Latest news with #Whipple
Time of India
6 days ago
- Health
- Time of India
Why Evidence based Robotic Surgery Is Becoming the New Standard of Care
New Delhi: In an era where precision is paramount and patient recovery is prioritised more than ever, robotic-assisted surgery (RAS) is no longer a futuristic concept—it is rapidly becoming the gold standard in operating rooms across the globe, and increasingly, in India. Once reserved for complex prostatectomies, robotic surgery today spans a wide range of specialties—from gynecology and gastrointestinal surgery to thoracic and oncologic procedures—delivering consistent benefits for both patients and surgeons. Dr. Myriam Curet, Global Chief Medical Officer, Intuitive Surgical , emphasises that the original value of RAS was in converting open surgeries into minimally invasive ones—a breakthrough that radically reduced hospital stays, post-operative complications, and improved patient outcomes. 'We started in urology where minimal access options were limited,' says Dr. Curet. 'But as evidence grew, we saw the benefits expand to patients previously considered inoperable via laparoscopy, those with high BMI or advanced disease. Now, robotics isn't just an alternative to open surgery, it's proving superior even to laparoscopy in many cases.' The Evidence Speaks A landmark study published in Annals of Surgery, dubbed the COMPARE Study, analysed over a million patients across seven cancer procedures and multiple countries. It found that RAS significantly reduced hospital stay, readmission, complication rates, and blood transfusions—despite a marginally longer operating time. Crucially, conversion rates (where a minimally invasive surgery has to be converted to open mid-procedure) were reduced by more than half with robotic approaches, a game-changer for patient trust and recovery. 'Conversion is traumatic for patients who come in expecting a short stay and walk out with a large incision and longer recovery,' says Dr. Curet. 'Robotics dramatically lowers this risk.' For Dr. Venkat P, a senior consultant robotic surgeon, Apollo Cancer Centre, Chennai, the impact has been nothing short of transformative. 'From reduced ICU stays and wound infections to faster discharge, RAS has become a blessing, especially for elderly or high-risk patients,' he explains. 'In the past, a major surgery meant 10-12 days in the hospital. Now? Two to three days.' He estimates a 40 per cent increase in surgical volumes at his center since adopting RAS. Many patients now actively request robotic surgery even switching hospitals or doctors to access it. 'Our best advocates are patients themselves,' he notes. Dr. Priya Kapoor, a consultant robotic surgical oncologist at Apollo Cancer Centres, highlights the remarkable reduction in hospital-acquired infections (HAIs). 'Our wound infection rate is Beyond infection control, oncologic precision has seen a leap. 'The robotic camera gives us a 10x magnified view, and the instruments offer unmatched dexterity. We can dissect and remove lymph nodes from locations human hands can't reach,' Dr. Kapoor adds. Procedures like robotic Whipple (a procedure to treat tumors and other conditions in the pancreas, small intestine and bile ducts) once deemed too complex are now regularly performed by experienced teams in India. 'Five years ago, robotic colorectal surgeries were rare. Today, they're standard of care,' says Dr. Kapoor. 'Soon, Whipple's will be, too.' Surgeons themselves are seeing improved quality of life. Dr. Curet, a practicing general and bariatric surgeon, recounts how ergonomics was one of the reasons she embraced RAS. 'Laparoscopic bariatric surgery took a toll on long hours, awkward postures, and physical strain. The robot changed that. I could operate comfortably, and my trainees learned faster, cutting learning curves from 100 to 40 cases.' For Dr Vishal Soni, Robotic Gastrointestinal, Hernia - AWR, and Obesity Surgeon, Zydus Hospitals, Ahmedabad, the biggest advantage of RAS lies in its predictability. 'With sub-millimeter precision, what I imagine as a surgeon is what I execute. Outcomes become more predictable, and that brings confidence to both me and my patient,' he says. Dr. Venkat echoes this: 'You're seated, relaxed, focused. Less physical exertion, better mental clarity. It's a win-win.' The Cost Conundrum: Short-Term vs Long-Term While RAS has been criticized for its higher upfront cost, surgeons argue that total cost of care must be considered. With shorter hospital stays, fewer infections, reduced ICU needs, and faster return to normal life, robotic surgery often ends up being more economical in the long run—especially when factoring in caregiver time, income loss, and quality of life. Dr. Venkat summarises it aptly: 'It's not just the hospital bill. Robotic surgery saves time, stress, and resources, for both the patient and their family.' As surgical oncology , GI, gynecology, and thoracic surgery continue to embrace RAS, it's becoming clear that robotic platforms are not just the future, they are the present. With India producing world-class evidence, expanding surgeon training, and deepening patient awareness, the shift is no longer just technological, it's transformational. In the next decade, as Dr. Venkat predicts, 'We won't be talking about robotic surgery. It will just be surgery.'
Yahoo
12-06-2025
- Yahoo
Ship captain convicted of poaching lobsters, crabs and mussels
A Vietnamese national and captain of a 400-foot cargo ship docked in Newington was arrested last week by Fish and Game officers after receiving a tip about illegal lobster trapping. Bui Cong Doai, 44, pleaded guilty to three misdemeanors for lobster and crab fishing without a license and illegal possession of someone else's lobster gear, as well as five other violations. He had a Vietnamese passport and United States visa, according to Conservation Officer Justin Whipple. In all, he paid $1,269 as part of the conviction. Mussels Bui Cong Doai, 44, pleaded guilty to three misdemeanors for lobster and crab fishing without a license and illegal possession of someone else's lobster gear, as well as five other violations. The cargo ship, Franbo Lohas, which sails under the Panama flag, had been docked on the Piscataqua River in Newington. Fish and Game noticed multiple ropes extending from the ship with traps belonging to a licensed New Hampshire commercial fisherman. 'There were four lines total off of the ship, two large and two small,' Whipple said. 'The two large each had a trap they were actively using to fish.' Officers found lobsters, crabs and bags of blue mussels. A female egg-bearing lobster was found in an undersized cage just to keep it alive. The investigation started after Whipple received a tip from a local lobsterman who had his gear tangled in lines coming from the cargo ship. 'When he retrieved his gear, he pulled up what was clearly an illegal lobster pot,' he said. 'He took some photos, gave me a call and reported it.' Fish and Game needed to get permission from the Coast Guard and the pier operator SubCom to board the ship. Based on information provided to Fish and Game, this is the first time the ship docked in New Hampshire. Bui Cong Doai, 44, pleaded guilty to three misdemeanors for lobster and crab fishing without a license and illegal possession of someone else's lobster gear, as well as five other violations. 'We had probable cause based on the photos to do the investigation with the blessing of the Coast Guard,' Whipple said. 'We wanted to do it quickly because we weren't sure when the ship would be leaving.' The violations include illegal trap construction, possession of a short egg-bearing lobster, unlawful possession of crabs, unlawful possession of blue mussels and an egg-bearing Jonah crab. Fish and Game was able to work with the courts for an expedited arraignment, which led to the conviction. The egg-bearing lobster likely had never been caught before because it did not have a 'v-notch' marking, which fishermen use to mark breeding lobster. 'Hopefully, it will encourage people to keep giving us calls if they see anything skeptical and know that we are willing to get out there and do the investigation and the legwork,' Whipple said. He's glad the case was able to be settled before the ship left port.
Yahoo
29-05-2025
- General
- Yahoo
Man sentenced in 2023 crash that killed ex-NBA player's daughter
GROTON, Conn. (WTNH) — A man was sentenced on Wednesday in the 2023 crash that killed former NBA player Tyson Wheeler's daughter. Scott Whipple, 26, of Mashantucket, was sentenced to 10 years, suspended after six years and five years' probation. Man arrested for Groton crash that killed dirt bike passenger In March, Whipple pleaded guilty to manslaughter in the second degree and reckless driving. This comes after a 24-year-old passenger, Tiara Wheeler, was killed in a dirt bike crash in August 2023. Police said around 9:26 p.m., they responded to a crash at the intersection of Long Hill Road and Meridian Street Extension. An investigation revealed that a 2010 Audi Q7 was traveling south on Long Hill Road and had a green left turn light at the intersection of Meridian Street Extension. As the Audi began to turn, several dirt bikes and ATVs were also traveling north on Long Hill Road and into the intersection. One of the dirt bikes with two riders on it, Whipple and Wheeler, entered the intersection and struck the right rear passenger section of the Audi, police said. Whipple also faced injuries in the crash, police said. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Los Angeles Times
24-05-2025
- Health
- Los Angeles Times
Whipple's Disease: Rare but Treatable Systemic Infection
Whipple's disease is a rare but serious systemic infection caused by the bacterium Tropheryma whipplei. It's found in the environment and even in asymptomatic carriers but targets middle-aged white men and can affect multiple organ systems—especially the small intestine. Because its early symptoms mimic more common conditions, diagnosis often requires a combination of clinical suspicion and specific laboratory testing. Tropheryma whipplei is a gram-positive bacterium first identified in 1907 and later linked to a chronic, relapsing multisystem illness. It's found in soil and sewage and can colonize healthy individuals without causing symptoms. But a small group—usually those with underlying immune system dysfunction—may develop full blown disease [1], [3]. Most patients with Whipple's disease are middle-aged Caucasian men, so what about genetic susceptibility and hormonal influence [4], [11]? Although the bacteria can live harmlessly in some, defects in cellular immunity likely allow it to multiply unchecked and cause multisystemic illness [10]. One of the weirdest things about Whipple's disease is how slowly and subtly it can unfold. Many patients first present with joint pain or arthropathy which may appear years before gastrointestinal symptoms. Unlike inflammatory arthritis, this joint pain often has no redness or swelling so it's hard to diagnose. Once gastrointestinal symptoms start, they usually include chronic diarrhea, abdominal pain and significant weight loss—hallmarks of malabsorption due to damage to the gastrointestinal tract, especially the small intestine [2], [6], [8]. Whipple's isn't limited to the gut. The disease can take many forms depending on which organs are involved. Some patients have cardiac symptoms like endocarditis, while others may have neurological symptoms. Some have symptoms of which are neurological symptoms. Some have isolated CNS symptoms—known as isolated Whipple's disease—without any gut symptoms at all. Children can also be affected, although this is less common. In pediatric cases, the disease often mimics acute infections with fever and lymphadenopathy [3]. Scientists are still figuring out how T. whipplei causes disease. What's clear is that it hijacks the host's immune system. The bacterium has been shown to replicate in host cells using interleukin 16 and induce cell death via apoptosis [3]. A subtle deficiency in the patient's T-cell mediated immunity may be the reason why only some carriers develop disease [4], [2]. This impaired immunity prevents the body from clearing the bacterium properly, allowing it to invade the small intestine's lining and spread through lymphatic and blood vessels to distant organs [9]. Diagnosing Whipple's disease can be tricky because of its many manifestations. The diagnostic gold standard is a small bowel biopsy—usually of the duodenum—with periodic acid–Schiff (PAS) staining which highlights the characteristic foamy macrophages filled with T. whipplei [2], [6]. For confirmation, polymerase chain reaction (PCR) testing targeting the 16S ribosomal RNA gene of T. whipplei is widely used. Immunohistochemistry and DNA sequencing can provide additional molecular confirmation especially in cases without classic gastrointestinal symptoms [12]. Whipple's disease is one of the few systemic infections where antibiotic treatment can potentially cure the disease. But treatment must be prolonged and monitored closely because of the risk of relapse [5]. A common approach is to start with intravenous ceftriaxone for two weeks and then long term oral trimethoprim-sulfamethoxazole for at least one year [7]. For patients who cannot tolerate this regimen, a combination of hydroxychloroquine and doxycycline has been used successfully [7]. Since the disease can affect the CNS, some experts recommend regimens that can cross the blood brain barrier. Relapses, especially of the brain, can occur years later so long term follow up is essential. Whipple's disease is a rare and fascinating illness that challenges clinicians with its many manifestations and slow progression. It often starts with vague joint pain or chronic digestive issues and can eventually affect almost every organ system—including the heart and brain. But with the right diagnostic tools and long term antibiotic treatment many patients can recover significantly. Research into the immunological mechanisms of susceptibility may one day lead to more targeted treatments or even prevention. For now awareness and early recognition are the best tools to fight this elusive disease. [1] Marth T. (2016). Whipple's disease. Acta clinica Belgica, 71(6), 373–378. [2] El-Abassi, R., Soliman, M. Y., Williams, F., & England, J. D. (2017). Whipple's disease. Journal of the neurological sciences, 377, 197–206. [3] Puéchal X. (2013). Whipple's disease. Annals of the rheumatic diseases, 72(6), 797–803. [4] Marth, T., & Raoult, D. (2003). Whipple's disease. Lancet (London, England), 361(9353), 239–246. [5] Schwartzman, S., & Schwartzman, M. (2013). Whipple's disease. Rheumatic diseases clinics of North America, 39(2), 313–321. [6] Ratnaike R. N. (2000). Whipple's disease. Postgraduate medical journal, 76(902), 760–766. [7] Biagi, F., Biagi, G. L., & Corazza, G. R. (2017). What is the best therapy for Whipple's disease? Our point of view. Scandinavian journal of gastroenterology, 52(4), 465–466. [8] Mönkemüller, K., Fry, L. C., Rickes, S., & Malfertheiner, P. (2006). Whipple's Disease. Current infectious disease reports, 8(2), 96–102. [9] Ramaiah, C., & Boynton, R. F. (1998). Whipple's disease. Gastroenterology clinics of North America, 27(3), 683–vii. [10] Marth, T., & Strober, W. (1996). Whipple's disease. Seminars in gastrointestinal disease, 7(1), 41–48. [11] Bai, J. C., Mazure, R. M., Vazquez, H., Niveloni, S. I., Smecuol, E., Pedreira, S., & Mauriño, E. (2004). Whipple's disease. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2(10), 849–860. [12] Fantry, G. T., & James, S. P. (1995). Whipple's disease. Digestive diseases (Basel, Switzerland), 13(2), 108–118.
Yahoo
23-05-2025
- Business
- Yahoo
Central Texas ‘stuck' in middle-income affordability crisis: National Association of Realtors
AUSTIN (KXAN) — A report published May 15 by the National Association of Realtors (NAR) claims that Texas' major metros face a 'significant shortage of homes' available for middle-income families. The NAR said that in order to meet demand, the US must build two homes that list below $260,000 for each home above $680,000. Unless that happens, 'homeownership will remain blocked for millions of Americans who are otherwise financially ready to buy,' the NAR said. 'Middle-income buyers – those who are supposed to form the backbone of the homebuying market – are making progress, but they're still shut out of more than half of the homes for sale today,' the NAR wrote. Austin leads the nation in affordable multi-family construction, but has the 10th lowest homeownership rate. Austin's housing market: How quickly are homes selling, and for how much? Austin Habitat for Humanity's Chief Impact Officer Billy Whipple spoke with KXAN about the report. 'Even as homes are coming online, the asking prices are higher than a lot of our wage earners. If you look at the median incomes, they're not able to afford the product coming online,' Whipple said. 'We've experienced a lot of growth here in Austin, and with that has come a lot more homes, a lot more units. I think we've all seen the construction.' Whipple said that while Habitat is 'stepping in' to meet demand, support from the local and state governments is necessary to help builders. 'Delivering homes affordably, where more people across our entire economic spectrum can get into home ownership, does require support, subsidy and speed,' he said. 'The longer it takes to go through zoning, permitting, construction, the more uncertainty is entered into the equation. And that always equates to more cost to deliver.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
