The robot behind the ‘grape surgery’ picture.

A while ago a picture appeared where surgeons a robotic surgery on a grape was performed. The robot that was used to perform this procedure was the Da Vinci robot, the current market leader.

We can see how. the procedure is executed on a grape

Robotic surgery has really taken surgery to the next level in terms of precision. One of the best systems on the market is the Da Vinci robot which provides a surgeon the ability to work be more precise while having the ability to see his patient in 3D.

The benefits of robotic surgery itself are amazing. Most articles reveal that they provide many benefits including less bleeding, less scarring, less post-operative pain, quicker recovery and a shorter stay in the hospital. Though there are many different robots depending on what type of surgery you’re preforming. Currently the Da Vinci robot is used in

-cardiac surgery
-colorectal surgery
-general surgery
-gynecologic surgery
-head and neck surgery
-thoracic surgery
-urologic surgery

However the robot doesn’t function completely on its own. There is always a surgeon needed to perform the procedure and to steer the robot and just like most operations there are always nurses are present as well.

The precision of the robot has been demonstrated on a grape back in 2014 and even went viral a month ago. Should you want to see this robot in action click here: https://www.youtube.com/watch?v=0XdC1HUp-rU Its precision is clearly noticeable and we can only imagine what the future of robotic surgery holds for us.

Should you be interested in the Da Vinci robot, you can find more information on the site of Intuitive Surgical, the company behind the robot, by clicking this link https://www.intuitive.com.

All about MRSA

After surgery one of the most feared complications is an infection with MRSA. MRSA stands for methiciline resistant staphylococcus aureus. This specific form is resistant to most antibiotics. Treatment options are limited for patients infected with MRSA and complications often arise. We will talk about all it’s implications here. 

Staph aureus

Under normal circumstances staph aureus is a bacteria that resides on the skin, in the mucus of the nose and in the gut. About 30% of the population is a carrier of staph aureus and will most likely never get sick or infected. The skin forms a great barrier to protect one against staphylococcus Aureus. The bacteria itself isn’t completely harmless: it can produce toxines, adhesines, enzymes and escape elements. Just like most bacteria it can adapt itself to it’s surroundings. However a regular staph aureus is sensitive to antibiotics and it can be treated.

Problems arise when a patient carries a type of staph aureus that is resistant to antibiotics. This resistance comes from the bacteria itself which, as mentioned before, has the possibility to adapt itself to it’s surroundings. This forms a problem, because MRSA is resistant to the most used antibiotics, in fact there’s only one antibiotic left to use.

Treatment options

There is currently only one type of medication which is used to treat MRSA and that’s vancomycine given intravenously. It is the only medication used against MRSA (in Belgium), however it comes with quite a few side effects which is why we doctors might be reluctant to use it.
Side effects include:
-neutropenia
-allergic reaction (fever, rash)
-nefrotoxicity
-ototoxicity
-tromboflebitis (on the site of the injection)
and there is of course risk that the bacteria adapts and becomes resistant to vancomycine.

Though vancomycine given intravenously provides a treatment option it’s recommended to use prevention strategies to avoid getting infected in the first place.

Prevention

When it comes down to hospital setting everything will be ensured to make the patient as bacteria free as possible before surgery. This includes disinfecting the patient (washing the area before surgery as well as using disinfectant). Making sure that the surgeon and everyone in the operation room has scrubbed in. And giving the patient post operative antibiotics if necessary.
Operating rooms often have a lower temperature and the air is continuously filtered. All measurements to assure an aseptic environment.

Consequences of an infection 

When someone has an open wound that is infected with MRSA, it can easily spread to other parts of the body. This can lead to infection of other organs, necrosis and septic shock. Because of the severity of these infections and the lack of alternative treatment options, MRSA is one of the most feared complications after surgery and most feared bacteria in the hospital hence why there are so many measures to prevent an infection with MRSA in any patient.
Should a patient be infected with MRSA the nurses and health care providers will make sure that they come in the room protected. Usually it’s not necessary for visitors to be protected though they are advised to disinfect their hands with soluble alcohol.
Special measurements will continue to be taken until the patient is free from MRSA.

Sources:
BCFI: https://www.bcfi.be/nl/chapters/12?frag=9431
Pictures: picture 1, Picture 2
Information: course “infectie en afweer’ taught by prof. dr. Bruno Verhasselt and prof. dr. Bart Vandekerckhove at the University of Ghent

Amboss

Amboss is an online quiz bank and what sets them apart from other quiz banks is that they put more focus on providing reliable information by adding references to their online library and question bank. While they are a European company they also focus on Step exams which is interesting for American students as well.

How does it work? This is my dashboard. As you can see, I haven’t been very active on Amboss. I prefer to learn my courses and then focus on questions. I’ve completed 23 questions so far all about one course. When looking at my last sessions, you can see I answered a few questions and am working on getting through the latest set of questions. The use of practice questions is a great study technique and has proven to be very efficient as well.

Library (is placed left) contains medical knowledge. Everything is put into different folders.
All subjects are sorted in learning cards: this contains the most important information and even has videos. Short information and link to a learning card. You could also add your own notes to every learning card and share it with your friends.
There are a few features on these learning cards. High yield mode: means that the information can be narrowed down to those subjects that are really important!
Another interesting feature is that if you make a mistake after a quiz, you can see in which topic it was. This is presented on the flashcards in the right corner.
And of course you can track your study progress this way!

At the bottom of these learning cards there are also a few pictures. There are anatomical pictures where you can test your knowledge. They also have an added feature for radiological pictures. And an overlay function which gives a direction of where you should be looking. You can then look at the caption to get an indication of whether you were looking in the right direction.

Question bank: you can answer some of the questions in their question bank. You can do custom sessions as well. You can start with any mode: there’s an exam preparation, custom session or you could answer questions per organ or per symptom. You can also choose to solve questions in exam mode or in study mode.
These questions consist of a full medical case, similar to a situation in a hospital. While making these questions you can highlight certain words/information in the questions depending on whether you find it relevant or important to solve that question.

Attending tip: this is an added feature, when you really have no idea about a certain response, you can get a tip to help answer this question.
Regardless of your response, an explanation will be provided. You get an explanation and again a link back to the learning card. If you answered a question wrong, you’ll see that that part will turn red in your learning card. That way you can track your progress.
After ending a session you’ll get an overview of how you performed.

Here I’ve highlighted some words and you can see the attending tip as well

Chalk talk: these are explanation videos that the Amboss team makes on their own. It gives a good overview of a topic.

And since they work together with osmosis you can also find a few osmosis videos included on their website.

So Amboss provides medical students a platform that not only provides more references and thus more reliable learning resources, they also give the opportunity to adapt it and even share it with your friends. But how pricy is it? They have a plus option and standard option. The standard option gives limited questions whereas the plus option gives you access to all questions. There is also a student life option which means you can buy amboss for the entire student career. This seems pricy but they offer group discounts so the more students buy together the lower the cost!
Should you be interested I’ve linked their site here and you can also start a 5 day free trial!

I hope you enjoyed this blogpost! Let me know in the comment section which question bank you prefer.

Lots of love
-Mavis

Ghent will gain another museum

The university of Ghent is coming with a new museum in 2020 and while it’s still very early, I wanted to write a piece about it to keep you updated!

The university of Ghent currently has a few different collections that are spread out across their different campuses and in 2020 they are coming up with a brand new museum that will house some of the most amazing pieces gathered from different faculties who housed these pieces until now. The museum director Marjan Doom has an entire team working with her to make this new museum a reality and let me tell you, this team has done an amazing job.

A simulation of how the museum will look.

So far they have quite a few things set up! First of all the museum will come in the new building next to De Plantentuin and it will open in spring/summer 2020.
What’s special about it, is that it provides a unique experience for its visitors. It’s different. The layout of this museum will be different, the topics are unique and the goal is to provide visitors a unique experience while they learn as they go.

The past year I’ve been fortunate to be part of a group of students who were able to learn more about this museum behind the scenes. It was a wonderful experience, however I must admit that it was difficult to combine with my studies! I have however learned a lot about the new museum the past year and have gotten the fortune to see some of the pieces the new museum will show to the public. I can’t tell you how amazing and unique the concept of this museum will be, but I can tell you that you have to visit it when you’re in Belgium or you’ll miss out on this wonderful combination of science, art and everything in-between. It will however be a journey worth going on.

Image source: Architectura.be

Behind the nobel prize: sulfa

Sulfonamide, also known as Prontosil was one of the miracle cures of the 19th century. Back then it was actually a non-bacterial synthetic drug that consisted of a sulfonamide-group that linked on a different molecule. If you happened to have read ‘The demon under the microscope’ by Thomas Hager you might recall that the discovery of this drug was definitely not a one-mans show. The discovery came from the hands of a trio: Gerard Domagk (physician and researcher), Joseph Klarer (chemist) and Friedrich Mietzsch (chemist). All three worked together for Farben industries, one of the biggest dye companies in the world, to synthethize a drug that could kill bacteria.

Both Klarer and Mietzsch were responsible for the production of different chemical molecules. Domagk would then take these structures and test them out on animals. They’d then take the results back and try to make the molecules more specific. They would add chemical groups or take groups away to increase the drug specificity. A technique that is still used today!

Eventually they found a molecule that somehow worked, it was named Prontosil rubor, because of the red color. Gerhard Domagk was responsible to test it out on the animals and he saw that it had great results, so he repeated the experiment on viral infections to see if it would work, however he came to the conclusion that only bacterial infections were susceptible to the drug. Even though the drug worked on the lab animals it took them a while to consider testing it on human beings. In fact, they only knew that it was effective in humans because Gerhard Domagk’s daughter had been infected with strep, she was going downhill very quickly and he saw no other option but to dose her with Prontosil and by doing so he proved it’s effectiveness in humans.
Two years after the discovery of Prontosil rubor, they published their results. Up until that moment Prontosil had only been available nationally, for own use. Something that was considered somewhat irresponsible as many women and neonatals were dying of the consequences of a puerpural infection. These bacterial infections could have been prevented with the use of this new drug.
Even though the drug had positive effects on patients, they still didn’t exactly know what it did in the body nor what effects and side effects were.

There are still a lot of old Prontosil ampoules sold online. A picture of an old package of Prontosil can be found above here.. It contained red ampoules with Prontosil in it.

That discovery belongs to French researchers who were able to identify that Prontosil became active in the body after it was cleaved in the nitrogen-nitrogen double bond. They also discovered that sulfanilamide was equally potent as Prontosil. The only difference was that sulfanilamide was available in most households, in fact it was cheap and easily available.
This ment that Prontosil which by that time had been patented had lost its value and that Farben Ig couldn’t benefit from their patent anymore.

Nevertheless Gerhard Domagk received the nobel prize for the discovery of Prontosil the first antibacterial drug. Because he won the prize during world war, and the germans thought that the nobel prize was heavily influenced by jews, he was unable to claim his prize at the time and received it years later. Klarer and Mietzsch never received a price for aiding in the discovery. Sulfanilamide is still available in a lot of different medications and is often given in one pill that also contains other drugs.

If you enjoyed this article let me know by clicking the like button down below.

Lots of love
-A doctor in spe

Jane Davis reading books

On Thursday the 21st of November I listened to a studium or a lecture from Jane Davis who talked about the influence of books on our lives and I must say that it felt as though my love for books was somehow reignited. Jane Davis is the founder of ‘The Reader’ which is an organization that brings people together through reading. Something a lot of people might benefit from. 

The goal of this studium was to talk about the influence reading might have on others. Talking about literature and poetry can have great influence on someones state of mind. It can provide a new perspective to look at yourself and your life and to gain new insights. In the past there have been numerous research papers that showed a connection between reading fiction and improvement in empathy. That means that reading a fictional book and getting into the characters and understanding what they’re feeling will help you understand the same thing in real life. There’s also an improvement in the theory of mind. This term means that one can see from a different perspective and empathy is something that’s often required from doctors. Doctors need to be empathetical to be able to know what the patient wants or needs and how he or she might feel at any given time which is most likely the reason why we had the opportunity to listen to a lecture that explained the importance of reading.

This lecture reignited my passion for reading and made me realize the influence books have had on my life. As a kid I read one book after the other trying to learn more about the world around me, growing up I traded in those books for a new type and along that road I seem to have lost my passion for literature along the way. However Jane Davis came along and reminded me of the feelings I used to have after reading a good book. The nostalgia couldn’t have been bigger.

Books and poetry add another dimension to life, giving people the opportunity to feel and experience what one otherwise might not. 

I’ve listed one article down below about the correlation between reading and empathy. Let me know what you think of it!

Lots of love
-A doctor in spe

Bibliography
https://www.sciencedirect.com/science/article/pii/S1364661316300705

School in the cloud

Think about a platform, where students can ask almost any question and can help find a response. Not only that children learn to collaborate and work with each other towards not only finding a goal but towards long-term learning. They gain skills along their journey to find an answer.

A school in the cloud is as their website describes: “A self-organised learning environment, or SOLE, can exist anywhere there is a computer, Internet connection, and students who are ready to learn. Within a SOLE students are given the freedom to learn collaboratively using the internet. An educator poses a Big Question and students form small groups to find an answer

The company was launched in 2014 in and gives children the chance to ask any big question they want. And they have grown into quite a big organisation that is active in over 20 countries. Currently there are a lot more volunteers, there are also ‘grannies’ which are people who help guide the proces of finding and answering questions.

You might ask me why I decided to write about school in the cloud. And there are a few reasons: firstly: the concept spoke to me. It was a unique concept that is focused on learning. The ability to help children abroad gain more knowledge on something they’re quite interested in, it’s heart warming. The internet opened many doors but school in the cloud is the door I hope children go through. This is to help children all over the world to gain more knowledge, and to stay hungry (as Steve Jobs would say it) with the use of a computer and spare time from a volunteer.

Should you be interested to become a teacher in the clouds, you might actually be able to help out. There is an entire manual on how to make a class in the cloud, how to keep the children busy and thinking. Something that should and could be introduced in schools.

I’m going to briefly link all information regarding school in the cloud down below including some interesting articles I found about a school in the cloud online. It raises the discussion about children learning for themselves.
https://www.theguardian.com/film/2018/oct/19/school-cloud-review-sugata-mitra
https://www.theschoolinthecloud.org
The founder of this company also has a few interesting TED talks.
https://www.ted.com/talks/sugata_mitra_how_children_teach_themselves
https://www.youtube.com/watch?v=y3jYVe1RGaU

Let me know in the comments down below what you think of the concept of a virtual school for children where they can explore certain topics under online supervision.

Lots of love
– A doctor in spe

Top 3 online volunteering sites

Voluntary work is important, not only as (pre)med students. Voluntary work matters and can truly change lives . In the 21st century voluntary work has become more accessible, it is now possible to virtually volunteer and make a difference in the world. Two weeks ago I wrote about becoming a U.N. online volunteer. This week I wanted to help you in the search for the best online volunteering position in proximity to you.

1. Volunteermatch.org

This organization launched it’s site in 1998 making it one of the first online volunteering sites. Since then they’ve won a Macworld web award, two Webby awards and was voted Best.org web site at the people’s choice awards. They’re a non profit organization that helps people to find a good cause and help out where they can. They offer both local and online voluntary options. 

2. Idealist.org

Idealist is comparable to volunteer match in terms of goals. However they also offer a platform for organizations that are around in your area. If you want to volunteer you can click above and you’ll get more information about positions that are currently available.

3. Catchafire.org

Catchafire is a bit different. It’s a site that helps you find a project that matches your field of work to a project. Say for example you’re a graphic design artist: you can find projects that are specifically linked to that.
Just like the other sites the project duration varies based on what you’re looking for. There are both long and short-term projects and you can choose whichever you’d like. 

These three sites were my top picks for online voluntary work, but I know that there are probably a lot more different sites out there. If you have any suggestions for online voluntary work let me know in the comment section down below!

Lots of love
-A doctor in spe

U.N. online volunteer

In the 21st century it should come as no surprise that online volunteering can also make a difference. There are quite a lot of benefits connected to volunteering online. You can save time, work from home but just like regular voluntary work you can make a change!

Today I specifically wanted to bring U.N. online voluntary program to your attention because both the volunteer as the organization looking for help benefit from this situation. The volunteer gets an opportunity to work on a project, engage with different people all over the world and they get to help someone out all while working from home.

The projects from the UN differ. They are often based on 11 sustainable development goals that the U.N. uses. Some are about equality, some about sanitation, some about water,…. There are a lot of diverse projects which makes these options for anyone who wants to help out on different projects all over the world without leaving the comfort of their home area.

Because the sustainable development goals are the center of their voluntary actions, I thought it might be interesting to shed some light on them.

The UN has 17 SDG’s which all have the same goal to work towards a better and more sustainable future for the entire world. Globalization has had a big influence on every part of our lives, the sustainable development goals might not be able to fully reverse it’s effect, but they can make a change and prevent the issue growing bigger. The SDG’s are all goals spread over different domains to tackle issues we need to solve as soon as possible. By volunteering for the U.N. you can help fulfill one of these SDG’s and work towards a better future.

Should you be interested in the U.N. online volunteering program you can click here. If you’re more interested in the sustainable development goals and you want to read the sustainable development report you can do it by clicking here. Remember that all of our little steps will make a big change and will definitely be worth it!

I hope you enjoyed this little blogpost! Remember that more information can be found at the site of the United Nations listed above.

Lots of love
-A doctor in spe

Top 3 free apps for students

I decided to write this post and share some of my favorite student applications with you. These apps can be used on both Mac and IOS which is a huge advantage.

  1. My homework

I’ve been using this app on and off, but I can’t emphasize enough how much I love it. The simple layout and the user friendliness are what makes me come back to it every time. This is the only app I use to finish on time for my deadlines and I must say that it has really helped me to keep track of what I’m doing and when. There are a lot of new applications coming on the market to help you plan, but this is honestly the only one you need.

2. Everynote


Though I love this application I often find the lack of memory a bit frustrating. As I’m on a free plan I can’t use every single everynote feature. However this is yet another great application for students. Everyone does exactly what it needs to and keeps all of your notes in one place. The application offers a simple and neat design and is suited for any user.

3. Pomodoro

Yet another great invention is Pomodoro. It’s a timer that helps you keep track of the time you actually work on a certain task. What I like is that you can set the time you want yourself (so you can work longer than 25 minutes on end). You can adjust the sound of the timer which is also a great asset. You can also see the hours you’ve worked on a certain taks. So overall definitely something I’d advise any student.

I hope you enjoyed this little blogpost! Let me know in the comment section down below which applications you prefer.

Lots of love
-A doctor in spe