Combined SPECT and EBV-DNA showed a very high diagnostic accuracy for AIDS-related PCNSL. Because PCNSL likelihood is extremely high in patients with hyperactive lesions and positive EBV-DNA, brain biopsy could be avoided, and patients could promptly undergo radiotherapy or multimodal therapy. On the contrary, in patients showing hypoactive lesions with negative EBV-DNA, empiric anti-Toxoplasma therapy is indicated. In patients with discordant SPECT/PCR results, brain biopsy seems to be advisable.

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This is the first time that an endoscopic tool based on soft materials has been integrated into a surgical robot. The soft endoscopic camera can be easily operated through the da Vinci Research Kit master console, thus increasing the workspace and the dexterity, and without limiting intuitive and friendly use.

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The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR). The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms) for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

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The aim of this study is to evaluate the sensitivity, specificity and safety of challenge tests and their usefulness in the diagnosis of latex allergy. Forty adult subjects (F/M = 34/6, aged 18-66 yrs) with a history of adverse reactions after latex exposure and positive prick test and/or specific IgE to latex were enrolled. They were compared with 20 control subjects. They underwent provocative (cutaneous, mucous-oral, sublingual, conjunctival, nasal, bronchial, vaginal) tests. Symptoms and drug scores were recorded for each patient during challenges. All patients reacted to at least one of the following: cutaneous, nasal and conjunctival tests. No systemic reactions requiring epinephrine occurred. Of the challenges, the vaginal test resulted as the safest, but it had low sensitivity and many limits related to the procedure. According to our data, bronchial and nasal tests had the highest sensitivity (76% and 82% respectively), and were more precise than other tests in determining latex exposure and symptoms, but the bronchial test also presented the highest rate of risk. Mucous and cutaneous tests resulted as the most reliable. For all the tests, specificity and positive predictive value were 100%. All control subjects resulted negative to all challenges. There were no statistically significant changes in skin and serologic tests between the first and second visits. Correlations between MIS and skin tests and between MIS and serum tests were not found. Challenges can be considered safe diagnostic procedures. Tests that most faithfully reproduce natural exposure, on the basis of a patient's history, are preferable.

The paper addresses the problem of the generation of collision-free trajectories for a robotic manipulator, operating in a scenario in which obstacles may be moving at non-negligible velocities. In particular, the paper aims to present a trajectory generation solution that is fully executable in real-time and that can reactively adapt to both dynamic changes of the environment and fast reconfiguration of the robotic task. The proposed motion planner extends the method based on a dynamical system to cope with the peculiar kinematics of surgical robots for laparoscopic operations, the mechanical constraint being enforced by the fixed point of insertion into the abdomen of the patient the most challenging aspect. The paper includes a validation of the trajectory generator in both simulated and experimental scenarios.Electronics 2019, 8, 957 2 of 24 requires addressing both technical and ethical/legal issues (see [6,7] for updated reviews). In particular, from the technological point of view, soft-tissue surgery in non-rigid anatomical environments forces taking into account hardly predictable scene changes, complicating the tasks of collision-free motion planning and physical environment interaction (i.e., contact with objects with unknown and even variable viscoelastic properties).The growth of investments in research and development projects for autonomous surgical robotics demonstrates the confidence and the expectations of the medical community regarding the benefits of such technologies. For example, the European Union has recently funded several projects related to the automation of surgical tasks, like I-SUR (Intelligent Surgical Robotics, FP7 Grant No. 270396, the automation of needle insertion and suturing tasks [8] by means of a dual-arm robot with hybrid parallel/serial kinematics. The cognitive control architecture proposed by I-SUR [9] was able to operate in either teleoperated [10] or autonomous mode [11], guaranteeing a stable switch between the two and an adaptive interaction with the environment in both modes [12]. The inherent relationship between surgical and industrial collaborative robotics is demonstrated by the fact that the same control methods (i.e., admittance control with variable dynamics) have also been applied by the same authors to enforce stability in pHRI [13,14]. Turning back to the specific case of the suturing task, the work presented in [11] proposed a motion planning solution based on a combination of previously-specified motion primitives for the dual-arm system, designed to mimic the bimanual gestures of a human surgeon, and collision-free paths generated with a plan-and-move strategy. Similar approaches to surgical robotic suturing were described in [15,16], investigating advanced learning techniques, or [17,18], addressing the task using more classical robot motion planning techniques and analytic geometry. Even though surgical suturing tasks have also been automated by designing specific devices, not mimicking at all human gestures [19], the solutions based on general-purpo...