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Giulia Marvaso,1,2,* Stefania Volpe,1,2,* Matteo Pepa,1,* Mattia Zaffaroni,1,* Giulia Corrao,1,2,* Matteo Augugliaro,1,* Franco Nolè,3,* Ottavio De Cobelli,2,4,* Barbara Alicja Jereczek-Fossa1,2,* 1Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy; 2Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; 3Medical Oncology Division of Urogenital & Head & Neck Tumors, IEO European Institute of Oncology IRCCS, Milan, Italy; 4Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy*These authors contributed equally to this workCorrespondence: Matteo PepaDivision of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, ItalyEmail matteo.pepa@ieo.itAbstract: After primary treatment for prostate cancer with either radical prostatectomy or radiotherapy, a significant proportion of patients are at risk of developing metastases. In recent years, a deeper understanding of the underlying biology together with improved imaging techniques and the advent of new therapeutic options including metastases-directed therapies and new drugs have revolutionized the management of low-burden metastatic disease, also known as oligometastatic state. The purpose of this narrative review is to report the recent developments in the management of hormone-sensitive oligometastatic prostate cancer patients.Keywords: oligometastatic prostate cancer, metastasis-directed therapies, narrative review, imaging, biology

Ilaria Proietti,1 Nevena Skroza,1 Alessandra Mambrin,1 Federica Marraffa,2 Ersilia Tolino,1 Nicoletta Bernardini,1 Anna Marchesiello,1 Giovanni Rossi,1 Salvatore Volpe,1 Concetta Potenza1 1Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy; 2Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, ItalyCorrespondence: Ilaria ProiettiDermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, ItalyEmail ilaria.proietti@uniroma1.itAbstract: Cancer patients are experiencing an increase in overall survival as a consequence of earlier diagnosis and newer effective anticancer therapies. However, cancer survivors often face long-term consequences from their original cancer diagnosis and long-term sequelae of anticancer treatment. Maintaining patients’ quality of life is of paramount importance and this can be accomplished by a multidisciplinary treatment approach, including aesthetic treatments to improve patients’ body image and positively impact their quality of life. In this perspective, we will discuss the importance of aesthetic treatments in cancer patients. In addition, we will summarise the data available regarding the use of several aesthetic treatments such as fillers, botulinum toxin and laser use in cancer patients, their safety, their efficacy, and the specific precautions that need to be implemented in this particular subset of cancer patients.Keywords: aesthetic treatment, cancer patient, fillers, botulinum toxin, laser therapy

Sara Volpe, Cosimo Tortorella, Vincenzo Solfrizzi, Giuseppina Piazzolla Interdisciplinary Department of Medicine, University of Bari “Aldo Moro” Medical School, Bari, 70124, ItalyCorrespondence: Giuseppina PiazzollaInterdisciplinary Department of Medicine, University of Bari “Aldo Moro” Medical School, Policlinico, Piazza G. Cesare 11, Bari, 70124, ItalyFax +39 080 5478126Email giuseppina.piazzolla@uniba.itIntroduction: New antidiabetic drugs have simplified treatment regimens in patients with type-2 diabetes (T2D). More importantly, they have proven to reduce cardiovascular risk by lowering insulin-resistance, blood pressure and body weight, in addition to avoiding inappropriate insulin therapy, responsible for hypoglycemic episodes and weight gain. In this context, accurate assessment of the metabolic status of T2D patients becomes essential. The C-peptide assay is a simple but often overlooked test that can provide a fundamental contribution to the correct disease classification and optimal therapeutic management of diabetic patients.Clinical Case: We report the case of a 72-year-old patient, treated with insulin for 26 years after a diagnosis of type-1 diabetes (T1D), resulting in inadequate glycemia control and a severe evolution of cardiovascular complications. After an accurate evaluation of the clinical history, phenotype and laboratory data, including the determination of C-peptide serum levels, a diagnosis was made of T2D not T1D. Considering the patient’s very high cardiovascular risk and dysmetabolic profile, insulin therapy was discontinued and more appropriate therapy with dulaglutide and metformin was instituted. These overall therapeutic modifications yielded remarkable clinical advantages in terms of the glycometabolic profile, weight reduction, abdominal circumference and body mass index decrease, as well as a better quality of life, with complete resolution of the dangerous hypoglycemic episodes.Conclusion: In the era of new cardioprotective antidiabetic drugs, we believe the importance of the C-peptide assay should be re-evaluated in order to avoid misdiagnosis and to improve the therapeutic approach to T2D.Keywords: diabetes, metabolic syndrome, hypoglycemia, obesity, dulaglutide, quality of life

The authors present an optimization procedure in designing infinitely variable transmission architectures, which allows them to achieve a significant reduction in power recirculation and, hence, an increase in mechanical efficiency. The focus of this paper is on infinitely variable transmissions used in off-highway vehicles and, in particular, on input and output coupled architectures. The optimized solutions have been analyzed in depth, with particular attention to the power flowing through the infinitely variable unit, which strongly influences the overall efficiency of the transmission. The major result of this study is that the so far neglected output coupled solution, if properly optimized, guarantees very good performance over the entire range of vehicle speed. The analysis then shows that the particular choice of either input or output coupled architecture by itself, or of a mixed solution, strictly depends on the specific application under consideration and that none of them should be discarded a priori. [DOI: 10.1115/1.3179145] Keywords: continuously variable transmission, infinitely variable transmission, power split, input coupled, output coupled, optimization, efficiency