Impact of robotic surgery on patient flow and resource use intensity in ovarian cancer.

There is an emerging focus on the role of robotic surgery in ovarian cancer. To date, the operational and cost implications of the procedure remain unknown. The objective of the current study was to evaluate the impact of integrating minimally invasive robotic surgery on patient flow, resource utilization, and hospital costs associated with the treatment of ovarian cancer during the in-hospital and post-discharge processes.

Incorporating robotic surgery into the management of ovarian cancer after neoadjuvant chemotherapy.

Introduction: With the rapid uptake of robotic surgery in surgical oncology, its use in the treatment of epithelial ovarian cancers is being evaluated. Complete cytoreduction represents the goal of surgery either at primary cytoreduction or after neoadjuvant chemotherapy in the setting of interval cytoreduction. In selected patients, the extent of disease would enable minimally invasive surgery.

Unexpected locations of sentinel lymph nodes in endometrial cancer.

Introduction: To evaluate the anatomical location of sentinel lymph nodes (SLN) following intra-operative cervical injection in endometrial cancer.

Methods: All consecutive patients with endometrial cancer undergoing sentinel lymph node mapping were included in this prospective study following intra-operative cervical injection of tracers. Areas of SLN detection distribution were mapped.

Impact of sentinel lymph node mapping on recurrence patterns in endometrial cancer.

Background: Sentinel lymph node (SLN) mapping has emerged as a promising solution to the ongoing debate regarding lymphadenectomy in the initial surgical management of endometrial cancer. Currently, little is known about its possible impact on location of disease recurrence compared to systematic lymphadenectomy.

Methods: In this retrospective study, 472 consecutive patients with endometrial cancer who underwent either SLN mapping (SLN cohort, n=275) or systematic lymphadenectomy (LND cohort, n=197) from sequential, non-overlapping historical time points were compared.

Virtual reality robotic surgery simulation curriculum to teach robotic suturing: a randomized controlled trial.

The objective of this randomized, controlled trial was to assess whether voluntary participation in a proctored, proficiency-based, virtual reality robotic suturing curriculum using the da Vinci(®) Skills Simulator™ improves robotic suturing performance. Residents and attending surgeons were randomized to participation or non-participation during a 5 week training curriculum. Robotic suturing skills were evaluated before and after training using an inanimate vaginal cuff model, which participants sutured for 10 min using the da Vinci(®) Surgical System.

Comparing indocyanine green, technetium, and blue dye for sentinel lymph node mapping in endometrial cancer.

Background And Aims: With the debate over extent of lymphadenectomy in endometrial cancer, sentinel lymph node (SLN) mapping may provide a focused approach to evaluate the most relevant lymph nodes (LN) while minimizing the complications. We evaluated SLN mapping using filtered technetium(99), indocyanine green (ICG), and blue dye.

Methods: Prospective evaluation of 100 patients who underwent SLN mapping by using submucosal and deep stromal cervical injections of technetium(99), ICG, and blue dye as part of the staging for endometrial cancer.

Vaginal vault dehiscence after robotic hysterectomy for gynecologic cancers: search for risk factors and literature review.

Introduction: Vaginal vault dehiscence following robotic-assisted hysterectomy for gynecologic cancer may be attributed to surgical techniques and postoperative therapeutic interventions. We searched for risk factors in patients with gynecologic cancers and complemented this with a literature review.

Methods: Evaluation of prospectively gathered information on all consecutive robotic surgeries for gynecologic cancers was performed in a tertiary academic cancer center between December 2007 and March 2012.

Accuracy of sentinel lymph node detection following intra-operative cervical injection for endometrial cancer: a prospective study.

Objective: The objective of this study is to evaluate the detection rate and diagnostic accuracy of sentinel lymph node (SLN) mapping using intra-operative cervical injection of filtered 99mTc-sulfur colloid (99mTc-SC) and patent blue in patients with endometrial cancer.

Methods: Prospective evaluation of the first 100 endometrial cancer patients undergoing SLN mapping using cervical injection of patent blue combined with filtered 99mTc-SC in the operating room was done. Patients underwent robotic-assisted lymphatic mapping with frozen section, hysterectomy, BSO, and completion bilateral lymphadenectomy (including para-aortic nodes in grade 2 and 3 tumors).

Relationship between body mass index and robotic surgery outcomes of women diagnosed with endometrial cancer.

Objective: This is a prospective evaluation of the outcome of minimal invasive surgery using robotics in function of the body mass index (BMI) of patients.

Methods: This is a prospective cohort study of consecutive women undergoing surgery for endometrial cancer at a tertiary care facility since the initiation of a robotic program in December 2007. Surgical and personal outcome variables as well as quality of life and postoperative recovery were assessed using a combination of objective and subjective/self-report questionnaires.

Technical modifications in the robotic-assisted surgical approach for gynaecologic operations.

To investigate the development of new technical approaches for improving the implementation of robotics in gynaecologic surgery, we conducted a prospective evaluation of five technical modifications developed during the implementation of a robotics program that included 171 robotic endometrial staging procedures from December 2007 until May 2010. Modification of the use of a Hohl uterine manipulator by applying only the intravaginal component minimizes the theoretical risk of spillage of endometrial cancer cells, without losing the capability of delineating the vaginal fornices. Entry to the peritoneal cavity under visual control using a left upper quadrant approach and a 5-mm endoscope through a 5-mm Endopath(®) trocar is quick and decreases the risk of bowel or vessel injury.

Fear-avoidance beliefs about back pain in patients with acute LBP.

Objective: We aimed to assess fear-avoidance beliefs in patients with acute low back pain (LBP) and to identify features of patients and general practitioners (GPs) associated with patients' fear-avoidance beliefs.

Methods: A cross-sectional study conducted in primary care practice in France. A total of 709 GPs completed a self-administered questionnaire assessing fear-avoidance beliefs [the Fear-Avoidance Beliefs Questionnaire (FABQ)] and 2,727 patients with acute LBP completed a self-administered questionnaire assessing pain, perceived handicap and disability (on the Quebec Back Pain Disability Scale) and fear-avoidance beliefs (on the FABQ).

Effect of a simple information booklet on pain persistence after an acute episode of low back pain: a non-randomized trial in a primary care setting.

Objective: Mass-media campaigns have been known to modify the outcome of low back pain (LBP). We assessed the impact on outcome of standardized written information on LBP given to patients with acute LBP.

Design: A 3-month pragmatic, multicenter controlled trial with geographic stratification.

Insulin initiation in type 2 diabetic patients admitted in hospital in France and follow-up at 1 year.

Objectives And Methods: The IDAHO 2 epidemiological survey was conducted in departments of diabetology in insulin-naïve type 2 diabetics for whom insulin was initiated. The objective was to assess the patients' profile, the treatments proposed during hospital stay and after one year.

Results: 797 patients were analysed.

General practitioners' fear-avoidance beliefs influence their management of patients with low back pain.

The objectives of this cross-sectional study conducted in primary care practice in France were to describe general practitioners' (GPs) fear-avoidance beliefs about low back pain (LBP), investigate the impact of these beliefs on their following guidelines for bed rest, physical activities, and sick leave, and uncover factors associated with GPs' fear-avoidance beliefs. A total of 864 GPs completed a 5-part self-administered questionnaire. Parts 1, 2, and 3 concerned demographic, professional data, and personal history of back pain, respectively.

Validation of the short-form REFLUX-QUAL (RQS), a gastro-esophageal reflux disease (GERD) specific quality of life questionnaire.

Introduction: Being an easy-to-use (eight items) quality of life questionnaire specific to GERD, the Reflux-Qual Short form (RQS) was developed for use in everyday practice. The purpose of this study was to assess the psychometric properties of the RQS.

Methods And Materials: The reliability of the RQS was measured by the Cronbach's alpha coefficient and its clinical validity by comparing the RQS score for increasing clinical severity groups.

[Optimizing history taking for evaluating the risk of venous thromboembolism: the OPTIMEV study].

Unlabelled: Venous thromboembolism (VTE) is a frequent disease and remains a major cause of mortality and morbidity among our patients. During the 20 past years, clinical description, diagnostic tools, and treatment have changed dramatically. Most published data describing risk factors for VTE no longer apply to the patients seen in daily practice.

[Observational study of criteria involved in the choice of hormone replacement therapy (HRT), when initiated and subsequently adapted].

Objectives: Multicentre observational longitudinal prospective study in France; search for criteria involved in the choice of the initial dose of oestrogen at the initiation of hormone replacement therapy (HRT); search for explicative and predictive factors for treatment adaptation.

Statistics: description and analysis (factorial analysis of multiple correspondences) of the criteria involved in the choice of the initial dose of oestrogen; percentage of women with treatment adaptation ; analysis (univariate, multivariate) of predictive factors for adaptation.

Results: Six hundred and fifty postmenopausal women, first treated with HRT, with complete data on modification (or not) of their treatment were included.

When a DMARD fails, should patients switch to sulfasalazine or add sulfasalazine to continuing leflunomide?

Objective: To evaluate the efficacy and safety of adding sulfasalazine to leflunomide treatment compared with switching to sulfasalazine alone in patients with RA with an inadequate response to leflunomide monotherapy.

Methods: Patients with active RA ((DAS28) >3.2) who were enrolled in the first open label phase of the RELIEF study received leflunomide for 24 weeks.

Efficacy and safety of leflunomide and predisposing factors for treatment response in patients with active rheumatoid arthritis: RELIEF 6-month data.

Objective: The RELIEF investigation was a 48-week, multicenter, international study comprising 2 phases. Results from the first phase, a 24-week open-label cohort study that evaluated the safety and efficacy of leflunomide, as well as predisposing factors to treatment response, are reported here.

Methods: Patients received leflunomide 100 mg once daily for 3 days, followed by 20 mg once daily thereafter.

Comparative endometrial histology in postmenopausal women with sequential hormone replacement therapy of estradiol and, either chlormadinone acetate or micronized progesterone.

Objectives: To determine the endometrial response in postmenopausal women treated with a sequential hormone replacement therapy (HRT) of estradiol and, either chlormadinone acetate (CA) or micronized progesterone (MP).

Methods: Three hundred and thirty-six postmenopausal women with a normal endometrium were randomized in the double-blind study. All patients received percutaneous estradiol 1.

Chlormadinone acetate versus micronized progesterone in the sequential combined hormone replacement therapy of the menopause.

Objective: The efficacy and safety of chlormadinone acetate (CA) versus micronized progesterone (P) were assessed in non-hysterectomized postmenopausal women.

Materials And Methods: This was a multicenter, randomized, parallel group study with a 6-month double-blind period followed by a 12-month open period. Patients were randomized to receive every month during 18 months percutaneous 17 beta-estradiol (E(2)) 1.

[Recurrent respiratory infections in patients with chronic obstructive bronchitis: medical treatment and costs].

The objective of this study is to describe usual medical management and costs associated with recurrent respiratory infections in subjects with chronic obstructive bronchitis in France. A prospective survey was performed in Autumn 1994 on a national sample of private practice pulmonologists (N = 71). Two hundred forty-four patients, presenting at least one infection of the lower respiratory tract, were included.

[A comparative controlled trial of 2 administration modalities of tiopronin in rheumatoid arthritis].

Thiopronin is a second line drug for rheumatoid arthritis with proven efficacy in controlled trials versus a placebo, D-penicillamine, or gold salts. This 4-month study was aimed mainly at comparing the efficacy and safety of two thiopronin regimens, i.e.

Mitogen-induced blastogenic responses of lymphocytes from marihuana smokers.

Blastogenic responses in vitro to phytohemagglutinin and pokeweed mitogen were examined in microcultures of peripheral blood lymphocytes from a group of 12 healthy, long-term marihuana smokers and a group of matched control subjects. With either mitogen, no significant difference in cellular incorporation of (3H)thymidine was noted between the groups. These results were interpreted to indicate that the functional status of blood lymphocytes was not altered by long-term smoking of marihuana.