Robotic Surgery Option for Colorectal Cancer

Advanced robotic options for colorectal cancer surgery are becoming available and require more study. Abstract:

Robotic surgery, used generally for colorectal cancer, has the advantages of a three-dimensional surgical view, steadiness, and seven degrees of robotic arms. However, there are disadvantages, such as a decreased sense of touch, extra time needed to dock the robotic cart, and high cost. Robotic surgery is performed using various techniques, with or without laparoscopic surgery. Because the results of this approach are reported to be similar to or less favorable than those of laparoscopic surgery, the learning curve for robotic colorectal surgery remains controversial. However, according to short- and long-term oncologic outcomes, robotic colorectal surgery is feasible and safe compared with conventional surgery. Advanced technologies in robotic surgery have resulted in favorable intraoperative and perioperative clinical outcomes as well as functional outcomes. As the technical advances in robotic surgery improve surgical performance as well as outcomes, it increasingly is being regarded as a treatment option for colorectal surgery. However, a multicenter, randomized clinical trial is needed to validate this approach.

Toxic Games

“Most Americans believe that if a chemical is in their cosmetics, their coat, or their couch, someone is making sure it is safe for their health”. 

This statement came from a recent Science editorial on toxic materials used in consumer products. I have never paid attention to the doom and gloom people ranting about how we are being poisoned by the profit-driven industries. 

However, the article in the respected Science journal was not written by one of these people: it was written by the researcher Arlene Blum, a collaborator of the legendary Dr. Bruce Ames. 

Probably because of its credibility, the article evoked a great dose of thought about the dangerous chemicals to which I expose my family and myself every day. Some of these agents damage the DNA (causing mutations) and increase the risk of cancer. There are approximately 80,000 industrial chemicals used in commerce in the U.S., and their safety is not exactly well established. 

One of the most well-known ways to distinguish harmless agents from substances that damage the DNA and cause mutations is the test designed by Dr. Ames. The test utilizes a bacterial species that grows only when the amino acid histidine is added to the medium. Therefore, in a medium with very little histidine, the bacteria will grow at the beginning, but as the amino acid is depleted, the bacteria would stop proliferating. However, if to the same medium we add the bacteria along with a substance that causes mutations (changes in DNA), some of the many bacterial cells would undergo mutations and continue to grow even in the absence of the amino acid histidine. This test has proven to be an excellent approach to revealing many substances as mutagenic agents. 

The U.S. still has the intellectual and technical power to identify dangerous agents; however, it is mind-boggling how information on the toxicity of some chemicals takes up to half-century to implement and start to phase out of use. In her Science article, Dr. Blum mentions one such compound – perfluorooctanoic acid (C8). 

Another bitter reminder that we are not well protected from harmful agents came from the same issue of Science, and it was about a pesticide produced by Bayer CropScience. This pesticide (called sometimes Synapse) was given a conditional approval for use by the Environmental Protection Agency (EPA) in 2008, and has been used for more than 200 U.S. crops. Almost eight years later, it seems that we have realized that the insecticide is pretty harmful… The game between the company and EPA is still to take place. 

Anyway, it seems that instead of being immersed in Hunger Games, we are all unwilling participants in the Toxic Games.

Navigating the shark-infested waters at work

By original author is Fbattail , the image is cropped by Chris huh - Original image: Carcharhinus-amblyrynchos.jpg by Fbattail at fr.wikipedia, March 14, 2004cropped image: Greyreefsharksmall.jpg by Chris huh at en.wikipedia, August 29. 2006Transfered to Commons by Harryemi, September 21, 2008, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=4834577

I am still learning how to navigate the dangerous waters at work. This is an essential skill, as I would like to keep my current position for as long as I can. 

Anyway, avoiding the sharks at my job is not easy, so I read with great interest the post How Nice People Can Master Conflict.

I guess, I need to practice my assertiveness, avoid the absolute statements, and try to use hypothetical situations to (politely) hint on the stupidity of some decisions and directives. 

Practice makes perfect...

Easter and Spring

This Easter morning, after breakfast I found myself looking at the garden from our huge living room window. 

Autumn Joy

The window overlooks the front garden and although the view is delightful, I have never had time in the morning to stop all the busy work and enjoy the garden. This Easter morning was different - I did most of the chores on Saturday.

I do not know if the life in our Spring garden is always as busy as it was this morning, but it seemed like nature put a show for me. 





 

There was a riot of birds. I saw at least five species, including a gorgeous cardinal, a blue jay, and a few doves. Some birds were looking for food, others were just perched on the ornamental bushes.There were also three couples (I recognized a pair of robins) busy in courting, playing, and following each other. 




 
With the binoculars I followed the minute details of the frantic Sunday morning activity: the little sparrows were carrying bits of dry grass in their beaks (probably for a nest), and the rest of the birds were attacking something invisible on the soil and the grass (I guess seeds and worms?).

 

There was one overly energetic squirrel, digging everywhere. In 20 minutes, it "searched" the entire front garden circling around like a little fluffy blizzard. Twice the squirrel found nuts; I wonder if these were previously hidden by the animal. We do not have a single nut tree on the block.




I remember reading about a Japanese study that simply looking at nature from the window affects the physiology in a positive way: the blood pressure goes down, and the life outlook/mood improves.