The continued proliferation
of malaria throughout temperate and
tropical regions of the world has promoted a push for more efficacious
treatments to combat the disease. Unfortunately, more recent remedies
such as artemisinin combination therapies have been rendered less
effective due to developing parasite resistance, and new drugs are
required that target the parasite in the liver to support the disease
elimination efforts. Research was initiated to revisit antimalarials
developed in the 1940s and 1960s that were deemed unsuitable for use
as therapeutic agents as a result of poor understanding of both physicochemical
properties and parasitology. Structure–activity and structure–property
relationship studies were conducted to generate a set of compounds
with the general 6-chloro-7-methoxy-2-methyl-4(1H)-quinolone scaffold which were substituted at the 3-position with
a variety of phenyl moieties possessing various properties. Extensive
physicochemical evaluation of the quinolone series was carried out
to downselect the most promising 4(1H)-quinolones, 7, 62, 66, and 67,
which possessed low-nanomolar EC50 values against W2 and
TM90-C2B as well as improved microsomal stability. Additionally, in
vivo Thompson test results using Plasmodium berghei in mice showed that these 4(1H)-quinolones were
efficacious for the reduction of parasitemia at >99% after 6 days.
Background
We evaluated the short‐term outcomes of robotic colorectal cancer surgery in octogenarian patients, focussing on postoperative morbidity and survival.
Methods
All patients ≥80 years in a prospective colorectal cancer database undergoing robotic curative colorectal cancer resection were included. Patient demographics, intraoperative findings, postoperative and oncological outcomes were recorded. Patients were further subdivided into two groups named: old (OG 80–85 years) and very old (VOG ≥ 86 years).
Results
Fifty‐eight consecutive patients were included (median age, 83 years; male, 53.4%; median BMI, 26.5). Median total operative time was 230 min, median blood loss 20 ml, median length of stay 7 days. Major complications were seen in 12% of patients; and the 90‐day mortality rate was 1.7%. Complete R0 resection achieved in 93% of cases, average lymph node harvest was 22. Overall and disease‐free survival was 81% and 87.3%, respectively (median follow‐up 24.5 months). We noticed a trend towards more advanced lesion staging in the VOG, but only N2 stage was significant (p = 0.03). There was a statistically significant difference in overall survival in favour of the OG (p = 0.024).
Conclusions
Robotic surgery is feasible in octogenarian patients undergoing curative colorectal cancer resection and is associated with good post‐operative outcomes and overall survival.
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