Oncogenesis- kaleidoscopic and multi-level reality

Oncogenesis is an extremely complex phenomenon. The mechanisms by which cancer is induced is only partially known. Consequently, therapeutic targets may be uncertain and results are often unsatisfactory. The purpose of this paper is to develop a trans-level and multiple transdisciplinary perspective describing the kaleidoscopic reality of oncogenesis. This manner of understanding oncogenesis as a complex process characterized by a non-linear dynamic, far from equilibrium and with unpredictable evolution, transcends the classical perspective and requires a paradigm shift. This approach is also facilitated by recent studies that focus on group phenomena, with emerging behaviors in a continuous phase transition. Biological systems, and obviously the human organism, express this type of behavior with critical self-organizing valences in the context of a genome - mesotope (environment) - phenotype interaction. For example, nature has transposed in the ecosystem, among other things, the performance pattern of its mineral history represented by the dynamic energy-matter-information unit (the principle of invariance). And multi-cell biological systems in the phylogenetic tree crown have multiple directed aerobic metabolisms in accordance with specific functions. Cancers, in turn, have a hybrid (anaerobic and aerobic) and unidirectional metabolism whose only and ultimate reason is the survival of the malignant cell. Understanding the transdisciplinary reality of oncogenesis offers novel development paths for new therapeutic strategies compared to current ones which have relatively limited efficiency

Postoperative Follow-Up and Recovery after Abdominal Surgery

Postoperative patient care has several components: - surveillance, − prevention of complications associated with surgical disease or other preexisting comorbidities, − specific postoperative treatment of the surgical disease and its complications. While these distinctions are purely didactic, the postoperative care merges into an active surveillance with a higher level of standardization than it would seem at first glance. Computing, interpreting and integrating signs and symptoms with active search of proofs by lab tests or other paraclinical explorations highly depends on skills and dedication of the entire healthcare team. Those attributes gained through continuous theoretical preparation but validated by current practice bring added value, always in favor of the patients’ best interests. In this chapter, we propose to explore the main clinical and paraclinical means and tools that can improve the outcomes of surgical procedures for a faster and safer recovery. We will also discuss the need for different types of surgical bed drains placement and their management, the use of antibiotics and thrombotic event prophylaxis

Clinicopathological Analysis of Complicated Colorectal Cancer: A Five-Year Retrospective Study from a Single Surgery Unit

Patients with primary colorectal cancer can present with obstructions, tumor bleeding, or perforations, which represent acute complications. This paper aimed to analyze and compare the clinical and pathological profiles of two patient groups: one with colorectal cancer and a related complication and another without any specific complication. We performed a five-year retrospective study on colorectal cancer patients admitted to a surgery unit and comparatively explored the main clinical and pathological features of the tumors belonging to the two groups. A total of 250 patients with colorectal cancer were included in the analysis. Of these, 117 (46.8%) had presented a type of complication. The comparative analysis that examined several clinical and pathological parameters showed a statistically significant difference for unfavorable prognosis factors in the group with complications. This was evident for features such as vascular and perineural invasion, lymph node involvement, pathological primary tumor stage, and TNM stage. Colorectal cancers with a related complication belonged to a group of tumors with a more aggressive histopathologic profile and more advanced stages. Furthermore, the comparable incidence of cases in the two groups of patients warrants further efforts to be made in terms of early detection and prognosis prediction of colorectal cancer

Factors Contributing to Surgical Site Infections: A Comprehensive Systematic Review of Etiology and Risk Factors

Surgical site infections persist as a substantial concern within the realm of hospital-acquired infections. This enduring issue is further compounded by the mounting challenge of antibiotic resistance, a surge in surgical interventions, and the presence of comorbidities among patients. Thus, a comprehensive exploration of all discernible risk factors, as well as proactive preventive and prophylactic strategies, becomes imperative. Moreover, the prevalence of multidrug-resistant microorganisms has reached alarming proportions. Consequently, there is an acute need to investigate and scrutinize all potential therapeutic interventions to counter this burgeoning threat. Consequently, the primary objective of this review is to meticulously assess the origins and risk elements intertwined with surgical site infections across a diverse spectrum of surgical procedures. As the medical landscape continues to evolve, this critical analysis seeks to provide a nuanced understanding of the multi-faceted factors contributing to surgical site infections, with the overarching aim of facilitating more effective management and mitigation strategies. By exploring these dimensions comprehensively, we endeavor to enhance patient safety and the quality of surgical care in this era of evolving healthcare challenges