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

Oxidative steam reforming of ethanol over a Pt/Al2O3 catalyst in a Pd-based membrane reactor

In this study, the ability of a Pd-Ag membrane reactor of producing ultrapure hydrogen via oxidative steam reforming of ethanol has been evaluated. A self supported Pd-Ag tube of wall thickness 60 mu m has been filled with a commercial Pt-based catalyst and assembled into a membrane module in a finger-like configuration. In order to evaluate the hydrogen yield behavior under different operating conditions, experimental tests have been performed at temperatures of 400 and 450 degrees C and pressures of 150 and 200 kPa. The oxidative steam reforming of ethanol has been carried out by feeding the membrane reactor with a gas stream containing a dilute water-ethanol mixture and air. Different water/ethanol feed flow rates (5, 10,15 g h(-1)), several water/ethanol (4, 10, 13) and oxygen/ethanol (0.3, 0.5, 0.7) feed molar ratios have been tested. The results pointed out that the highest hydrogen yield (moles of permeated hydrogen per mole of ethanol fed) corresponding to almost 4.1 has been attained at 450 degrees C and 200 kPa of lumen pressure by using a water/ethanol/oxygen feed molar ratio of 10/1/0.5. The results of these tests have been compared with those reported for the ethanol steam reforming in a Pd-Ag membrane reactor filled with the same Pt-based catalyst. This comparison has shown a positive effect on the hydrogen yield of small oxygen addition in the feed stream. (C) 2010 Professor T. Nejat Veziroglu. Published by Elsevier Ltd. All rights reserved