#oncol

[chinmay-001]

Breast Cancer Treatment In Dubai | Breast Cancer Specialist Dubai - Dr Rajeev Kaushal

Meet Dr. Rajeev - Best Oncologist in Dubai. He is the Cancer Specialist in Dubai, offering comprehensive care for breast, prostate, bladder, kidney, lung cancers, and more.

[real-odark]

jobs i think all the saw characters would have if they weren't in saw, and didnt all have like the same 2 jobs (discluding some characters who actually have independent jobs, who i'll just put their regular jobs) with some explanations........

john - architect/engineer (obviously); too old to do anything else (jk) and also the jobs just perfect for him

jill - engineer (obviously); i feel like she could also do some childrens programs though, similar to what ill say to lynn, because she wants to feel like a mom since she never got to be one ,,!!

lawrence - doctor (obviously), oncologist; i dont actually have anything to say about this one but. stream oncol-la-la-la-logist from saw the musical

adam - veterinarian, and freelance photographer on the side (obviously); you know if youve read the og script he talks about how he wanted to be a vet. well we're gonna let him Yeaaaa.

amanda - journalist; a mostly independent job, and i know her and adam are similar in how they are the eyes in the sky, i also think she has very strong senses of justice for this job

lynn - doctor (obviously), pediatrician; she works with kids to help her through what she won't be getting to do with her son, to protect him--so instead pays the service to other children

kerry - lawyer; like amanda, a strong sense of justice. not only do i think she is very good at thinking under pressure, but i KNOW shed be serving cunt in that courtroom

eric - highschool sports coach; has a lot of pent up anger and likes to have control of his situation, especially by people who will just. listen to him. he also uses this to try and get close to daniel by working at his school (its probably not working)

daniel - minimum wage grocery store bagger; hes like a teenager, its this or working at an ice cream parlor and ones less socially demanding for the awkward kid he is

strahm - chef; another job for people with anger (watch the bear streaming on hulu), but idk if i can back this up by anything other than saying his face just looks like he makes a mean omelette?

perez - ceo of some financial services; money money money must be funny in a rich mans world. i know shes super confident and was definitely a math mu kid in school so i think she could top off some banking job, but would probably do some local volunteer service stuff as well #communitygal.

hoffman - detective (obv); since his name is legally detective!! just kidding idk i just cant picture him as anything else.

[punshi-punshi]

Foto desde uno de los miradores de la reserva natural cerro Oncol, en Valdivia, Chile.

Al fondo se puede ver la localidad de Pilolcura.

Es irónico que este parque en plena reserva valdiviana sea de forestal Araucoxd.

Camara:Yashica FX-3 2000.

El rollo es una carga de cine.

[numberonerutter]

Fan theory: Tek Knight is just a freak and his brain cancer has no bearing on it.

Sorry if this sounds deranged, it is because I am mentally ill 👍

Admittedly, I’m not a brain surgeon. Also I haven’t actually watched the whole of Gen V, I just watched The Whole Truth like 2 seconds ago in Biology class. Honestly I don’t care that much about The Boys I just have a hyperfixation on Iron Man and this is tangentially related.

Tek Knight is obviously based off Iron Man. There’s no debating that.

It’s not a stretch to assume that Tek Knight’s brain cancer thing was inspired by Marvel Ultimates’ portrayal of Iron Man where he has a brain tumor that turns into an ai/son who ultimately (ha) dies because Reed Richards discovered that Iron Man had such awful thoughts that the mind gem started growing in his brain and was removed by Quicksilver (who is in an incestuous relationship with his twin) and in the process Quicksilver also removed the brain tumor. Marvel Ultimates was wilding and it has a reboot (don’t know why they would reboot peak) and I hope Tony’s ai/son makes an appearance.

Tek Knight was based on the many shades of Tony Stark. Back in the 60s, Stan wanted a character who was a redeemed asshole. But at least Tek Knight never built concentration camps in space like TS. But it’s okay because he was sad or something. I wonder if TK will put cameras in people’s showers… It’s cherry-picked is what it is.

TK doesn’t hallucinate or anything like Ultimates!Tony Stark! No, that’s not hardcore enough for Gen V. Instead he fucks anything with a hole.

“Fatigue, pain, anxiety and depression are the most frequently reported cancer symptoms which can be compounded by existing psychologic conditions… Primary brain tumor (PBT) patients encounter many stigmas… loss of economy due to decreased cognition, loss of functional status with motor and sensory deficits and loss of individual freedoms such as driving due to epilepsy and behavioral issues…Emotional and physical distress were the two most commonly reported domains encompassing the problems of fatigue, fears, depression, memory and concentration and worry.” CNS Oncol. 2016 Oct; 5(4): 241–249. Published online 2016 Jul 11. doi: 10.2217/cns-2016-0010

Tek Knight isn’t such a special snowflake that his brain tumor manifests other than this. I swear to God. He clearly doesn’t have the other problems.

One only need look at the barbaric practice of lobotomies to see how differently brain trauma manifests. So yeah, maybe it is because of brain cancer, who fucking knows. I hate being alive.

So yeah, I’m fake-claiming Tek Knight. He’s lying about having cancer, or at least lying about that one symptom. No one in the history of ever has had that symptom, Tek Knight is a fucking freak who hides behind trauma to continue his disgusting behavior. He can fool everyone but he can’t fool me.

[datajournalismntu]

Taiwan’s Oral cancer incidence rate is significantly higher than the global average. Why has betel nuts become the main culprit?

Did you know that the rate of oral cancer among Taiwanese is much higher than the world average?

As early as the mid-1990s, oral medicine experts in Taiwan called on society to pay attention to the issue of betel nut chewing and oral cancer. Since then, many medical studies have confirmed the high correlation between oral cancer and betel nut culture in Taiwan. However, the betel nut issue has not been taken seriously by the government for a long time. Under the government's "three no policy" of not counseling, not encouraging, and not prohibiting, oral cancer remains high in the ranking of cancer incidence and mortality among male cancers in Taiwan.

Betel nut is closely related to oral cancer. According to the latest report of the International Agency for Research on Cancer, 88% of oral cancer patients worldwide have the habit of chewing betel nut (Lancet Oncol. Published online 9 October 2024), and they are mainly distributed in Central Asia and Southeast Asia. What’s serious is that Taiwan’s oral cancer incidence rate is much higher than the world average.

How did betel nut become the main culprit of oral cancer in Taiwan? Why do Taiwanese have such a huge demand for betel nuts? Who is eating betel nut? Let’s start from the supply and demand of areca nut.

According to a press release issued by WHO in August this year (2024), areas around the world with the habit of chewing betel nut are distributed in Central Asia (India, Bangladesh, Pakistan, Sri Lanka) and Southeast Asia (Myanmar, Indonesia, Thailand). Oral cancer is also one of the top 15 cancers in these seven countries. A closer look at the latest age-standardized incidence rates of oral cancer in various countries shows that they all lose to Taiwan (about 22 people per 100,000 people suffer from oral cancer).

Looking back at Taiwan, Graphic 2 shows the incidence rates of oral cancer in 2021 across its 22 administrative regions. Among them, the incidence rates of oral cancer in the central, southern, and eastern regions differ significantly from those in the northern and outlying island areas.

In addition to the fact that blue-collar workers in Taiwan are predominantly concentrated in the central, southern, and Hualien-Taitung regions, over 80% of Taiwan’s betel nut plantations are located in Pingtung County, Nantou County, Chiayi County, and Hualien County.

According to the 2023 Agricultural Statistics Yearbook, the betel nut planting areas in the four administrative regions shown above account for more than 80% of the total betel nut cultivation area nationwide.

Due to the low cost and high profitability of betel nut cultivation, the planting area in Taiwan expanded rapidly from the 1970s to the mid-1980s.

In 1971, Taiwan’s betel nut planting area was only 1,607 hectares, rising to 4,100 hectares by 1981, and by 1996, it had grown to 56,581 hectares, an increase of tenfold over these 15 years.

Since betel nut is primarily cultivated in Pingtung County, Nantou County, Chiayi County, and Hualien County, these four administrative regions are used for comparison with Taiwan as a whole.

Data from the Taiwan Cancer Registry over the years show that the incidence rates of oral cancer in these four regions are indeed higher than the national average and exhibit an upward trend.

The reason betel nuts keep people chewing is due to the release of arecoline, a "central nervous system stimulant," when the nuts are chewed. This stimulant provides warmth and an energy boost. As betel nut chewers continue to chew, they feel increasingly energized but also face an elevated risk of developing oral cancer. The International Agency for Research on Cancer (IARC) has classified betel nut as a Group 1 carcinogen, and arecoline can lead to dependency. Additionally, other ingredients like betel inflorescence and slaked lime also contain carcinogenic chemicals that amplify the risk. Betel nut enthusiasts are predominantly from the working class. For instance, it's common to see long-distance truck drivers constantly chewing betel nuts to stay alert during their trips. Take 22-year-old gravel truck driver Zhong Liangju, who consumes 60-80 betel nuts during a 10-hour drive. Behind these numbers lie significant financial and health costs—ultimately, this makes the working class a high-risk group for oral cancer.

Here’s the translation into English with a professional, journalistic tone:

Zhong Liangju starts his day at 5 a.m., before dawn, driving his gravel truck for 10 straight hours until he can finally rest at 6 p.m. Accompanying him throughout the day is Taiwan's betel nut. Before each shift, Zhong stops by a betel nut stall, spends NT$300 on betel nuts, and begins his long journey. Chewing two nuts at a time, the strong bite and stimulating taste help keep him alert. Consuming 6 to 8 nuts per hour, he ends up chewing around 80 betel nuts on a single trip.

Similarly, Mr. Guo, another truck driver, has spent as much as 30% of his monthly salary—about NT$30,000—on betel nuts during his career. Driving his 17-ton truck, Mr. Guo has chewed betel nuts to stay awake for 28 years. Even though he eventually stopped after losing his teeth, his body had already become desensitized to the effects of betel nuts, and his health had suffered. In fact, it is not uncommon for workers to spend 20 to 30% of their salary on betel nuts. Mr. Luo, a former construction worker, and Ah Ming, an ironworker, both spend nearly 20% of their income—about NT$6,000—on betel nuts each month. Meanwhile, Mr. Guo’s expenses reached 30% of his income. According to a betel nut stall owner in Taoyuan, 70% of his customers are laborers and truck drivers. "They usually don’t complain about the costs," the owner remarked. The heavy reliance on betel nuts among low-wage workers indicates a significant demand, creating a thriving betel nut market. This raises the question: with so many stalls opening up, where exactly is the profit?

Betel nut has a special guild system and sales chain in Taiwan. Interviewees said that, depending on the difference between off season and peak season, the guilds and the wholesales would set the market price and take a cut based on the season's production and demand, which would allow the farmers to make a higher profit compared to other crops. On the other hand, downstream betel nut stands often sell betel nut at a fixed price and ensure that the businessmen can earn a certain profit by adjusting the quantity, quality and the proportion of additives of betel nut in one package.

For example, if a betel nut stand sells a packet of betel nut at a fixed price of NTD 50, the stand will most likely use NTD 25 as a basic profit for deciding on the quality, the size of the betel nut to be purchased, and the ultimate number of a packet betel nut to be sold to the customer.

Since betel nut consumers have a fixed customer base (600,000 to 1 million people), betel nut farmers and betel nut stands are able to make a high profit, allowing the betel nut industry to survive in Taiwan for a long time and hardly disappear.

Statistics from the Ministry of Agriculture (MOA) for the year 2023 show that betel nut is still the second most planted crop in Taiwan after rice. Comparing betel nut with other competitive land use crops in the major producing countries, it can be seen that the labor cost and total production cost of betel nut is almost half of mango and banana, while the total planted area of betel nut is about 2.5 times of mango and banana.

Betel nut can be managed roughly and does not require much labor to maintain a stable income, allowing betel nut farmers to be more independent of age and the pressure to change crops or jobs. The low cost and extensive planting of betel nut has made betel nut a highly profitable industry in south-central Taiwan.

In order to reduce the production of betel nut and improve the incidence of oral cancer among Taiwan, the government proposed the policy of converting abandoned betel nut orchards into land in ROC year 97. In the past 17 years, it has gone through three stages of the plan to convert abandoned orchards. The fourth stage (ROC year 112~115) is being implemented.

According to the results report of Legislative Yuan, in the first phase (ROC year 97), the expected area of ​​abandoned orchards to be converted was 3,928 hectares, and spent a total of approximately 198.82 million NTD in subsidies; in the second phase (ROC year 103-106), the expected area of ​​abandoned gardens to be converted was 4,800 hectares, and a total of approximately 116.22 million NTD subsidies was issued; In the third stage (ROC year 108~110), the expected area of ​​abandoned gardens to be converted was 700 hectares, and a total of approximately 131.6 million NTD was issued.

Although the area of ​​betel nut cultivation in Taiwan has indeed declined in the past 17 years (from 50,457 hectares in ROC year 96 to 37,293 hectares in ROC year 112), the effectiveness of the policy of converting abandoned betel nut orchards is only 31%, and the total amount of subsidies invested has exceeded 440 million NTD.

[harshnews]

Hematologic Malignancies Market Size, Share, Trends, Growth and Competitive Analysis

"Global Hematologic Malignancies Market – Industry Trends and Forecast to 2029

Global Hematologic Malignancies Market, By Type (Leukaemia, Lymphoma, Myeloma), Therapy Type (Chemotherapy, Immunotherapy, Targeted Therapy), Diagnosis (Blood Tests, Biopsy, Imaging Tests, Others), Route of Administration (Oral, Parenteral, Others), Dosage Form (Tablets, Capsules, Injections, Others), End-Users (Hospitals, Specialty Clinics, Homecare, Others), Distribution Channel (Hospital Pharmacy, Retail Pharmacy, Online Pharmacy, Others) – Industry Trends and Forecast to 2029

Access Full 350 Pages PDF Report @

**Segments**

- **Type**: The hematologic malignancies market can be segmented based on the type of malignancy, including leukemia, lymphoma, and multiple myeloma. Leukemia is a cancer of the blood cells, while lymphoma affects the lymphatic system. Multiple myeloma, on the other hand, is a cancer that forms in a type of white blood cell called a plasma cell.

- **Treatment**: Segmentation based on treatment modalities includes chemotherapy, immunotherapy, targeted therapy, stem cell transplant, and others. Chemotherapy is a common treatment for hematologic malignancies that involves the use of drugs to kill cancer cells. Immunotherapy utilizes the body's immune system to fight cancer cells, while targeted therapy focuses on specific molecules involved in cancer growth.

- **End-User**: The market can also be segmented by end-user, such as hospitals, specialty clinics, research institutes, and others. Hospitals are the primary point of care for hematologic malignancies patients, where they receive diagnosis, treatment, and follow-up care. Specialty clinics may offer specialized treatments or clinical trials for these conditions.

**Market Players**

- **Roche**: A leading player in the hematologic malignancies market, Roche offers a range of innovative therapies and diagnostic tools for leukemia, lymphoma, and multiple myeloma. The company's commitment to research and development has resulted in groundbreaking treatments that improve patient outcomes.

- **Johnson & Johnson**: With a focus on cutting-edge oncology therapies, Johnson & Johnson has made significant advancements in the treatment of hematologic malignancies. The company's portfolio includes novel drugs that target specific cancer pathways, providing new options for patients.

- **Novartis**: Known for its expertise in precision medicine, Novartis has developed several targeted therapies for hematologic malignancies. By identifying genetic mutations driving cancer growth, Novartis delivers personalized treatments that are more effective and less toxic for patients.

- **AbbVie**:AbbVie is a key player in the hematologic malignancies market, known for its strong focus on developing innovative therapies for various types of blood cancers. The company's robust pipeline includes potential treatments for leukemia, lymphoma, and multiple myeloma, leveraging cutting-edge technologies and research to address unmet medical needs in this space. AbbVie's commitment to oncology research and development has led to the introduction of novel treatment options that aim to improve patient outcomes and quality of life.

In the competitive landscape of the hematologic malignancies market, AbbVie distinguishes itself through a combination of strategic partnerships, investments in research, and a patient-centric approach to drug development. The company's collaborative efforts with academic institutions, research organizations, and other industry partners have resulted in the acceleration of novel therapeutic solutions for blood cancers. By prioritizing patient needs and engaging in meaningful dialogue with healthcare providers, AbbVie continues to shape the future of hematologic oncology with a focus on personalized medicine and targeted therapies.

AbbVie's portfolio of hematologic malignancy treatments encompasses a diverse range of modalities, including small molecule inhibitors, monoclonal antibodies, and immunotherapies. These innovative therapies target specific pathways and molecular mechanisms involved in the development and progression of blood cancers, offering new hope for patients who may not have responded to conventional treatments. By leveraging its expertise in precision medicine and biomarker-driven approaches, AbbVie continues to advance the field of hematologic oncology with a strong emphasis on tailored treatment regimens that consider individual patient characteristics and disease profiles.

In addition to its focus on drug development, AbbVie also plays a crucial role in raising awareness about hematologic malignancies and promoting early detection and diagnosis. Through educational initiatives, patient advocacy programs, and community engagement efforts, the company strives to empower patients, caregivers, and healthcare professionals with the knowledge and resources needed to effectively manage blood cancers. By fostering a culture of collaboration and knowledge-sharing, AbbVie contributes to the overall**Global Hematologic Malignancies Market Analysis**

- **Type**: The global hematologic malignancies market, segmented by type, includes leukemia, lymphoma, and multiple myeloma. With advancements in precision medicine and targeted therapies, the market is witnessing a shift towards personalized treatment regimens tailored to the specific type of malignancy, driving growth in the segment.

- **Therapy Type**: The market segmented by therapy type comprises chemotherapy, immunotherapy, and targeted therapy, among others. The rising prevalence of hematologic malignancies and the increasing adoption of novel treatment approaches are driving the demand for innovative therapies, leading to significant market growth in this segment.

- **Diagnosis**: Diagnostic modalities such as blood tests, biopsies, imaging tests, and others play a crucial role in the early detection and management of hematologic malignancies. The emphasis on early diagnosis and personalized medicine is driving the market for diagnostic tools, contributing to the overall growth of the hematologic malignancies market.

- **Route of Administration**: Different routes of administration, including oral, parenteral, and others, offer varied options for delivering hematologic malignancy treatments. The convenience and efficacy of different administration routes influence patient compliance and treatment outcomes, shaping the market dynamics in this segment.

- **Dosage Form**: The market segmented by dosage form includes tablets, capsules, injections, and others. The availability of diverse dosage forms caters to patient preferences and treatment needs, promoting adherence and enhancing the overall therapeutic outcomes in

Key points covered in the report: -

The pivotal aspect considered in the global Hematologic Malignancies Market report consists of the major competitors functioning in the global market.

The report includes profiles of companies with prominent positions in the global market.

The sales, corporate strategies and technical capabilities of key manufacturers are also mentioned in the report.

The driving factors for the growth of the global Hematologic Malignancies Market are thoroughly explained along with in-depth descriptions of the industry end users.

The report also elucidates important application segments of the global market to readers/users.

This report performs a SWOT analysis of the market. In the final section, the report recalls the sentiments and perspectives of industry-prepared and trained experts.

The experts also evaluate the export/import policies that might propel the growth of the Global Hematologic Malignancies Market.

The Global Hematologic Malignancies Market report provides valuable information for policymakers, investors, stakeholders, service providers, producers, suppliers, and organizations operating in the industry and looking to purchase this research document.

TABLE OF CONTENTS

Part 01: Executive Summary

Part 02: Scope of the Report

Part 03: Research Methodology

Part 04: Market Landscape

Part 05: Pipeline Analysis

Part 06: Market Sizing

Part 07: Five Forces Analysis

Part 08: Market Segmentation

Part 09: Customer Landscape

Part 10: Regional Landscape

Part 11: Decision Framework

Part 12: Drivers and Challenges

Part 13: Market Trends

Part 14: Vendor Landscape

Part 15: Vendor Analysis

Part 16: Appendix

Countries Studied:

North America (Argentina, Brazil, Canada, Chile, Colombia, Mexico, Peru, United States, Rest of Americas)

Europe (Austria, Belgium, Denmark, Finland, France, Germany, Italy, Netherlands, Norway, Poland, Russia, Spain, Sweden, Switzerland, United Kingdom, Rest of Europe)

Middle-East and Africa (Egypt, Israel, Qatar, Saudi Arabia, South Africa, United Arab Emirates, Rest of MEA)

Asia-Pacific (Australia, Bangladesh, China, India, Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Thailand, Taiwan, Rest of Asia-Pacific)

Browse Trending Reports:

Thermal Imaging Cameras Market Baby Food Market Thin Film Encapsulation Market Paper Coating Materials Market Protein Engineering Market Psoriasis Treatment Market Whole Exome Sequencing Market Std Diagnostics Market Medication Delivery Systems Market Lane Keep Assist System Market Liquid Synthetic Rubber Market Mainframe Market Myxoid Round Cell Liposarcoma Drug Market Hematology Analyzer Market Low Differential Pressure Sensor Market Biofuel Enzyme Market Aroma Ingredients Market Coconut Water Market

About Data Bridge Market Research:

Data Bridge set forth itself as an unconventional and neoteric Market research and consulting firm with unparalleled level of resilience and integrated approaches. We are determined to unearth the best market opportunities and foster efficient information for your business to thrive in the market. Data Bridge endeavors to provide appropriate solutions to the complex business challenges and initiates an effortless decision-making process.

Contact Us:

Data Bridge Market Research

US: +1 614 591 3140

UK: +44 845 154 9652

APAC : +653 1251 975

Email: corporatesales@databridgemarketresearch.com"

[headneckroboticsurgery]

H&N Robotic Surgery Update. July 27, 2024

What´s new in PubMed this week Kim GJ, Shin HI, Bang J, Sun DI, Kim SY. Assessment of oncologic and cosmetic outcomes of robotic elective neck dissection in early-stage tongue cancer. Eur J Surg Oncol. 2024 Jul 14;50(10):108548. doi: 10.1016/j.ejso.2024.108548. Epub ahead of print. PMID: 39047329. Outcomes support retroauricular neck dissection based on cosmetic satisfaction. When neck…

[arrangoiz]

Oncoplastic Breast Incision in Large Breast with Ptosis

In general, patients with significant ptosis of the breast: Obtain better cosmetic results with a reduction mammoplasty compared to donut or Benelli mastopexy Lesions distant to the nipple areolar complex: Can be difficult to access through a mastopexy incision References Lebovic GS. Oncoplastic surgery: a creative approach to breast cancer management. Surg Oncol Clin N Am. 2010;19(3):…

[masterofd1saster]

CJ court watch Kenneth Eugene Smith execution

SCt declined on Thurs to stay the execution in Smith v. Hamm, 601 U. S. __ (2024). J. Sotomayor was incensed and dissented. J.J. Kagan and Jackson also dissented.

The issue was whether nitrogen hypoxia is a cruel and unusual method of execution. The state's response to his petition included

When Alabama scheduled Smith to be executed in 2022, he challenged the State’s lethal injection protocol. Nitrogen hypoxia would be preferable, Smith said, because he would “lose consciousness within seconds, and experience no pain or discomfort while dying within minutes.” DE39-1:¶86.1 On August 25, 2023, the State agreed to execute Smith by nitrogen hypoxia, not lethal injection, and moved to set a new execution date**** https://www.supremecourt.gov/DocketPDF/23/23-6562/298749/20240125133540947_Oppo%20to%20Stay%20and%20BIO%20FINAL.pdf

***

***The execution process began at 7:53 p.m. CT Thursday, and Smith was pronounced dead at 8:25 p.m., according to Alabama Department of Corrections officials. Nitrogen flowed for about 15 minutes during the procedure, state corrections commissioner John Hamm said in a news conference. Smith, who was on a gurney, appeared conscious for “several minutes into the execution,” and “shook and writhed” for about two minutes after that, media witnesses said in a joint report. That was followed by several minutes of deep breathing before his breath began slowing “until it was no longer perceptible for media witnesses,” the media witnesses said. When asked at the news conference about Smith shaking at the beginning of the execution, Hamm said Smith appeared to be holding his breath “for as long as he could” and may have also “struggled against his restraints.” “There was some involuntary movement and some agonal breathing, so that was all expected and is in the side effects that we’ve seen and researched on nitrogen hypoxia,” Hamm said. “So nothing was out of the ordinary of what we were expecting.” Agonal breathing is an irregular, gasping breath pattern that can happen when someone is near death.*** https://www.cnn.com/2024/01/26/us/alabama-execution-nitrogen-what-we-know/index.html

+++

Blanke, C. (2017). Characterizing 18 years of the Death with Dignity Act in Oregon. JAMA Oncol. 3(10) reported >950 cases of physician assisted suicide in Oregon. Blanke found

Patients rarely remained unconscious for long periods; median time to death was 25 minutes, but the range was 1 minute to more than 4 days. The medications were relatively devoid of unexpected toxic effects. Vomiting was unusual (24 patients, 2.4%). Six patients awakened, giving the medications an efficacy rate of 99.4%.

Smith's death was right in the ball park for what you'd expect for "death with dignity."

[lemoriamaipu]

DONDE COMIENZAN LOS ÁRBOLES

por EDUARDO RAGÓN

Yo era pequeño en ese tiempo, unos 8 o 9 años debo haber tenido cuando mi mamita nos llevaba donde el tata Manuel. Él era ya muy ancianito cuando yo lo conocí, los años era un hombre relativamente de pocas palabras, moreno, de gestos toscos, pero de mirada muy amable, sobre todo con nosotros, conmigo y mis primos chicos. Siempre andaba ocupado en algo, yo sentía que nunca lo veía descansar, sólo cuando atardecía y se sentaba junto a la cocina a tomar mate, de lo contrario siempre estaba afuera trabajando en algo, arreglando alguna reja del gallinero, atendiendo a los caballos o picando trocitos de leña con una hachita pequeña de la que jamás se separaba. El filo lo usaba para picar leña y cortar cuerdas y la culata del reverso para golpear y martillar, me acuerdo.

A mí me gustaba visitarlo a él y a mi lela Violeta, pero la verdad es que cuando no venían mis primos con la tía Mari no había muchas cosas que hacer para un niño pequeño allá en Calfuco, si hasta en verano la lluvia a veces nos tenía en casa por días. La mejor parte era jugar con las gallinas y explorar el campo y el bosque que parecían abrazarlo todo hasta donde mi joven vista llegaba. Recuerdo que me gustaba encaramarme al techo del potrero o trepar árboles hasta lo más alto que me permitieran mis cortas extremidades; allí me sentaba y me fascinaba un rato ante un horizonte más amplio sobre el cual pensar. Mi insaciable curiosidad me hacía preguntarme si alguna vez se acababan los árboles o si había algo después de todo el verde, ¿quizás en mayo cuando llega el otoño a pintar de ausencia todas las copas? ¿cómo saberlo?  Yo me preguntaba si el problema era que yo fuese muy pequeño o si era el bosque el que era demasiado grande, lo único que sabía era que necesitaba algo más grande que el potrero o el quillay del arroyo para averiguarlo.            

La respuesta llegó al verano siguiente, cuando mi madre y mi tía nos llevaron de paseo a Oncol. Nunca había visto un cerro tan grande, era una montaña esmeralda que parecía levantarse hasta el cielo rodeada de pequeños ríos y cascadas, bañada de pies a cabeza por el canto de miles de aves, vestida de vendavales y perfumada de suaves neblinas que a veces el sol reclamaba por turnos. Nos tomó cerca de una hora y media llegar a la cima. Éste era el potrero que necesitaba trepar para despejar mis dudas, y la respuesta era certera: el verdoso amor del bosque se derramaba como una caricia sobre la tierra en toda su extensión, de mar a cordillera, y Oncol era el pulmón central de este espectáculo de canelos, ulmos y olivillos que hacían vibrar la tierra. Lo único que interrumpía aquel manto infinito era el mar, los volcanes y la cordillera que separaba nuestra tierra de Argentina, todo claramente apreciable desde la cima. La gente encargada de cuidar el parque nos contaba que éste era el cerro más grande de la región y el bosque perenne más grande del sur. Verde todos los días del año, una cúpula imperecedera de flores y musgo y vida y sonidos eternos.

En la sobremesa de la cena esa noche le conté todo a mi abuelo, le hablé de aquel bosque inmortal desde donde puede verse todo lo que vive en estas tierras, de las flores, del viento, las cascadas, y de cómo mis dudas sobre el final de los árboles se habían disipado. Entusiasmado él me pregunto si sabía cómo había nacido semejante bosque vivo. Me dejó perplejo, estaba tan preocupado por saber dónde terminaban los árboles que jamás me pregunté dónde comenzaban, si es que comenzaban en algún lado. Me quedé pasmado mirando sus bigotes canosos.

- Bueno, ¿quiere saber o no, mijo? -me preguntó rompiendo el silencio. - ¿En serio sabes, tata? -respondí con cierto grado de incredulidad. - ¡Bah! No voy a saber yo, ñatito.  Es una historia que saben todos los viejos, mi abuelo me la contaba a mí y a mis hermanos.

       Entonces hizo el ruido que hacen los viejos cuando se levantan de una silla y partió a buscar su mate, o el vino, no recuerdo bien. En la cocina sólo sonaba el crepitar de los troncos en la estufa y el sonido que hacían los zapatos de mi tata al arrastrarse por las tablas.

- Ya, ahora sí pues, mijo -dijo incorporándose de nuevo a la mesa mientras se servía una taza de algo-, ¿en qué estábamos entonces? -mi madre y mi tía se rieron burlonamente- Qué se ríen ustedes, par de carambas nomás, cuando lleguen a mi edad se les van a olvidar las cosas también. - ¡La historia del bosque po’, tata     - ¡Ah, sí! El bosque siempre verde. Hace mucho tiempo, mijo, pero hace tiempazo oiga, había un lonko acá de la zona, muy respetado, valiente y fuerte el hombre. Él estaba a cargo de coordinar las familias más grandes del Butahuillimapu, que es toda esta zona. La gente lo quería mucho a él, harta estima le tenían, y muchas veces venían varones de todos lados que pretendían a alguna de sus tres hijas. Tres hijas tenía el lonko, todas lindas y valientes, decía la gente, trabajadoras también. Con el tiempo dos de ellas ya se habían casado, una con el hijo de un guerrero importante de la zona y otra estaba prometida al hijo de un lonko del sector. La única niña soltera, la menor y la más bonita, dicen, era pretendida por una gente importante del Butahuapi, que ahora le llaman la isla grande de Chiloé.              Un día llegó un carro con dos mozos lleno con carne seca, ovejas, tejidos y collares, tirado por una yunta de bueyes, grandotes los bichos, oiga. La carreta la escoltaba detrás un hombre alto de cabellos negros y largos, en un caballo negro y con un poncho plomo, igual que los ojos del dueño, a todos les daba mala espina, se notaba de lejos que era un calcu… un brujo, decían los más viejos. Venían de parte de un lonko de la isla que mandó esas ofrendas junto a sus hombres para pedir la mano de la joven. Por esos días había una tormenta que llevaba semanas azotando la tierra sin parar. El tralkam y el llüfke caían sin cesar sobre la tierra, como si el wenumapu estuviera castigando por algo. A comienzos de ese año hubo un puniküyen, la luna se había oscurecido por completo esa vez, y los viejos y la gente hizo rogativas e hizo kümpen para pedir clemencia, pero los viejos saben que no siempre alcanza, y la presencia de ese brujo en medio de la tormenta tenía a todos los viejos nerviosos.      Cuando la carreta finalmente llegó a la casa del lonko de acá, salieron a recibirlos en la lluvia y la primera pregunta del hombre fue preguntar por el dueño de la carreta, ya que consideraba una falta de respeto que un hombre con pinta de brujo y dos pelagatos llegaran a pedir la mano de su hija. Los hombres le contaron de inmediato que ese no era el caso, ellos sólo eran los encargados de traer los regalos para agradarles a él y su hija, y que el lonko de la isla llegaría en un par de días apenas menguara un poco el temporal. Sus palabras eran que en un peuma se le reveló que alguien le robaría el corazón de la joven así que envió a sus hombres cuanto antes y que luego llegaría él con más regalos a hablar con el padre en persona y aclarar todo formalmente. El problema fue que apenas apareció la joven mujer el brujo quedó enamorado a primera vista. Quizás cuánto había visto aquel hombre en su vida, pero definitivamente nada tan bello como la hija del lonko. Algunos dicen que fue amor a primera vista para ambos, otros dicen que el calcu la embrujó en los días que estuvo esperando al jefe.

Lo único cierto es que, cuando paró la lluvia al pasar una semana, un día antes de que llegara el lonko de la isla, el brujo y la joven se escaparon sin decirle a naiden. No había rastro de la joven, ni del hombre ni de su caballo. Pa’ qué le cuento la escoba que quedó pues, mijo, cuando llegó el lonco del butahuapi, él y el padre de la joven salieron detrás del brujo y prometieron tierras y animales a cualquiera que llegara de vuelta con la joven y la cabeza del forastero.    Pasaron así 2 días, cuando en las afueras de Lliuco uno de los grupos de hombres que andaban a la siga de la pareja pilló una fogata apagada y huellas de un caballo en dirección al bosque, hacia Oncol. Ligeritos de patas partieron a toda prisa hasta que los lograron ver en una quebrada. Los hombres del lonko cayeron en picada contra el caballo del brujo, lanzaron piedras, lanzas y flechas, uno de ellos incluso aseguró haber herido de muerte al brujo, cuando en eso cruzando un riachuelo cayó una niebla densa; densa, densa. Uno de los caballos del grupo tropezó con unas piedras y cayó rodando, haciendo tropezar al resto. Finalmente, los hombres decidieron parar porque era imposible avanzar en velocidad con esa niebla en un terreno que no conocían “obra de ese brujo de mierda debe ser”, dijeron a coro los hombres.

El brujo y la joven siguieron cabalgando hasta llegar a un claro en medio del bosque, ahí el hombre se dio cuenta de que era la joven que venía herida, una flecha o una lanza la hirió a un costado de la espalda y no la dejaba respirar bien. El brujo pasó la tarde haciendo ungüentos, mezclando cenizas, preparando jarabes, haciendo súplicas a los pillanes y a los ngen. La joven por su lado cada vez se veía más pálida y débil, parecía que su destino estaba decidido ya, pero el brujo no sabía rendirse. Cuando la medicina que conocía no funcionaba recurrió a todos los hechizos que conocía, pactó tratos con todos los espíritus que conocía; del nagmapu, nuestra tierra, y del miñchemapu, la tierra de abajo. Dicen que los pillanes de hace tiempo que querían el am del brujo, su alma, así que aceptaron varios tratos, dicen que el brujo cambió sus ojos por un par más de horas para seguir luchando, y que así mismito siguió luchando, cambiando todo cuanto tenía y lo que no tenía también lo empeñó. Con cada trato, con cada súplica, con cada hechizo su ruego se hacía más fuerte, pero la joven no mejoraba, ya ni siquiera palabras podía pronunciar. Cuando ya caía la noche la joven dio su último suspiro y partió, pero el brujo no podía resignarse. En la oscuridad seguía rezando palabras que no se deben pronunciar jamás y con cada maldición y con cada golpe de sus brazos cansados la tierra parecía temblar. Llegó la medianoche y püyen en lo más alto dejaba caer su luz sobre el brujo que a estas alturas parecía casi tan muerto como su amada. El hombre no podía ver nada, pero sentía la piedad y el abrazo de la madre del wenumapu sobre él, así que con sus últimas fuerzas cambió lo que le quedaba de vida a su cuerpo para traer de vuelta a la joven, y con ese último aliento se lo llevaron de este mundo, pero cuando el de arriba manda, mijo, no hay nada que uno pueda hacer para echar el tiempo atrás.

           - Y ¿qué pasó entonces, tata? ¿murieron los dos? -pregunté yo, quebrando el silencio que todos teníamos junto al fuego, al lado del abuelo.                         - Pues sí, pero el sacrificio y las súplicas del hombre por traer de vuelta a la joven fueron tantas que a la tierra no le quedó más remedio que florecer como nunca lo hizo. Flores y enredaderas brotaron junto a la joven para abrazarla, de las lágrimas del brujo brotaron cascadas y sobre su cadáver crecieron árboles gigantes, y no pararon más de crecer. Brotaron plantas y flores nuevas, árboles que el rimü, el otoño, no puede tocar y se creó un bosque gigante que permanece verde todos los días del año, todos los años de la vida. Y dicen, dicen que en el corazón del bosque, donde una vez hubo un claro, sobre una cama de flores hay una hermosa joven, cuyo cadáver el tiempo no se puede llevar, aunque yo jamás la he visto, ¿no la viste tú cuando estuviste allá? 

[punshi-punshi]

Foto panorámica desde la cumbre del cerro Oncol, reserva natural en Valdivia, chile.

Me causa gracia que está reserva sea propiedad de Forestal Arauco xd.

Camara: Phentax Espio 90mc.

Rollo: Carga de cine Kodak Visión 500.

Fecha: Verano 2022.

Autor: yoxd

[cancerhospital99]

Surgical Oncology

"Unveiling a realm of advanced care and innovation 🏥✨ Step into our cutting-edge surgical suite, where expertise meets compassion and technology transforms lives. 🚀🔬

[datajournalismntu]

臺灣口腔癌罹患率高於世界平均，檳榔成罪魁禍首?

徐敬萱 張玳瑋 劉亭君 謝博硯 / 報導

根據國際癌症研究機構的最新報告，全球口腔癌患者當中有88%的人有嚼食檳榔的習慣（Lancet Oncol. Published online 9 October 2024），而且主要分布在中亞與東南亞地區。嚴重之處在於，臺灣的口腔癌罹患率，遠高於世界平均。衛福部追究原因時，認為國人吃檳榔的習慣，可能是臺灣口腔癌罹患率居高不下的主因。

早在1990年代中期，就有口腔醫學專家呼籲，必須重視嚼食檳榔後導致口腔癌的問題。爾後更有其他醫學研究陸續證實，臺灣口腔癌與檳榔文化的高度相關性。然而檳榔問題長期以來不受政府正視，在政府不輔導、不鼓勵、不禁止的「三不政策」之下，口腔癌在臺灣男性癌症罹癌率與死亡率排名中高居不下。

根據世界衛生組織（WHO）在今（2024）年八月的報告指出，全球有嚼食檳榔習慣的地區主要分布在中亞（印度、孟加拉、巴基斯坦、斯里蘭卡）與東南亞（緬甸、印尼、泰國）。巧合的是，口腔癌同時也是這七個國家國內的15大癌症之一。進一步查詢資料後發現，台灣的口腔癌年齡標準化發生率（每十萬人口約22人罹患口腔癌），遠高於這七個國家。

回頭檢視臺灣，圖2顯示台灣不同縣市的口腔癌發生率。以目前公布的2021年數據來看，中南部及東部的口腔癌發生率，與北部及離島地區產生明顯區別。

同時，臺灣檳榔種植的產區有八成以上集中在屏東縣、南投縣、嘉義縣和花蓮縣。

根據2023年臺灣農業年報，台灣包括花蓮、南投、嘉義、屏東四個縣市種植檳榔面積，就占全國檳榔種植面積八成以上。

由於檳榔的種植成本低、經濟利潤豐厚，臺灣檳榔種植面積在70年代到80年代中期急速增加。民國60年全臺檳榔種植面積僅1607公頃，民國70年已上升至4100公頃，到了民國85年更成長到56581公頃，這15年之間成長了10倍之多。

從臺灣癌症登記歷年統計的資料顯示，台灣四大種植檳榔縣市—屏東縣、南投縣、嘉義縣及花蓮縣，這四個縣市的口腔癌發生率高於全台，且呈現日益攀升的趨勢。

檳榔之所以讓人不斷嚼食，是因為檳榔子（青仔）咀嚼時，名為「中樞神經興奮劑」的檳榔植物鹼會釋放到口腔中，帶來保暖與提神的效果。檳榔嚼食者因此越嚼越有勁，卻也越可能發生令人憂心的口腔癌。國際癌症研究總署(IARC)已證實檳榔子為第一級致癌物，當中的檳榔素更會讓嚼食者產生依賴性。除檳榔子以外，其餘原料如荖花、石灰，也都具有強化致癌的化學物質。

檳榔的愛好者多為基層勞工，舉例而言，民眾不難看見長途駕駛司機不停吃檳榔以便提神開完整趟車程。現年22歲的砂石車司機鍾良駒，在連續10小時的開車時間裏，會吃���60-80顆檳榔。數字背後，是不容小覷的金錢與健康成本——換句話說，基層勞工也因此成為口腔癌的高風險族群。

鍾良駒早上5點天未亮時，就得開著砂石車啟程，一路開到晚上6點才能休息，一開就是10小時。這一路上陪伴他的，便是台灣檳榔。鍾良駒工作前會先到到檳榔攤，掏出300元買檳榔後，便展開長途車程。他一次咬2顆檳榔，極強的咬勁與刺激性的口味，讓鍾良駒能夠時刻保持清醒。以一小時6至8顆的數量計算，一趟車程，會有80顆的檳榔下肚。

鍾良駒說，因為父親也有嚼食檳榔的習慣，先是跟著父親吃，後來受工作影響，現年22歲的鍾良駒，至今已累積10年的檳榔咬齡。「吃久了，也成為習慣了。」鍾良駒緩緩得說。

同樣是大車司機的郭先生，在多年的司機生涯中，曾把3成薪水（約3萬元），都花在購買檳榔中。開著17公噸的龐大車身，郭先生一路吃著檳榔提神，就這樣有了28年的咬齡。即便後來，郭先生因為牙齒掉落再也咬不動檳榔，因而戒除，不過嚼食檳榔已經有28年的他，身體早已對檳榔麻痹，身體也受到傷害。

事實上，花2到3成的薪水購買檳榔的狀況並不罕見。曾為工程工人的羅先生與鐵工的阿明，每月會把近2成（6000元）的拿來購買檳榔，而郭先生在檳榔的花費更是高達薪水的3成。桃園菁優檳榔老闆觀察，他的客群有7成是工人與大車司機，針對檳榔花費，老闆���示，「他們通常不太會抱怨。」

基層勞工依賴檳榔賺錢，顯示相當高的需求量，無形中也形成龐大的檳榔市場。令人好奇的是，一家一家開張的檳榔攤，賺頭何在？

作為在台灣長期年產值超過百億的重要農產品，檳榔有其特殊的公會制度與銷售產業鏈。檳榔攤老闆表示，依據淡旺季的不同，公會與大盤商會以當季的產量與需求決定市價與抽成。因此相對於其他農作物，檳榔農能獲得較高的利潤。另一方面，下游的檳榔攤常以固定價格作為販售單位，透過調配一包檳榔的顆數、品質與添加物比例，以確保能賺取一定的利潤。

以檳榔攤固定販售一包50元的檳榔為例，檳榔攤老闆多半將25元的利潤作為標準，再決定要購買的檳榔產地、品質、大小，還有最終販賣給顧客的顆數。若是當季檳榔價格較高，就可能搭配便宜但品質較差的檳榔，或是減少一包檳榔的數量。由於檳榔有固定的食用族群，預估約60至100萬人，檳榔農與檳榔攤皆能獲得豐厚的利潤，讓檳榔產業在台灣得以長期生存，難以消失。

農業部2023年的統計資料顯示，檳榔仍是僅次於稻米，在台灣栽種面積第二大的作物。將檳榔與其主要生產縣市中其他競用土地的作物比較，可以發現栽種檳榔的人工成本與總生產成本幾乎為芒果與香蕉的一半，檳榔的總種植面積卻約是芒果與香蕉的2.5倍。

檳榔可以粗放管理，不需要太多人力維護就能有穩定收入，讓檳榔農能較不受年紀影響，背負轉職或轉作的壓力，低成本且種植廣泛使檳榔成為台灣中南部的高利潤產業。

為了降低檳榔生產量，以改善國人口腔癌發生率，政府於民國97年提出檳榔廢園轉作政策，至今（民113年）17年間歷經了三階段的廢園轉作計畫，第四階段（民國112~115年）正在執行中。

根據農委會成果報告與立法院農業特別收入基金預算報告，第一階段（民國97年）預期廢園轉作面積為3928公頃，實際執行面積為1605（執行率41%），共核發約1億9882萬補助款；第二階段（民國103~106年）預期廢園轉作面積為4800公頃，實際執行面積為720公頃（執行率15%），共核發約1億1622萬元補助款；第三階段（民國108~110年）預期廢園轉作面積為700公頃，實際執行面積為658公頃（執行率94%），共核發約1億3160萬元補助款。

儘管這17年來全台灣檳榔種植面積確實在下降（從民國96年的50457公頃，降到112年的37293公頃），��而檳榔廢園轉作政策整體成效僅31%，投入的補助款總和卻已超過4億4000萬元。