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

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

Effect of supplementation of diets for quails with vitamins A, D and E on performance of the birds and quality and enrichment of eggs Efeito da suplementação de dieta de codornas com vitaminas A, D e E sobre o desempenho das aves e a qualidade e o enriquecimento dos ovos

The objective of this research was to evaluate the performance of birds and the quality and enrichment of eggs from quails fed diets supplemented with vitamins A, D and E. Three experiments were performed, one for each vitamin, under completely randomized experimental design, with six replicates and eight birds per plot, totaling 192 quails. Performance of birds was evaluated by the daily feed intake, egg weight, laying percentage (%) and food conversion, per kg and dozen of eggs. It was also evaluated the internal quality (Haugh unit, yolk index and yolk and albumen percentages) and external quality (eggshell percentage, egg specific gravity, eggshell thickness and weight) and the concentration of vitamins in egg yolk by using the high performance liquid chromatography method. Vitamins supplementation did not improve productive performance neither the internal and external quality of the eggs, except for vitamin D supplementation, which increased intake. Incorporation of vitamin A in yolk increased 536.27% at level 30,000 UI/kg, vitamin D increased 13.43% at 1,500 UI/kg and vitamin E increased 479.05% at 600 UI/kg, and these results evidence that the nutritional value of eggs, related to vitamins, can be increased through supplementation of diets for quails.<br>Objetivou-se nesta pesquisa avaliar o desempenho das aves e a qualidade e o enriquecimento de ovos de codornas sob suplementação com vitaminas A, D e E. Foram realizados três experimentos, um para cada vitamina, em delineamentos inteiramente casualizados, com seis repetições e oito aves por parcela, totalizando 192 codornas. O desempenho das aves foi avaliado pelo consumo diário de ração, peso dos ovos, porcentagem de postura e conversão alimentar, por kg e dúzia de ovos. Também foram avaliadas a qualidade interna (unidade Haugh, índice gema e porcentagens de gema e albúmen) e externa (porcentagem de casca, peso específico, espessura e peso da casca) e a concentração das vitaminas na gema dos ovos, mediante o método de cromatografia líquida de alta eficiência. A suplementação das vitaminas não melhorou o desempenho produtivo nem a qualidade interna e externa dos ovos, com exceção da suplementação de vitamina D, que elevou o consumo. A incorporação de vitamina A na gema aumentou 536,27% no nível de 30.000 UI/kg, a de vitamina D 13,43% no nível de 1.500 UI/kg e a de vitamina E 479,05% no nível de 600 UI/kg, e isso evidencia que o valor nutricional dos ovos, relacionado à vitamina, pode ser aumentado com a suplementação na dieta das codornas

Efeito da suplementação de dieta de codornas com vitaminas A, D e E sobre o desempenho das aves e a qualidade e o enriquecimento dos ovos

Objetivou-se nesta pesquisa avaliar o desempenho das aves e a qualidade e o enriquecimento de ovos de codornas sob suplementação com vitaminas A, D e E. Foram realizados três experimentos, um para cada vitamina, em delineamentos inteiramente casualizados, com seis repetições e oito aves por parcela, totalizando 192 codornas. O desempenho das aves foi avaliado pelo consumo diário de ração, peso dos ovos, porcentagem de postura e conversão alimentar, por kg e dúzia de ovos. Também foram avaliadas a qualidade interna (unidade Haugh, índice gema e porcentagens de gema e albúmen) e externa (porcentagem de casca, peso específico, espessura e peso da casca) e a concentração das vitaminas na gema dos ovos, mediante o método de cromatografia líquida de alta eficiência. A suplementação das vitaminas não melhorou o desempenho produtivo nem a qualidade interna e externa dos ovos, com exceção da suplementação de vitamina D, que elevou o consumo. A incorporação de vitamina A na gema aumentou 536,27% no nível de 30.000 UI/kg, a de vitamina D 13,43% no nível de 1.500 UI/kg e a de vitamina E 479,05% no nível de 600 UI/kg, e isso evidencia que o valor nutricional dos ovos, relacionado à vitamina, pode ser aumentado com a suplementação na dieta das codornas.The objective of this research was to evaluate the performance of birds and the quality and enrichment of eggs from quails fed diets supplemented with vitamins A, D and E. Three experiments were performed, one for each vitamin, under completely randomized experimental design, with six replicates and eight birds per plot, totaling 192 quails. Performance of birds was evaluated by the daily feed intake, egg weight, laying percentage (%) and food conversion, per kg and dozen of eggs. It was also evaluated the internal quality (Haugh unit, yolk index and yolk and albumen percentages) and external quality (eggshell percentage, egg specific gravity, eggshell thickness and weight) and the concentration of vitamins in egg yolk by using the high performance liquid chromatography method. Vitamins supplementation did not improve productive performance neither the internal and external quality of the eggs, except for vitamin D supplementation, which increased intake. Incorporation of vitamin A in yolk increased 536.27% at level 30,000 UI/kg, vitamin D increased 13.43% at 1,500 UI/kg and vitamin E increased 479.05% at 600 UI/kg, and these results evidence that the nutritional value of eggs, related to vitamins, can be increased through supplementation of diets for quails

Egg quality during storage and deposition of minerals in eggs from quails fed diets supplemented with organic selenium, zinc and manganese

Three experiments with Japanese laying quails were performed aiming to assess the effect of supplementation with minerals in organic form on the egg quality during storage and the deposition of minerals in eggs. The assessments of each experiment were related to one mineral, thus, experiment 1 assessed the supplementation with selenium in 0.35-, 0.70- and 1.05-mg/kg levels of feed; experiment 2, the supplementation with zinc in 50-, 100- and 150-mg/kg levels of feed; and experiment 3, the supplementation of manganese with 60-; 120- and 180-mg/kg levels of feed. All diets were evaluated compared with a control diet without mineral supplementation. Birds were distributed in a completely randomized experimental design, with eight birds per plot and six replicates per treatment. Fifty-five days after the beginning of diets, the yolks of three eggs from each plot were collected for selenium, zinc and manganese quantification, whereas the albumens of three eggs from each parcel were collected for analysis of selenium concentration. Eggs were collected at the last days of the experimental period from each experiment, to be stored at room temperature (28±2 °C) and refrigeration (4 °C) during different periods (0, 10, 20 and 30 days), except for experiment 3, in which eggs were stored at 0, 10 and 20 days. Percentages of albumen and yolk, yolk index, Haugh unit and moisture loss of eggs were evaluated. The supplementation with selenium is able to maintain the egg yolk index unchanged over the storage periods; however, supplementation with zinc and manganese is not effective to keep the quality of stored eggs. Supplementation with selenium and manganese is effective to increase the concentration of these minerals at 328.66% in the albumen and at 74.47% in the yolk, respectively. The different levels of zinc do not change the egg composition

Effect of centre volume on pathological outcomes and postoperative complications after surgery for colorectal cancer: results of a multicentre national study

Background: The association between volume, complications and pathological outcomes is still under debate regarding colorectal cancer surgery. The aim of the study was to assess the association between centre volume and severe complications, mortality, less-than-radical oncologic surgery, and indications for neoadjuvant therapy.Methods: Retrospective analysis of 16,883 colorectal cancer cases from 80 centres (2018-2021). Outcomes: 30-day mortality; Clavien-Dindo grade >2 complications; removal of >= 12 lymph nodes; non-radical resection; neoadjuvant therapy. Quartiles of hospital volumes were classified as LOW, MEDIUM, HIGH, and VERY HIGH. Independent predictors, both overall and for rectal cancer, were evaluated using logistic regression including age, gender, AJCC stage and cancer site.Results: LOW-volume centres reported a higher rate of severe postoperative complications (OR 1.50, 95% c.i. 1.15-1.096, P = 0.003). The rate of >= 12 lymph nodes removed in LOW-volume (OR 0.68, 95% c.i. 0.56-0.85, P = 12 lymph nodes removed was lower in LOW-volume than in VERY HIGH-volume centres (OR 0.57, 95% c.i. 0.41-0.80, P = 0.001). A lower rate of neoadjuvant chemoradiation was associated with HIGH (OR 0.66, 95% c.i. 0.56-0.77, P < 0.001), MEDIUM (OR 0.75, 95% c.i. 0.60-0.92, P = 0.006), and LOW (OR 0.70, 95% c.i. 0.52-0.94, P = 0.019) volume centres (vs. VERY HIGH).Conclusion: Colorectal cancer surgery in low-volume centres is at higher risk of suboptimal management, poor postoperative outcomes, and less-than-adequate oncologic resections. Centralisation of rectal cancer cases should be taken into consideration to optimise the outcomes

Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

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