Fewer complications, better outcomes with robot-assisted prostate cancer surgery

[ Back to EurekAlert! ] Public release date: 24-Apr-2012
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Contact: Dwight Angell
Dwight.Angell@hfhs.org
313-876-8709
Henry Ford Health System

DETROIT Robot-assisted surgery is now both more common and far more successful than radical "open" surgery to treat prostate cancer in the United States, according to a new Henry Ford Hospital study published in the current issue of the medical journal European Urology.

The research, led by scientists at Henry Ford Hospital's Vattikuti Urology Institute (VUI), is the first to compare in a nationwide population sample the results of robot-assisted radical prostatectomy (RARP) to the standard surgical procedure, open radical prostatectomy (ORP).

The researchers found, based n a representative 20 percent sample of the U.S. that:

  • 19,278 patients underwent RARP or ORP in 647 medical institutions between October 2008 and December 2009.
  • Of those, 11,889 underwent RARP and 7,389 underwent ORP.
  • More RARPs were performed at teaching institutions in urban locations, and a higher proportion of RARPs were performed at high-volume hospitals.
  • RARP patients were less likely than ORP patients to need a blood transfusion, less likely to have a prolonged hospital stay, and less like to suffer complications during or after surgery, including cardiac, respiratory, and vascular problems.

ORP involves opening the lower abdomen with a long incision, and removing the entire diseased prostate gland and some surrounding tissue in the hope of preventing the cancer from spreading to other parts of the body.

A similar procedure, known as RARP, is done through tiny incisions using minimally invasive laparoscopic surgery. Henry Ford Hospital pioneered the use of robots to assist surgeons in this delicate procedure, and the new study confirms earlier Henry Ford findings that RARP is now the most common technique in the United States for treating localized prostate cancer.

Prostate cancer is the most common "solid organ" malignancy and the second leading cause of cancer death in U.S. men. Radical prostatectomy became the standard treatment after it was shown that the surgery resulted in higher survival rates than "watchful waiting."

But in the past 10 years, "we've seen a significant trend toward the use of minimally invasive approaches to RP for the treatment of prostate cancer, particularly in the U.S.," says Quoc-Dien Trinh, M.D., a fellow at VUI and lead author of the study.

"While this evolution has been controversial, there have been few comparative studies. Most of those looked only at single institutions or single surgeons, and they were of poor evidentiary quality."

Most significantly, the new study found "superior" results with RARP in virtually every outcome studied, including the amount of necessary blood transfusions, complications during and after surgery, and length of hospital stay.

At Henry Ford, which did much of the original work on robotic surgery for prostate cancer, 98 percent of patients go home within 24 hours of the operation and major complications are less than 2 percent, according to Mani Menon, M.D., director of Henry Ford's Vattikuti Urology Institute.

In selecting the study's subjects, researchers relied on the Nationwide Inpatient Sample (NIS) maintained by the Agency for Healthcare Research and Quality under the U.S. Department of Health and Human Services.

In another first-of-a-kind study published in European Urology in February 2011, Henry Ford urologists and epidemiologists determined that RARP is safe over the long term, with a complication rate of less than 10 percent. That followed another Henry Ford study that found nearly 87 percent of patients whose cancerous prostates were removed by robot-assisted surgery had no recurrence of the disease after 5 years.

That was followed in September 2011 by another Henry Ford-led international study that found prostate cancer patients who undergo radical prostatectomy get better results at teaching hospitals than at non-academic medical institutions.

The authors of the new research paper noted that while their study did not examine the disparities in patient access to robotic surgery, they did find significant differences between RARP and ORP patients:

  • More of them were white.
  • They had fewer additional diseases or disorders.
  • They were more likely to get their surgery at urban academic centers.

"This is significant not only because better surgical outcomes are expected at academic centers," says Dr. Trinh, "but other recent data show that patients without private insurance those covered by Medicare or Medicaid, or self-paid are more likely to have complications during and after surgery, and need much more time in the hospital."

###

Funding: Vattikuti Urology Institute at Henry Ford Hospital.

Article: http://europeanurology.com/article/S0302-2838(11)01411-4/fulltext


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[ Back to EurekAlert! ] Public release date: 24-Apr-2012
[ | E-mail | Share Share ]

Contact: Dwight Angell
Dwight.Angell@hfhs.org
313-876-8709
Henry Ford Health System

DETROIT Robot-assisted surgery is now both more common and far more successful than radical "open" surgery to treat prostate cancer in the United States, according to a new Henry Ford Hospital study published in the current issue of the medical journal European Urology.

The research, led by scientists at Henry Ford Hospital's Vattikuti Urology Institute (VUI), is the first to compare in a nationwide population sample the results of robot-assisted radical prostatectomy (RARP) to the standard surgical procedure, open radical prostatectomy (ORP).

The researchers found, based n a representative 20 percent sample of the U.S. that:

  • 19,278 patients underwent RARP or ORP in 647 medical institutions between October 2008 and December 2009.
  • Of those, 11,889 underwent RARP and 7,389 underwent ORP.
  • More RARPs were performed at teaching institutions in urban locations, and a higher proportion of RARPs were performed at high-volume hospitals.
  • RARP patients were less likely than ORP patients to need a blood transfusion, less likely to have a prolonged hospital stay, and less like to suffer complications during or after surgery, including cardiac, respiratory, and vascular problems.

ORP involves opening the lower abdomen with a long incision, and removing the entire diseased prostate gland and some surrounding tissue in the hope of preventing the cancer from spreading to other parts of the body.

A similar procedure, known as RARP, is done through tiny incisions using minimally invasive laparoscopic surgery. Henry Ford Hospital pioneered the use of robots to assist surgeons in this delicate procedure, and the new study confirms earlier Henry Ford findings that RARP is now the most common technique in the United States for treating localized prostate cancer.

Prostate cancer is the most common "solid organ" malignancy and the second leading cause of cancer death in U.S. men. Radical prostatectomy became the standard treatment after it was shown that the surgery resulted in higher survival rates than "watchful waiting."

But in the past 10 years, "we've seen a significant trend toward the use of minimally invasive approaches to RP for the treatment of prostate cancer, particularly in the U.S.," says Quoc-Dien Trinh, M.D., a fellow at VUI and lead author of the study.

"While this evolution has been controversial, there have been few comparative studies. Most of those looked only at single institutions or single surgeons, and they were of poor evidentiary quality."

Most significantly, the new study found "superior" results with RARP in virtually every outcome studied, including the amount of necessary blood transfusions, complications during and after surgery, and length of hospital stay.

At Henry Ford, which did much of the original work on robotic surgery for prostate cancer, 98 percent of patients go home within 24 hours of the operation and major complications are less than 2 percent, according to Mani Menon, M.D., director of Henry Ford's Vattikuti Urology Institute.

In selecting the study's subjects, researchers relied on the Nationwide Inpatient Sample (NIS) maintained by the Agency for Healthcare Research and Quality under the U.S. Department of Health and Human Services.

In another first-of-a-kind study published in European Urology in February 2011, Henry Ford urologists and epidemiologists determined that RARP is safe over the long term, with a complication rate of less than 10 percent. That followed another Henry Ford study that found nearly 87 percent of patients whose cancerous prostates were removed by robot-assisted surgery had no recurrence of the disease after 5 years.

That was followed in September 2011 by another Henry Ford-led international study that found prostate cancer patients who undergo radical prostatectomy get better results at teaching hospitals than at non-academic medical institutions.

The authors of the new research paper noted that while their study did not examine the disparities in patient access to robotic surgery, they did find significant differences between RARP and ORP patients:

  • More of them were white.
  • They had fewer additional diseases or disorders.
  • They were more likely to get their surgery at urban academic centers.

"This is significant not only because better surgical outcomes are expected at academic centers," says Dr. Trinh, "but other recent data show that patients without private insurance those covered by Medicare or Medicaid, or self-paid are more likely to have complications during and after surgery, and need much more time in the hospital."

###

Funding: Vattikuti Urology Institute at Henry Ford Hospital.

Article: http://europeanurology.com/article/S0302-2838(11)01411-4/fulltext


[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


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Droplet and StackAR bring physical interface to virtual experiences, communicate through light (hands-on)

Image

Light-based communication seems to wind throughout the MIT Media Lab -- it is a universal language, after all, since many devices output light, be it with a dedicated LED or a standard LCD, and have the capacity to view and interpret it. One such device, coined Droplet, essentially redirects light from one source to another, while also serving as a physical interface for tablet-based tasks. Rob Hemsley, a research assistant at the Media Lab, was on hand to demonstrate two of his projects. Droplet is a compact self-contained module with an integrated RGB LED, a photodiode and a CR1216 lithium coin battery -- which provides roughly one day of power in the gadget's current early prototype status. Today's demo used a computer-connected HDTV and a capacitive-touch-enabled tablet. Using the TV to pull up a custom Google Calendar module, Hemsley held the Droplet up to a defined area on the display, which then output a series of colors, transmitting data to the module. Then, that data was pushed to a tablet after placing the Droplet on the display, pulling up the same calendar appointment and providing a physical interface for adjusting the date and time, which is retained in the cloud and the module itself, which also outputs pulsing light as it counts down to the appointment time.

StackAR, the second project, functions in much the same way, but instead of outputting a countdown indicator, it displays schematics for a LilyPad Arduino when placed on the tablet, identifying connectors based on a pre-selected program. The capacitive display can recognize orientation, letting you drop the controller in any position throughout the surface, then outputting a map to match. Like the Droplet, StackAR can also recognize light input, even letting you program the Arduino directly from the tablet by outputting light, effectively simplifying the interface creation process even further. You can also add software control to the board, which will work in conjunction with the hardware, bringing universal control interfaces to the otherwise space-limited Arduino. Both projects appear to have incredible potential, but they're clearly not ready for production just yet. For now, you can get a better feel for Droplet and StackAR in our hands-on video just past the break.

Continue reading Droplet and StackAR bring physical interface to virtual experiences, communicate through light (hands-on)

Droplet and StackAR bring physical interface to virtual experiences, communicate through light (hands-on) originally appeared on Engadget on Tue, 24 Apr 2012 15:03:00 EDT. Please see our terms for use of feeds.

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Corn pricing affected by global warming, federal mandates not helping, study finds

Researchers out of Purdue and Stanford University have found evidence that small temperature increases over the next two decades could have a surprisingly drastic impact on the volatility of corn prices. And federal biofuel mandates may make things worse.

Geothermal, nuclear, wind, natural gas, soybean biodiesel, corn ethanol ? these are just some of the possible ways to thwart greenhouse gas emissions that spur global warming. Yet each technological option is far from perfect, and understandably, harbors its own unique complications.

Skip to next paragraph

A recent study published in Nature Climate Change, illustrates such a complication for biofuels derived from corn grown in the United States. Scientists found that, over the next two decades, climate change will probably increase the volatility of corn prices, even more so than expected factors like oil prices and trade policies. Biofuel mandates affect volatility too, and the study also suggests that such federal mandates could actually amplify the effect of rising temperature on the pricing of crop from the US corn belt.

"Frankly, I was surprised that climate had the largest effect of these three influences," said Noah Diffenbaugh of the Stanford?Woods Institute for the Environment in a recent Stanford Press Release. "These are substantial changes in price volatility that come from relatively moderate global warming."

This research, funded by the Department of Energy, illuminates two interrelated problems. The first: even if climate change stays within the internationally established "safe" limit of 3.6 degrees Fahrenheit above preindustrial temperatures, a smaller temperature change could still drive up the frequency of severe heatwaves in the US, which would in turn sharply increase the volatility of corn yields, the study suggests.

The second is the constraining effect federal biofuel mandates have on the corn market. This has already been demonstrated before, as the mandates encouraged farmers to plant more corn instead of, for example, soybeans, which historically drove up the price of soy. Without regulation, the corn market, in a particularly temperate season, could allocate more of its crop to biofuel production. Alternatively, in a season of severe heat, it could keep more of its crop for food supplies, thus satisfying demand for the US's dominant crop, and keeping prices down. But under the current federal scheme, the market does not have this flexibility.

Though the study found a surprisingly strong link between climate change and corn price volatility, the researchers noted a relatively small projected impact on overall food prices. They did, however, speculate that if US corn farmers could not increase their crops' heat tolerance by as much as 6 degrees Fahrenheit, much of the US corn belt would have to migrate north, toward the Canadian border, to escape the oppressive heat extremes.

Discussion of how rising temperatures will affect corn prices seems far removed from the national debate over climate policy, which is still focused on whether or not fossil fuels contribute to global warming (almost all climate scientists say that they do).?

Corn-based biofuels have received regulatory encouragement since the Energy Tax Act of 1978, a part of the larger National Energy Act that promoted the shift of US energy to renewable and more efficient sources. Congressional intentions aside, there has been increasing public discussion about the real value of biofuels, both environmentally and economically.

Robert F. Service, writing?in Science Magazine?in 2009, highlighted the underreported strain on water resources biofuels would impose. Whereas refining oil requires 10 to 40 liters of water to produce one megawatt hour, corn ethanol irrigation requires between two and eight million liters to produce the same supply. In essence, Service writes, "an increased reliance on biofuel trades an oil problem for a water problem."

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Jon Jones? next opponent: Dan Henderson

After Jon Jones defended the UFC light heavyweight belt with a win over Rashad Evans, questions immediately turned to his next opponent. At Saturday's post-fight press conference, UFC president Dana White confirmed Dan Henderson would get the next shot at trying to unseat Jones.

This title shot comes after Henderson had a banner year in 2011. He won the Strikeforce light heavyweight belt, beat MMA legend Fedor Emelianenko, then returned to the UFC with a win over Mauricio "Shogun" Rua in a fight that's considered one of the best of all time.

It will be Henderson's third chance to win the UFC belt. After winning titles in Pride, Henderson lost UFC title shots to Anderson Silva at middleweight and Quinton "Rampage" Jackson at light heavyweight. Back in 1998, Henderson won the UFC middleweight tournament at UFC 17, but that is the only UFC title he's won in his 15-year MMA career.

[ Also: UFC 145 recap: Jon Jones' length crucial in handling Rashad Evans for decision win ]

Though White didn't nail down a date for the Jones-Henderson bout, UFC 149 in Calgary was mentioned as a possibility.

Could Henderson be the man to stop Jon Jones? Tell us in the comments, on Facebook or on Twitter.

Other popular content on Yahoo! Sports:
? Tim Brown: White Sox's Philip Humber claims unexpected place in MLB history with perfect game
? NFL prospect Alfonzo Dennard arrested five days before draft
? Jonathan Toews saves Blackhawks' season with OT goal to beat Coyotes

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What Are The Benefits Of Consuming ... - Health & Fitness Tools

20th April, 2012 - Posted by health news -

What you devour, is who you might be.

If you eat some chicken that chicken is going to be broken down and the amino acids are going to be used to repair cells and build muscle. So be cautious with the meals you devour as it can really create a difference. Awareness of how our diet effects our wellbeing and the nutrition we need has led to more people eating superfoods. Do you know what superfoods in fact are? Well, there are a couple of kinds of foods, the great and the bad. Bad foods include empty calories that will just make you fat if consumed in excess and good foods which have calories designed to provide plenty of energy as well as antioxidants to help decrease illness and disease. Superfoods, as you?ll have guessed, come under good foods.

In the end, your body wants the best nutritional foods to survive. You need protein to create and mend cells, carbohydrates to deliver your body energy and fats to keep your body running right. Obviously, to include to all this you can not live without water. There are also supplementary nutrients, such as vitamins and minerals which you?ll need but are harder to get into your diet. For instance, Omega-3, which is a fatty acid that is essential for your body, as it can keep down the amount of bad cholesterol inside the blood. Omega-3 is within salmon, and that is classed being a superfood as it includes this fatty acid and it?s a very good supply of protein. Omega-3 could also aid your brain by shielding it from diseases you usually get from aging. You can locate Omega-3 in many fish, nuts and seeds, most of which are classed as superfoods.

Another important function of superfoods is how they help our immune systems. Superfoods are recommended for their beneficial effect on your resistance and garlic is one such food known for this. One benefit of eating garlic could possibly be in how it helps to reduce your cholesterol. If you have hyper sensitive stomach then it?s best not to eat garlic as it can irritate the lining. Green tea can be an option for you, in particular if the thought of drinking plenty of water, which as previously stated is an important factor in your overall health, is something you can not do. If you consider the amount of antioxidants it has and the very fact it also offers polyphenols, then green tea in fact is worth drinking. In addition, it seems that green tea may have preventative qualities in stopping the growth of tumors.

Lycopene can be an antioxidant found in tomatoes which can be why they are also considered to be superfoods. Another superfood is spinach which is abundant with iron along with one of the B vitamins known as folate. Lutein, a nutrient found in spinach is very important for visual strength as we grow older.

It now seems to be a good time to start eating some superfoods to have the healthy advantages of all the minerals, vitamins and other necessary nutrients they contain.

If you?re interested in eating better you may want to give some thought to purchasing a product like Anabolic Cooking. Certainly you need to look at the Anabolic Cooking review to discover what folks are saying with regards to it, and whether you can receive a Anabolic Cooking bonus.

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AP Source: Obama briefed on Secret Service case

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