Lately there has been a lot of hype concerning
Laser and Robotic surgery. But what is it and is it really better? Most
of the time it is not.
Robotic surgery is not R2D2 doing surgery. It is more like a remote control
hobby device; the surgeon is working from a remote control device while
the machine follows his instructions. He (or she) is usually watching
on a TV screen; but sometimes live. Recent advances may involve a 3D
virtual reality; allowing remote operations by tele-medicine.
The advantages of robotics include a finer control of movement with less
slipping of the knife likely. As well, surgery is possible in very
confined locations. Disadvantages include the lack of direct
visualization and two-dimensional pictures. A major issue is the lack of
sensory feedback; most robotics do not allow that. The surgeon does not
know when the tissue has a different feel or density.
So for
most surgeries an experienced surgeon doing it manually is far better
than robotics. Indeed in a recent study of benign ovarian lesions on
87,000 women researchers found there were 50% more complications in
robotic cases.
Lasers are being used in surgery as special
knives or scalpels. They burn a very fine line through tissue, and have
minimal bleeding due to the cauterization. However, like robotics, there
is no feedback from the tissue; and there effects of small surgical
errors by the operator are magnified.
There are several tissue
specific colored lasers but these also can damage normal tissue. I had
three cases of patients who had green laser prostate surgery by an
inexperienced laser surgeon. All three had severe complications and
required additional surgeries and long term incontinence.
Much
of the hype about laser and robotic surgeries has been promulgated by
the manufacturers of this very expensive equipment whose surgeries are
far more expensive than standard procedures. Like new drugs we need to
be cautious; they are rarely major advances.
I review a
surgeon's experience and complication rates. I much prefer an
experienced surgeon using standard instruments. Never be afraid of
asking how many of these procedures the surgeon has performed; if the
physician gets insulted I would strongly recommend you go somewhere
else.
Broccoli and AutismIn recent studies, researchers have discovered that a chemical found in broccoli, sulforaphane, seemed to result in a mild improvement of symptoms of autism in 80% of children (as judged by their parents).This is too preliminary to use as a treatment, but since it is believed that the changes that result in autism may begin before birth, it would be prudent for pregnant women to eat adequate vegetables and broccoli!
Since the introduction of he back to sleep campaign (infants sleeping on their backs) there has been a more than a 50% decrease in Sudden Infant Death Syndrome (SIDS). However, accidental suffocation has not changed.
In an analysis of infant deaths, researchers found that there was a significantly higher risk in infants sleeping on sofas. Some of the causes probably include the baby rolling into the corner, and the softness of the pillows.
One of the theories of SIDS is that when a baby is on their stomach, especially on a softer surface, their nose and face forms a small indentation. When we breath we breath out carbon dioxide; this gas is heavier than air. With a baby, who moves much less and has a less powerful breath, the carbon dioxide gas may remain around their face. Their reflexes and motion can then lead to suffocation.
So don't let your babies sleep on the couch! Leave that for Grandpa!
There have been some questions about the use of cows milk in adults. Many state that cows milk is for calves, not humans, but the protein, vitamins and calcium in milk do have a high nutritive value.However there are some compounds in milk that could produce adverse effects. D-galactose, found in milk, has been shown to induce oxidative stress damage and chronic inflammation in animals, and such changes have been associated with cardiovascular disease, cancer, bone loss, and sarcopenia in humans.
Researchers in Sweden followed almost 100,000 patients for almost 20 years. They found that in the higher consumption groups (3 glasses per day) had almost double the risk of cardiovascular disease, as well as an increased risk of fractures as compared to those that drank less than one glass a day.
As usual, moderation is the key!
Eczema in children is treated by use of moisturizing creams to help restore the normal skin barrier. But can the use of these creams actually prevent the development of this rash?In a study in Great Britain parents were randomized to using one of three creams (sunflower oil, Cetaphil cream, or Aquaphor Healing Ointment, their choice) daily even the absence of a rash in infants. They started at 6 weeks and were evaluated after 6 months. The group was higher risk; having a first degree relative with atopic dermatitis.
The study discovered a 50% reduction in eczema. This is significant.
My daughter uses coconut oil on her baby; this child has had beautiful skin and no diaper rash! I would recommend it to everyone.
I recently reported that many dietary supplements included dangerous and unapproved compounds, in varying and sometimes dangerous concentrations. These included anabolic steroids, Prozac and Viagra. Some have been associated with fatal liver disease.
In response to the earlier report the FDA recalled many of the supplements.
In this follow up study, researchers found that 27 products recalled between 2009 and 2012 still contained the substances that were banned by the FDA. And 20% of these products contained an additional banned product.
The FDA needs more teeth to enforce their rules. And all of us have to continue to be more careful about using supplements. As you know I am against virtually all of these.
As many of you have probably heard, the study that purportedly showed the use of green coffee beans causing weight loss was false. The "researcher" changed weight numbers and results intentionally in order to show its efficacy.
Then the manufacturers paid Dr Oz for his endorsement, and undoubtedly made millions of dollars. We need to be more careful with these "fringe" treatments before accepting them.
Incidentally, in most coffee plantations the beans are picked both green and red. The red ones go to premium coffee, and the green to regular brands.
