectory were significantly lower in the female than the male population (p<0.05). None of the virtual trajectories traversed the hip joint. In 112/120 trajectories (93.3%), there were no cortical breaches in the iliac bones. In eight trajectories in four patients, the virtual trajectory crossed either the medial iliac cortex (4/120; 3.3%) or the medial iliac cortex and the iliacus muscle (4/120; 3.3%). CONCLUSION: The anterosuperior iliac and ischial spines can be used safely and reliably as landmarks to perform the double oblique anterior approach.
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Acetábulo/diagnóstico por imagen , Acetábulo/cirugía , Cementoplastia/métodos , Osteólisis/diagnóstico por imagen , Osteólisis/cirugía , Radiografía Intervencional/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anciano de 80 o más Años , Puntos Anatómicos de Referencia , Estudios de Factibilidad , Femenino , Fluoroscopía , Humanos , Masculino , Persona de Mediana Edad , PuncionesRESUMEN
AIM: To assess the value and efficacy of real-time shear-wave elastography (SWE) of normal testicular parenchyma and various common testicular diseases in clinical practice. MATERIALS AND METHODS: SWE was undertaken in 338 patients (mean age: 43.2±17.2 years, range 17-78 years) comprising normal testicles (n = 358), testicular microlithiasis (n = 40), and various testicular diseases (n = 208) and the stiffness was recorded. The final diagnosis was correlated with the clinical context, long-term follow-up, or histopathology. Statistical evaluation was performed to provide a stiffness threshold for pathological diagnosis. RESULTS: The mean size of testicular lesions was 2.6±1.5 cm (range: 10-42 mm). The mean Young's modulus value for normal testis was recorded at 4.55±2.54 kPa. Whatever the stage of microlithiasis, a higher statistically significant stiffness value was recorded. For acute orchitis, the mean stiffness value was slightly higher, but not statistically significantly. The testicular tumoural processes presented a median stiffness value of 21.02 kPa with a cut-off of 16.1 kPa. Fibrosis presented the highest median stiffness value of 30.03 kPa with a cut-off of 26.3 kPa. By analysing the distribution of the different pathological groups, the difference was statistically significant between fibrosis and tumoural processes (p = 0.001). CONCLUSION: SWE is a feasible technique in the exploration of the testicular parenchyma. SWE values can be used to differentiate testicular fibrosis from a tumoural process with confidence.
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Diagnóstico por Imagen de Elasticidad/métodos , Enfermedades Testiculares/diagnóstico por imagen , Testículo/diagnóstico por imagen , Adolescente , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Testiculares/patología , Neoplasias Testiculares/diagnóstico por imagen , Neoplasias Testiculares/patología , Testículo/patología , Adulto JovenRESUMEN
OBJECTIVE: To determine the pejorative predictive factors on oncologic outcomes of percutaneous MR-guided whole gland prostate cancer cryoablation (CA). METHODS: Medical records of patients treated from 2009 to 2012, to assess medium-term oncologic outcomes, were reviewed. Prostate biopsies were performed in local recurrence suspicion (biochemical failure, MR follow-up failure). RESULTS: Among 18 patients, mean age of 72.6 (61-78), 2 (11 %) and 7 (38.9 %) biological and reported biopsy-proven local recurrence respectively with our initial technic of CA. Mean follow-up and recurrence were 56.3 (±21.7) and 20.7 (±13.9) months respectively. A previous treatment of prostate cancer (P=0.5), pre-treatment PSA (P=0.2), pre-treatment Gleason/ISUP score (P=0.4), nadir PSA post-CA (P=0.22) were not associated with recurrence. Bilateral positive cores appears as a pejorative predictive factor (P=0.04). However mean pre-treatment positive cores percentage, 25 (±16.5) in responding patients versus 40.7 (±25.2) in case of recurrence, and maximum percentage of cancer extent in each positive core, 10.6 (±9.3) in responding patients versus 18.7 (±16.5) in case of recurrence, seemed associated with local recurrence after prostate CA but our analysis wasn't able to find a difference (P=0.09 and P=0.3 respectively) due to a lack of power. CONCLUSION: Bilateral positive cores appears as a pejorative predictive factor. In our experience, important tumor volume seem to be a pejorative predictive factor for oncologic outcomes after PCA whereas treatment, PSA, Gleason/ISUP score, nadir PSA are not. LEVEL OF EVIDENCE: 4.
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Criocirugía/métodos , Imagen por Resonancia Magnética , Neoplasias de la Próstata/cirugía , Anciano , Biopsia , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Recurrencia Local de Neoplasia , Valor Predictivo de las Pruebas , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Estudios Retrospectivos , Carga TumoralRESUMEN
Enhanced Recovery After Surgery (ERAS) pathway is a multi-disciplinary, patient-centered protocol relying on the implementation of the best evidence-based perioperative practice. In the field of colorectal surgery, the application of ERAS programs is associated with up to 50% reduction of morbidity rates and up to 2.5 days reduction of postoperative hospital stay. However, widespread adoption of ERAS pathways is still yet to come, mainly because of the lack of proper information and communication. Purpose of this paper is to support the diffusion of ERAS pathways through a critical review of the existing evidence by members of the two national societies dealing with ERAS pathways in Italy, the PeriOperative Italian Society (POIS) and the Associazione Italiana Chirurghi Ospedalieri (ACOI), showing the results of a consensus development conference held at Matera, Italy, during the national ACOI Congress on June 10, 2019.
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Cirugía Colorrectal , Consenso , Recuperación Mejorada Después de la Cirugía/normas , Sociedades Médicas , Comorbilidad , Consejo , Humanos , Italia , Cuidados Preoperatorios/métodosRESUMEN
Fast-neutron-induced fission of ^{238}U at an energy just above the fission threshold is studied with a novel technique which involves the coupling of a high-efficiency γ-ray spectrometer (MINIBALL) to an inverse-kinematics neutron source (LICORNE) to extract charge yields of fission fragments via γ-γ coincidence spectroscopy. Experimental data and fission models are compared and found to be in reasonable agreement for many nuclei; however, significant discrepancies of up to 600% are observed, particularly for isotopes of Sn and Mo. This indicates that these models significantly overestimate the standard 1 fission mode and suggests that spherical shell effects in the nascent fission fragments are less important for low-energy fast-neutron-induced fission than for thermal neutron-induced fission. This has consequences for understanding and modeling the fission process, for experimental nuclear structure studies of the most neutron-rich nuclei, for future energy applications (e.g., Generation IV reactors which use fast-neutron spectra), and for the reactor antineutrino anomaly.
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Male germ cells undergo different processes within the female reproductive tract to successfully fertilize the oocyte. These processes are triggered by different extracellular stimuli leading to activation of protein phosphorylation. Protein kinase C (PKC) is a key regulatory enzyme in signal transduction mechanisms involved in many cellular processes. Studies in boar sperm demonstrated a role for PKC in the intracellular signaling involved in motility and cellular volume regulation. Experiments using phorbol 12-myristate 13-acetate (PMA) showed increases in the Serine/Threonine phosphorylation of substrates downstream of PKC in boar sperm. In order to gain knowledge about those cellular processes regulated by PKC, we evaluate the effects of PMA on boar sperm motility, lipid organization of plasma membrane, integrity of acrosome membrane and sperm agglutination. Also, we investigate the crosstalk between PKA and PKC intracellular pathways in spermatozoa from this species. The results presented here reveal a participation of PKC in sperm motility regulation and membrane fluidity changes, which is probably associated to acrosome reaction and to agglutination. Also, we show the existence of a hierarchy in the kinases pathway. Previous works on boar sperm suggest a pathway in which PKA is positioned upstream to PKC and this new results support such model.
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Proteína Quinasa C/metabolismo , Espermatozoides/enzimología , Animales , Membrana Celular/efectos de los fármacos , Membrana Celular/enzimología , Masculino , Fosforilación/efectos de los fármacos , Motilidad Espermática/efectos de los fármacos , Espermatozoides/efectos de los fármacos , Porcinos , Acetato de Tetradecanoilforbol/farmacologíaRESUMEN
The present study was carried out to characterize the cervical mucus (CM) collected when inseminating Holstein cows and to relate the secretion pattern with pregnancy. The mucus was collected from mid-cervix of 64 cows with spontaneus estrus (SE) and induced estrus (IE). The quantity, pattern and consistency of the mucus, pH, arborization patterns and the sperm motility were observed. The levels of progesterone and estradiol 17ß in serum were also determined. Pregnancy detection was performed by means of transrectal ultrasonography 60 days after insemination. Mucous secretion of cows with SE was significantly different from those with IE, showing a lower degree of crystallization (SE 2.00; IE 2.75) and a lower level of steroid hormones (P4: SE 0.17 ng/ml and IE 0.33 ng/ml (t 1.99547 α 0.05); E2: SE 30.95 pg/ml and IE 47.76 pg/ml (t 1.99495 α 0.05). Progesterone level was significantly lower and estrogen significantly higher in pregnant cows (P) in relation to that observed in non pregnant females (N) (P4: P 0.20 ng/ml and N 0.44 ng/ml (t 1.99602 α 0.05); E2: P 54.77 pg/ml and N 40.75 pg/ml (t 1.99505 α 0.05). In conclusion pregnancy was associated with acopious, clear and watery discharge (similar to egg white), with an arborization degree of 2.25, presence of atypical fern leaves together with rosette formations and needles or thorns on rails due to low levels of progesterone accompanied by high concentrations of estrogens.
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PURPOSE: The diagnostic, therapeutic and health-care management protocol (Protocollo Gestionale Diagnostico-Terapeutico-Assistenziale, PDTA) by the Association of the Italian Endocrine Surgery Units (U.E.C. CLUB) aims to help treat the patient in a topical, rational way that can be shared by health-care professionals. METHODS: This fourth consensus conference involved: a selected group of experts in the preliminary phase; all members, via e-mail, in the elaboration phase; all the participants of the XI National Congress of the U.E.C. CLUB held in Naples in the final phase. The following were examined: diagnostic pathway and clinical evaluation; mode of admission and waiting time; therapeutic pathway (patient preparation for surgery, surgical treatment, postoperative management, management of major complications); hospital discharge and patient information; outpatient care and follow-up. RESULTS: A clear and concise style was adopted to illustrate the reasons and scientific rationales behind behaviors and to provide health-care professionals with a guide as complete as possible on who, when, how and why to act. The protocol is meant to help the surgeon to treat the patient in a topical, rational way that can be shared by health-care professionals, but without influencing in any way the physician-patient relationship, which is based on trust and clinical judgment in each individual case. CONCLUSIONS: The PDTA in thyroid surgery approved by the fourth consensus conference (June 2015) is the official PDTA of U.E.C. CLUB.
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Atención a la Salud/normas , Hospitalización/estadística & datos numéricos , Guías de Práctica Clínica como Asunto/normas , Enfermedades de la Tiroides/diagnóstico , Enfermedades de la Tiroides/cirugía , Tiroidectomía/normas , Tiempo de Tratamiento/normas , Consenso , Humanos , ItaliaRESUMEN
PURPOSE: Triple channel algorithm and specific procedures make more reliable radiochromic dosimetry for treatment planning verification and quality assurance in radiation therapy. A tool to obtain radiochromic dose distributions and compare them with the ones resulting from a treatment planning system was developed and applied. METHODS: The tool was developed as Microsoft Excel macro; it builds dose calibration curves against net optical density of Gafchromic EBT3 film, produces axial, coronal and sagittal dose maps and allows to evaluate them against dose distributions calculated by the Varian treatment planning system Eclipse using gamma index and gamma angle. RESULTS: The net optical density standard errors of estimate of calibration curves at 6 MV Varian DBX600 linac energy were 0.2%, 0.4% and 0.2% for the red, green and blue channels. Tests of these curves by means of three independent eight dose points measurement series, at 15 MV and 6 MV Varian 2100C linac and at 6 MV DBX600 linac energies, showed less than 2% of dose errors for the red channel and less than 3% for the green channel in the range 100-450 cGy. The comparisons between dose distributions from Gafchromic EBT3 triple channel algorithm and the ones from Eclipse analytic anisotropic algorithm (AAA) showed values of gamma index 95th percentile between 0.6 and 1.0. CONCLUSION: The obtained results encourage the application of this tool in radiation therapy quality assurance.
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Dosimetría por Película/métodos , Dosis de Radiación , Oncología por Radiación , Algoritmos , Calibración , Dosificación Radioterapéutica , Planificación de la Radioterapia Asistida por Computador , Programas Informáticos , IncertidumbreRESUMEN
AIM: To update the Diagnostic-Therapeutic-Healthcare Protocol (Protocollo Diagnostico-Terapeutico-Assistenziale, PDTA) created by the U.E.C. CLUB (Association of the Italian Endocrine Surgery Units) during the I Consensus Conference in 2008. METHODS: In the preliminary phase, the II Consensus involved a selected group of experts; the elaboration phase was conducted via e-mail among all members; the conclusion phase took place during the X National Congress of the U.E.C. CLUB. The following were examined: diagnostic pathway and clinical evaluation; mode of admission and waiting time; therapeutic pathway (patient preparation for surgery, surgical treatment, postoperative management, management of major complications); hospital discharge and patient information; outpatient care and follow-up. CONCLUSIONS: The PDTA for parathyroid surgery approved by the II Consensus Conference (June 2013) is the official PDTA of the U.E.C. CLUB.
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Enfermedades de las Paratiroides/diagnóstico , Enfermedades de las Paratiroides/cirugía , Glándulas Paratiroides/cirugía , Paratiroidectomía/métodos , Paratiroidectomía/normas , Consenso , Formularios de Consentimiento/normas , Vías Clínicas/normas , Atención a la Salud/normas , Consejo Dirigido/normas , Hospitalización , Humanos , Guías de Práctica Clínica como Asunto , Tiempo de Tratamiento/normas , Listas de EsperaRESUMEN
The oviduct supports the transport and final maturation of gametes, and harbors fertilization and early embryo development. The oviductal epithelium is responsible for providing the correct environment for these processes. Deleted in malignant brain tumor 1 (DMBT1) is expressed by multiple organisms and several cell types, and the interaction of the rabbit ortholog of DMBT1 with galectin-3 (gal-3) modulates the polarity of epithelial cells. This interaction has not yet been shown in locations other than rabbit kidney and human-cultured endothelial cells. DMBT1 and gal-3 also protect epithelial layers from pathogens and trauma, and are innate immunity components. DMBT1 has been detected in the porcine oviduct, and gal-3 has been reported in the Fallopian tube and in the cow oviduct. Interaction between both proteins would show a probable physiological function in the female reproductive tract. This work describes the presence and co-localization of DMBT1 and gal-3 mainly in the apical region of the epithelial cells of the Fallopian tube and the porcine oviduct, and co-immunoprecipitation in membrane-enriched epithelial cell extracts from the porcine oviduct. The findings strongly support a functional interaction in the mammalian oviduct, suggestive of a role on epithelial protection and homeostasis, which might be related to epithelium-gamete interaction.
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Trompas Uterinas/metabolismo , Galectina 3/metabolismo , Receptores de Superficie Celular/metabolismo , Animales , Western Blotting , Femenino , Inmunohistoquímica , PorcinosRESUMEN
Distributions of the largest fragment charge, Zmax, in multifragmentation reactions around the Fermi energy can be decomposed into a sum of a Gaussian and a Gumbel distribution, whereas at much higher or lower energies one or the other distribution is asymptotically dominant. We demonstrate the same generic behavior for the largest cluster size in critical aggregation models for small systems, in or out of equilibrium, around the critical point. By analogy with the time-dependent irreversible aggregation model, we infer that Zmax distributions are characteristic of the multifragmentation time scale, which is largely determined by the onset of radial expansion in this energy range.
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In sows, the oviductal sperm-binding glycoprotein (SBG), which binds to the periacrosomal region of boar sperm, has been shown to be involved in sperm selection. In this work, we isolated porcine sperm proteins that interact with SBG. One of them is identified as a homologue of human S100A7 (psoriasin). Anti-human S100A7 antibodies show that this homologous protein localises to the head of sperm. The isolation of a homologue of S100A7 based on affinity to SBG and its localisation at the head of sperm leads us to suggest that S100A7's homologous protein may be involved in the negative selection of sperm by SBG in pigs. Human S100A7 shows antibacterial properties, particularly over Escherichia coli, a species that has demonstrated deleterious effects on human sperm. We searched for S100A7 in human sperm and found that it is present and localises at the acrosomal region. Thus, we report the presence of S100A7 in human sperm and of a homologous protein in pig, with similar localisations. In humans, an antimicrobial role seems likely for psoriasin; in porcine sperm the studied protein binds to SBG suggesting a function in sperm selection, but an antimicrobial function cannot be ruled out.
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Proteínas S100/metabolismo , Proteínas de Plasma Seminal/metabolismo , Secuencia de Aminoácidos , Animales , Western Blotting , Cromatografía de Afinidad , Electroforesis en Gel Bidimensional , Femenino , Humanos , Inmunohistoquímica , Datos de Secuencia Molecular , Unión Proteica , Proteína A7 de Unión a Calcio de la Familia S100 , Proteínas S100/química , Proteínas de Plasma Seminal/aislamiento & purificación , Homología de Secuencia de Aminoácido , Porcinos , Espectrometría de Masas en TándemRESUMEN
This research aims to understand the prevalence of religious slaughter practices in Italy. Two different ways of slaughtering animals are identified. Conventional slaughter is performed with prior stunning; kosher slaughter is practiced without stunning. Halal slaughter is performed for most animals without stunning. Halal slaughter with prior stunning is acceptable for 5.90% of small ruminants. For Halal slaughter in Italy, the terms "religious slaughter with stunning" and "religious slaughter without stunning" should be used to differentiate religious slaughter practices, keeping animal welfare in perspective.
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Mataderos , Bienestar del Animal , Islamismo , Judaísmo , Animales , Recolección de Datos , Italia , Aves de Corral , Rumiantes , Encuestas y CuestionariosRESUMEN
Fragment partitions of fragmenting hot nuclei produced in central and semiperipheral collisions have been compared in the excitation energy region 4-10 MeV per nucleon where radial collective expansion takes place. It is shown that, for a given total excitation energy per nucleon, the amount of radial collective energy fixes the mean fragment multiplicity. It is also shown that, at a given total excitation energy per nucleon, the different properties of fragment partitions are completely determined by the reduced fragment multiplicity (i.e., normalized to the source size). Freeze-out volumes seem to play a role in the scalings observed.
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AIM: To review and to update the management protocols in thyroid surgery proposed two years ago by 1st Consensus Conference called on the topic by the Italian Association of Endocrine Surgery Units (UEC Club). METHOD: The 2nd Consensus Conference took place November 30, 2008 in Pisa within the framework of the 7th National Congress of the UEC Club. A selected board of endocrinologists and endocrine surgeons (chairmans: Paolo Miccoli and Aldo Pinchera; speaker: Lodovico Rosato) examined the individual chapters and submitted the consensus text for the approval of several experts. This plain and concise text provides the rationale of the thyroid patient management and wants to be the most complete possible tool for the physicians and other professionals in the field. CONCLUSIONS: The diagnostic, therapeutic and healthcare management protocols in thyroid surgery approved by the 2nd Consensus Conference are officially those proposed by the Italian Association of Endocrine Surgery Units (UEC Club) and are subject to review by two years.