13 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

    Conversando di bioetica. Questioni sull'inizio e la fine della vita

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    Le nuove possibilit\ue0 offerte dal progresso delle scienze biologiche e biomediche non solo possono mettere a rischio la garanzia dei diritti fondamentali degli individui, ma contribuiscono anche a rimodellare e a ridefinire il significato di quei diritti che sembravano essere, solo qualche anno fa, acquisiti e consolidati. Proprio per questo, da pi\uf9 parti, si afferma la necessit\ue0 di formulare veri e propri "nuovi diritti" che siano in grado di offrire delle tutele reali ai cittadini. Per poter comprendere quali siano i problemi reali e quali le possibili risposte \ue8 necessario innanzitutto che si crei un dialogo tra le differenti discipline e che i vari punti di vista scientifico, etico, filosofico, giuridico, medico e della comunicazione trovino luoghi in cui si possano confrontare liberamente e senza pregiudizi

    Skin ultrasound in dermatologic surgical planning

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    High-resolution ultrasonography was performed on 55 patients with palpable skin lesions, all submitted to surgical excision and to histologic diagnosis. In all the cases, the ultrasound picture was confirmed by the surgical appearance of the lesions. The sonographic structure was characteristic in the case of cysts and angiomas, lymphangiomas in particular. Ultrasonography is considered a simple and reliable technique for the pre-operative evaluation of skin nodules, as it gives a clear picture of their size, depth, and outline. However, sonography cannot substitute for the clinical dermatologic approach and the need for an histologic diagnosis
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