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The risk of lymphedema after postoperative radiation therapy in endometrial cancer
Devarati Mitra,Paul J. Catalano,Nicole Cimbak,Antonio L. Damato,Michael G. Muto,Akila N. Viswanathan 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.1
Objective: Lower extremity lymphedema adversely affects quality of life by causing discomfort, impaired mobility and increased risk of infection. The goal of this study is to investigate factors that influence the likelihood of lymphedema in patients with endometrial cancer who undergo adjuvant radiation with or without chemotherapy. Methods: A retrospective chart review identified all stage I–III endometrial cancer patients who had a hysterectomy with or without complete staging lymphadenectomy and adjuvant radiation therapy between January 2006 and February 2013. Patients with new-onset lymphedema after treatment were identified. Logistic regression was used to find factors that influenced lymphedema risk. Results: Of 212 patients who met inclusion criteria, 15 patients (7.1%) developed new-onset lymphedema. Lymphedema was associated with lymph-node dissection (odds ratio [OR], 5.6; 95% CI, 1.01 to 105.5; p=0.048) and with the presence of pathologically positive lymph nodes (OR, 4.1; 95% CI, 1.4 to 12.3; p=0.01). Multivariate logistic regression confirmed the association with lymph-node positivity (OR, 3.2; 95% CI, 1.0007 to 10.7; p=0.0499) when controlled for lymph-node dissection. Median time to lymphedema onset was 8 months (range, 1 to 58 months) with resolution or improvement in eight patients (53.3%) after a median of 10 months. Conclusion: Lymph-node positivity was associated with an increased risk of lymphedema in endometrial cancer patients who received adjuvant radiation. Future studies are needed to explore whether node-positive patients may benefit from early lymphedema-controlling interventions.
Thermal management solutions for a lightweight 3L GaN inverter
Roberto Trani,Antonio Pio Catalano,Alberto Castellazzi,Vincenzo d’Alessandro 전력전자학회 2019 ICPE(ISPE)논문집 Vol.2019 No.5
This paper presents a comparative study of different approaches and solutions to the cooling of new type highly compact flat packages for gallium nitride (GaN) transistors. The focus here is on an inverter intended for hybrid and full-electric transport applications, where optimization of the gravimetric power density is paramount. As a case-study, a 3-level active neutral point clamped (aNPC) bi-directional inverter-rectifier topology is considered. The outcomes of the investigation are manifold: optimum design of thermal vias is considered; it is highlighted that the use of a graphene layer just underneath the chip can help reduce the temperature gradient between chip and PCB and can also improve heat-conduction in subsequent layers of the assembly, by enabling a better exploitation of lateral heat-flow possibilities, too; the benefit of using a soldered DCB substrate to assist heat removal from the vias towards the heat-sink is quantified for different materials of the insulating layer (ceramic).
Facon, Thierry,Dimopoulos, Meletios A.,Dispenzieri, Angela,Catalano, John V.,Belch, Andrew,Cavo, Michele,Pinto, Antonello,Weisel, Katja,Ludwig, Heinz,Bahlis, Nizar J.,Banos, Anne,Tiab, Mourad,Delforge American Society of Hematology 2018 Blood Vol.131 No.3
<P>This FIRST trial final analysis examined survival outcomes in patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM) treated with lenalidomide and low-dose dexamethasone until disease progression (Rd continuous), Rd for 72 weeks (18 cycles; Rd18), or melphalan, prednisone, and thalidomide (MPT; 72 weeks). The primary endpoint was progression-free survival (PFS; primary comparison: Rd continuous vs MPT). Overall survival (OS) was a key secondary endpoint (final analysis prespecified >= 60 months' follow-up). Patientswere randomized to Rd continuous (n = 535), Rd18 (n = 541), or MPT (n = 547). At a median follow-up of 67 months, PFS was significantly longer with Rd continuous vs MPT (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.59-0.79; P < .00001) andwas similarly extended vs Rd18. Median OS was 10 months longer with Rd continuous vs MPT (59.1 vs 49.1 months; HR, 0.78; 95% CI, 0.67-0.92; P = .0023), and similar with Rd18 (62.3 months). In patients achieving complete or very good partial responses, Rd continuous had an approximate to 30-month longer median time to next treatment vs Rd18 (69.5 vs 39.9 months). Over half of all patients who received second-line treatment were given a bortezomib-based therapy. Second-line outcomes were improved in patients receiving bortezomib after Rd continuous and Rd18 vs after MPT. No new safety concerns, including risk for secondary malignancies, were observed. Treatment with Rd continuous significantly improved survival outcomes vsMPT, supporting Rd continuous as a standard of care for patients with transplant-ineligible NDMM.</P>
Vascular compression syndromes: a pictorial review
Renato Farina,Pietro Valerio Foti,Isabella Pennisi,Tiziana Vasile,Mariangela Clemenza,Giuliana La Rosa,Luca Crimi,Marco Catalano,Francesco Vacirca,Antonio Basile 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.3
Vascular compression syndromes include a group of rare vascular changes due to extrinsic compression of veins or arteries by surrounding structures. These pathologies are often underestimated due to their rarity, clinicians’ poor level of knowledge, and the non-specificity of their symptoms. The best known are Eagle syndrome, thoracic outlet syndrome, nutcracker syndrome, May-Thurner syndrome, Dunbar syndrome, and popliteal entrapment syndrome. This work summarizes the main ultrasonographic characteristics, symptoms, and treatments of choice for these syndromes. Knowledge of these conditions’ characteristic signs is essential for the differential diagnosis. Failure to diagnose these rare diseases can expose patients to serious complications and risks to their health.