scholarly journals Application of da Vinci robots in the surgery of selected human cancers

2021 ◽  
pp. 253-260
Author(s):  
Yusuf Jamal ◽  
Fahad Al-Khodairy
Keyword(s):  
Clinical Trials ◽  
Robotic Surgery ◽  
Clinical Outcomes ◽  
Surgical Procedures ◽  
Retrospective Studies ◽  
Da Vinci ◽  
Laparoscopic Procedure ◽  
Oncological Outcomes ◽  
Human Cancers ◽  
To Come

The discovery of da Vinci surgical systems significantly contributed to cancer surgeries worldwide, however, the clinical and oncological outcomes are still debatable. Many retrospective studies have highlighted the advantage of robotic surgery over laparoscopic or open surgical procedures for various cancers, however, more multicentered, coordinated, random clinical trials must be conducted to outline the specific advantages of da Vinci robots. They have been widely used in cancer surgeries, however, higher operative cost and comparable oncological outcomes with laparoscopic approaches further forced manufacturers to come up with affordable and efficient specialized robotic surgery systems. Nevertheless, robotic surgery using da Vinci robots has been widely accepted for hysterectomy and prostatectomy over the laparoscopic procedure and this review briefly discusses da Vinci robots in the surgery of various human cancers and their clinical outcomes.

scholarly journals Robotic Surgery: da Vinci® and beyond

2012 ◽  
Vol 94 (1) ◽  
pp. 8-9 ◽  
Author(s):  
Katie Bennett
Keyword(s):  
Robotic Surgery ◽  
Surgical Procedures ◽  
Da Vinci ◽  
High Volume ◽  
Indelible Mark ◽  
The Uk

In 2001 the first da Vinci® robot (Intuitive Surgical Inc) was installed in the UK at St Mary's hospital, London. It was initially used for high-volume, standard surgical procedures. More than 10 years on, 27 robots are in use in England. The da Vinci® robot, used primarily in urology but also in gynaecology, ENT, colorectal, cardiology and paediatrics, is making an indelible mark on the NHS.

Crizotinib Versus Chemotherapy on ALK-positive NSCLC: A Systematic Review of Efficacy and Safety

2018 ◽  
Vol 19 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Mingxia Wang ◽  
Guanqi Wang ◽  
Haiyan Ma ◽  
Baoen Shan
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Events ◽  
Objective Response Rate ◽  
Retrospective Studies ◽  
Response Rate ◽  
Objective Response ◽  
Treated Group ◽  
Efficacy And Safety ◽  
Alk Positive

Introduction: Crizotinib was approved to treat anaplastic lymphoma kinase (ALK)- positive non-small cell lung cancer (NSCLC) by the Food and Drug Administration in 2011.We conducted a systematic review of clinical trials and retrospective studies to compare the efficacy and safety of crizotinib with chemotherapy. </P><P> Methods: We searched electronic databases from inception to Dec. 2016. Clinical trials and retrospective studies regarding crizotinib and crizotinib versus chemotherapy in treatment of NSCLC were eligible. The primary outcomes were the objective response rate (ORR) and disease control rate (DCR). Results: Nine studies (five clinical trials and four retrospective studies) including 729 patients met the inclusion criteria. Crizotinib treatment revealed 1-year OS of 77.1% and PFS of 9.17 months. And crizotinib had a better performance than chemotherapy in ORR (OR: 4.97, 95%CI: 3.16 to 7.83, P<0.00001, I2=35%). DCR revealed superiority with crizotinib than chemotherapy (OR: 3.42, 95% CI: 2.33 to 5.01, P<0.00001, I2=0%). PR (partial response) were significant superior to that of chemotherapy through direct systematic review. No statistically significant difference in CR (complete response) was found between crizotinib-treated group and chemotherapy-treated group. Regarding SD (stable disease), chemotherapy-treated group had a better performance than crizotinib-treated group. Common adverse events associated with crizotinib were visual disorder, gastrointestinal side effects, and elevated liver aminotransferase levels, whereas common adverse events with chemotherapy were fatigue, nausea, and hematologic toxicity. This systematic review revealed improved objective response rate and increased disease control rate in crizotinib group comparing with chemotherapy group. Crizotinib treatment would be a favorable treatment option for patients with ALK-positive NSCLC. ALK inhibitors may have future potential applications in other cancers driven by ALK or c-MET gene mutations.

scholarly journals Standardising clinical outcomes measures for adult clinical trials in Fabry disease: A global Delphi consensus

2021 ◽  
Author(s):  
D. Moreno-Martinez ◽  
P. Aguiar ◽  
C. Auray-Blais ◽  
M. Beck ◽  
D.G. Bichet ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Fabry Disease ◽  
Clinical Outcomes ◽  
Delphi Consensus ◽  
Outcomes Measures

scholarly journals Matching comparisons of therapeutic efficacy suggest better clinical outcomes for patients treated with peginterferon beta-1a than with glatiramer acetate

2021 ◽  
Vol 14 ◽  
pp. 175628642097591
Author(s):  
Thomas F. Scott ◽  
Ray Su ◽  
Kuangnan Xiong ◽  
Arman Altincatal ◽  
Carmen Castrillo-Viguera ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Propensity Score ◽  
Clinical Outcomes ◽  
Glatiramer Acetate ◽  
Therapeutic Efficacy ◽  
Individual Patient Data ◽  
Patient Data ◽  
Phase Iii ◽  
Lower Probability ◽  
Phase Iii Clinical Trials

Background: Peginterferon beta-1a and glatiramer acetate (GA) are approved first-line therapies for the treatment of relapsing forms of multiple sclerosis, but their therapeutic efficacy has not been compared directly. Methods: Clinical outcomes at 2 years, including no evidence of disease activity (NEDA), for patients receiving peginterferon beta-1a 125 mcg every 2 weeks (Q2W) or GA 20 mg/ml once daily (QD) were compared by propensity score matching analysis using individual patient data from ADVANCE and CONFIRM phase III clinical trials. In addition, clinical outcomes at 1–3 years for patients receiving peginterferon beta-1a Q2W or GA 40 mg/ml three times a week (TIW) were evaluated using a matching-adjusted comparison analysis of individual patient data from ADVANCE and the ADVANCE extension study, ATTAIN, and aggregate patient data from the phase III GALA and the GALA extension studies. Results: Propensity-score-matched peginterferon beta-1a patients ( n = 336) had a significantly lower annualized relapse rate [ARR (0.204 versus 0.282); rate ratio = 0.724; p = 0.045], a significantly lower probability of 12-week confirmed disability worsening (10.0% versus 14.6%; hazard ratio = 0.625; p = 0.048), and a significantly higher rate of NEDA (20.3% versus 11.5%; p = 0.047) compared with GA 20 mg/ml QD patients after 2 years of treatment. Matching-adjusted peginterferon beta-1a patients (effective n = 276) demonstrated a similar ARR at 1 year (0.278 versus 0.318; p = 0.375) and significantly lower ARR at 2 years (0.0901 versus 0.203; p = 0.032) and 3 years (0.109 versus 0.209; p = 0.047) compared with GA 40 mg/ml TIW patients ( n = 834). Conclusion: Results from separate matching comparisons of phase III clinical trials and extension studies suggest that peginterferon beta-1a 125 mcg Q2W may provide better clinical outcomes than GA (20 mg/ml QD or 40 mg/ml TIW).

scholarly journals The Role of Artificial Intelligence in Fighting the COVID-19 Pandemic

2021 ◽  
Author(s):  
Francesco Piccialli ◽  
Vincenzo Schiano di Cola ◽  
Fabio Giampaolo ◽  
Salvatore Cuomo
Keyword(s):  
Artificial Intelligence ◽  
Clinical Trials ◽  
Digital Transformation ◽  
Daily Activities ◽  
Commercial Vehicles ◽  
Human Skills ◽  
To Come ◽  
Complex Scenario ◽  
The Impact

AbstractThe first few months of 2020 have profoundly changed the way we live our lives and carry out our daily activities. Although the widespread use of futuristic robotaxis and self-driving commercial vehicles has not yet become a reality, the COVID-19 pandemic has dramatically accelerated the adoption of Artificial Intelligence (AI) in different fields. We have witnessed the equivalent of two years of digital transformation compressed into just a few months. Whether it is in tracing epidemiological peaks or in transacting contactless payments, the impact of these developments has been almost immediate, and a window has opened up on what is to come. Here we analyze and discuss how AI can support us in facing the ongoing pandemic. Despite the numerous and undeniable contributions of AI, clinical trials and human skills are still required. Even if different strategies have been developed in different states worldwide, the fight against the pandemic seems to have found everywhere a valuable ally in AI, a global and open-source tool capable of providing assistance in this health emergency. A careful AI application would enable us to operate within this complex scenario involving healthcare, society and research.

Feasibility of Reduced-Port Robotic Surgery for Myomectomy with the da Vinci Surgical System

2017 ◽  
Vol 24 (6) ◽  
pp. 926-931 ◽  
Author(s):  
Jeong Jin Kim ◽  
Chahien Choi ◽  
Su Hyun Nam ◽  
Woo Young Kim
Keyword(s):  
Robotic Surgery ◽  
Da Vinci ◽  
Da Vinci Surgical System ◽  
Reduced Port ◽  
Vinci Surgical System ◽  
Surgical System

scholarly journals Pathogenetic and predictive value of biomarkers in patients with ALI and lower severity of illness: results from two clinical trials

2012 ◽  
Vol 303 (8) ◽  
pp. L634-L639 ◽  
Author(s):  
Ashish Agrawal ◽  
Hanjing Zhuo ◽  
Sandra Brady ◽  
Joseph Levitt ◽  
Jay Steingrub ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Outcomes ◽  
Predictive Value ◽  
Secondary Analysis ◽  
Activated Protein C ◽  
Oxygenation Index ◽  
Severity Of Illness ◽  
Plasminogen Activator Inhibitor ◽  
High Plasma ◽  
Plasminogen Activator Inhibitor 1

Plasma and bronchoalveolar lavage (BAL) biomarkers related to the pathogenesis of acute lung injury (ALI) have previously been associated with poorer clinical outcomes and increased disease severity among patients with ALI. Whether these biomarkers have predictive value in a less severely ill population that excludes septic patients with high APACHE II scores is currently unknown. We tested the association of plasma and BAL biomarkers with physiological markers of ALI severity or clinically relevant outcomes in a secondary analysis of a clinical trial of activated protein C for the treatment of ALI. Plasma plasminogen activator inhibitor-1 (PAI-1) and mini-BAL protein were both significantly associated with increased oxygenation index ( P = 0.02 and 0.01, respectively), whereas there was a trend toward an association between IL-6 and oxygenation index ( P = 0.057). High plasma IL-6, thrombomodulin, and mini-BAL protein were all significantly associated with fewer ventilator-free days (VFDs) ( P = 0.01, 0.01, and 0.05, respectively); no markers were associated with mortality, but we hypothesized that this was due to the small size of our cohort and the low death rate. To confirm these associations in a larger sample, we identified a restricted cohort of patients from the ARDS Network ALVEOLI study with similar baseline characteristics. We retested the associations of the significant biomarkers with markers of severity and clinical outcomes and studied IL-8 as an additional biomarker given its important predictive value in prior studies. In this restricted cohort, IL-6 was significantly associated with oxygenation index ( P = 0.02). Both IL-6 and IL-8 were associated with decreased VFDs and increased 28-day mortality. Future studies should be focused on examining larger numbers of patients with less severe ALI to further test the relative predictive value of plasma and mini-BAL biomarkers for clinically relevant outcomes, including VFDs and mortality, and for their prospective utility in risk stratification for future clinical trials.

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