33 research outputs found

    Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

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    IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

    A palaeoenvironmental reconstruction of the Middle Jurassic of Sardinia (Italy) based on integrated palaeobotanical, palynological and lithofacies data assessment

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    During the Jurassic, Sardinia was close to continental Europe. Emerged lands started from a single island forming in time a progressively sinking archipelago. This complex palaeogeographic situation gave origin to a diverse landscape with a variety of habitats. Collection- and literature-based palaeobotanical, palynological and lithofacies studies were carried out on the Genna Selole Formation for palaeoenvironmental interpretations. They evidence a generally warm and humid climate, affected occasionally by drier periods. Several distinct ecosystems can be discerned in this climate, including alluvial fans with braided streams (Laconi-Gadoni lithofacies), paralic swamps and coasts (Nurri-Escalaplano lithofacies), and lagoons and shallow marine environments (Ussassai-Perdasdefogu lithofacies). The non-marine environments were covered by extensive lowland and a reduced coastal and tidally influenced environment. Both the river and the upland/hinterland environments are of limited impact for the reconstruction. The difference between the composition of the palynological and palaeobotanical associations evidence the discrepancies obtained using only one of those proxies. The macroremains reflect the local palaeoenvironments better, although subjected to a transport bias (e.g. missing upland elements and delicate organs), whereas the palynomorphs permit to reconstruct the regional palaeoclimate. Considering that the flora of Sardinia is the southernmost of all Middle Jurassic European floras, this multidisciplinary study increases our understanding of the terrestrial environments during that period of time

    Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

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    This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

    5PC - The fossil plant record of Sardinia. Field Guidebook of the 9th EPPC, Sardinia 1-4 Sept. 2014

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    The excursion will touch some of the sections where to collect plant fossil remains of Carboniferous, Permian and Jurassic deposits. To gather a fossil plant collection from the Miocene lacustrine sections is today very difficult because the artificial lake for water supply, such as the Omodeo Lake, has submerged the “Fossil Forest of Zuri” with its silicified trunks 12-15 m high and more than a meter in diameter and, furthermore, the stratigraphy of fill Miocene lacustrine basins is at present, for the most, hidden by the development of intensively cultivated fields. New findings of fossil plants are actually retrieved when canals for water distribution have been excavated in the interested areas. The “Foresta Fossile” of the Perfugas-Martin basin, and the “Foresta Fossile of Zuri” that are protected by a severe regional and national laws are, ironically, self-endangered

    The Miocene "Palmoxylon cavallottii (Lovisato & Sterzel, 1900)" and allied species

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    Cenozoic rocks of Sardinia contain several plant remains. Fossil woods are easily found and numerous outcrops have been reported since the second half of the last century, especially in central and northern Sardinia. Despite this, reports are not always associated with detailed taxonomic and palaeo floristic studies. Coincidently, due to a relocation and a new organization of an exhibition of fossils, a sliced portion of the holotype of the Miocene stem Palmoxylon cavallottii was recovered. This is a part of the same plant specimen studied by Sterzel (1900), which is stored at the Natural Museum of Chemnitz (Germany). According to the Saint Louis Code "if the type specimen of a name of a fossil plant is cut into pieces, all parts originally used in establishing the diagnosis ought to be clearly marked". As a direct consequence of this, the revision of the aforementioned recovered specimen allowed to improve (or emend) the original diagnosis. In our preliminary results, we detected the characteristic arrangement of the fibrovascular bundles according to the "Cocos type" typology: the bundles of the central area become reniform (kidney -like) in shape. We have counted fibrovascular bundles finding an increasing quantity of bundles in the central part of the stem. Close to the cork, vascular bundles appear fewer (lower density) and their shape can be somewhat irregular. Vascular bundles are larger in the middle part and become smaller near the edge. The goal of this study is to understand if the Sardinian part of the holotype can confirm that P. cavallottii is a valid species to be included in the updated Palmoxylon list and, if not, whether it could be put into a synonymy. We also compared this specimen with other allied Sardinian species dating back to the Miocene to understand similarities on the basis of their paleogeography

    Circinate vemation in Jurassic foliage: new data from Sardinia

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    Palaeobotany deals with the recovery and identification of plant remains from geological contexts. Plant fossils are usually represented by disarticulated parts of plants and because of that parataxonomy has been introduced for identifying these fossils. The organ-genus Spiropteris Schimper, 1869 is used to identifY coiled and immature leaves. This is the only genus erected for this kind of developmental stage and, according to some authors, it includes only ferns and seed ferns. This interpretation is challenged by the general diagnosis given by Schimper in its "Traite de Paleontologie Generale, Tome Premiere". Indeed, circinate vernation arrangement of immature leaves is known in the fossil record since the appearance of land plants and comprises gymnosperms. Due to a relocation and a new organization of the expositions, a lost portion of the Jurassic Lovisato plant collection of the University of Cagliari is now available and shows bennettitalean fragments arranged in coils. These remains are preserved in sandy lithology and for this reason the microstructures of cuticles are not preserved. The Bennettitales (Engler, 1892), a Mesozoic (Triassic to Cretaceous) group of gymnosperms, is extinct today. They have entire or simple pinnate leaves, morphologically similar to those of cycads (like the extant Cycas revoluta Thunb, 1782) and only distinguishable by epidermal features (syndetocheilic stomata). Recent studies show two different evolutionary lines for these two groups of plants. Even if they are distinct, they share ontogenetic similarities. Leaves of Pterophyllum Brongniart, 1825 with circinate vernation for the first time were discovered in the Carnian of Austria (Pott & Krings, 2007). The remains now assigned to Spiropteris in the Lovisato Collection might belong to the genus Ptilophyllum Morris in Grant, 1840, in view of their good preservation in this kind of Sardinian rock, which is generally not suitable for the preservation of fern remains
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