Since 2003 we are using in our stapedotomies the Nitinol 'Smart' Piston. This prosthesis has a Teflon 'vestibular' end and a wire shaft made by Nitinol, with a heat activated self-crimping loop. Nitinol is an alloy of Nickel + Titanium, belonging to the class of the so-called smart materials, i.e. materials with shape-memory and superelastic properties. Nitinol is lightweight and highly biocompatible thanks to the thin layer of Titanium oxide covering the Nickel surface. The special advantage of this piston is that the loop grips by itself very uniformly and quite tightly around the incudal process or the malleus handle when a minimal heating (about 60 degrees C) is applied using a disposable heater ('Thermal Tip'). This piston was successfully used in our Department between 2003 and 2004 in a first group of 42 cases of stapedotomy and in 7 cases of malleostapedotomy. The shape and the uniformity of the loop grip was controlled by examining fresh temporal bone specimens by S.E.M. (x21 / 166) and in all specimens the loop was uniformly surrounding the ossicle, without 'dead' spaces. It is our feeling that this prosthesis is very useful in stapes surgery for at least two reasons: 1. because it improves the quality of the interface 'piston loop/long process of incus'; 2. because the duration of the procedure is reduced.

Community pharmacies are among the most easily accessible health services. Considering the major impact of COVID-19 in social terms, the purpose was to analyse the evolution of the relationship between community pharmacies and customers during the pandemic in 2020 and to understand which strategies should be implemented in the future. The data have been collected from May to December 2020. Pharmacists administered a questionnaire, also available online, to all customers that agreed to participate. The total number of respondents was 502. The results obtained confirm a generally high level of satisfaction with pharmacies among customers and appreciation for the role of community pharmacies. For the future, the priority is to monitor the situation to break down social inequalities. A task that can be entrusted to the branch of the healthcare service ideally suited to this end: local medicine, of which the community pharmacy is an essential element. The post-pandemic pharmacy will need to have the skills to provide accurate and reliable information on issues, including broad topics such as prevention and lifestyle to fight “syndemic” (two or more factors that work together to make a disease worse) and “infodemic” (too much information including false or misleading information during a disease outbreak).

Thanks to their distribution throughout the territory and extended opening hours, community pharmacists are among the healthcare specialists most easily accessible to the public and often represent the first point of consultation both for the treatment of acute health conditions and, more generally, for health and therapy advice. The objective of the present study was to evaluate whether post-graduate courses/further training courses for pharmacists might influence the quality of patient management and care and, consequently, the satisfaction of the users who entered the pharmacy. We used the revenues of the pharmacies (Group A) in which these pharmacists are employed as a performance indicator. We compared the data for this group with the national averages for Italian pharmacies (Group B) and with those of a group (Group C) of selected pharmacies as similar as possible to the pharmacies in Group A based on a number of well-defined parameters. The comparison of revenues, year-on-year changes, and the average number of sales by the pharmacies in the three groups indicates that the pharmacies in Group A had the best performance, not only when compared with the national average but especially compared with the control group, specifically selected to make the comparison as significant as possible.