THE ROLE OF CHITOTRIOSIDASE ACTIVITY AS A PROGNOSTIC BIOMARKER IN SARCOIDOSIS

Introduction: Chitotriosidase (ChT) is a chitinase that is massively expressed by lipid-laden tissue macrophages in human beings. The aim of this study was to compare ChT activities in the serum and bronchoalveolar lavage (BAL) fluid and serum ChT levels with serum angiotensin converting enzyme (ACE) levels in patients with newly diagnosed pulmonary sarcoidosis (SARC), pulmonary tuberculosis (TB) and interstitial lung disease (ILD), all of which create difficulties in the differential diagnosis in daily practice

Blowout mechanism of Alasehir (Turkey) geothermal field and its effects on groundwater chemistry

Anatolia region is one of the most seismically active regions in the world and has a considerably high level of geothermal energy potential. Some of these geothermal resources have been used for power generation and direct heating. Most of the high enthalpy geothermal systems are located in western part of Turkey. Alasehir is the most important geothermal site in western part of Turkey. Many geothermal wells have been drilled in Alasehir Plain to produce the geothermal fluid from the deep reservoir in the last 10 years. A blowout accident happened during a geothermal well drilling operation in Alasehir Plain, and significant amount of geothermal fluid surfaced out along the fault zone in three locations. When drilling string entered the reservoir rock about 1000 m, blowout occurred. As the well head preventer system was closed because of the blowout, high-pressure fluid surfaced out along the fault zone cutting the Neogene formation. In order to understand the geothermal fluid effects on groundwater chemistry, physical and chemical compositions of local cold groundwater were monitored from May 2012 to September 2014 in the study area. The geothermal fluid was found to be of Na–HCO3 water type, and especially, arsenic and boron concentrations reached levels as high as 3 and 127 mg/L, respectively. The concentrations of arsenic and boron in the geothermal fluid and groundwater exceeded the maximum allowable limits given in the national and international standards for drinking water quality. According to temporally monitored results, geothermal fluid has extremely high mineral content which influenced the quality of groundwater resources of the area where water resource is commonly used for agricultural irrigation.Dokuz Eylul University (2014.KB.FEN.012); State Hydraulic Work

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

The management of complicated colorectal cancer in older patients in a global perspective after COVID-19: the CO-OLDER WSES project

BACKGROUND: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CRC. Early diagnosis of CRC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC. This group of patients is often required to be managed when they are symptomatic in the emergency setting with high morbidity and mortality rates. Our main aim is to provide clinical data about the management of elderly patients presenting complicated colorectal cancer who required emergency surgical management to improve their care. METHODS: The management of complicated COlorectal cancer in OLDER patients (CO-OLDER; ClinicalTrials.gov ID: NCT05788224; evaluated by the local ethical committee CPP EST III-France with the national number 2023-A01094-41) in the emergency setting project provides carrying out an observational multicenter international cohort study aimed to collect data about patients aged ≥75 years to assess modifiable risk factors for negative outcomes and mortality correlated to the emergency surgical management of this group of patients at risk admitted with a complicated (obstructed and perforated) CRC. The CO-OLDER protocol was approved by Institutional Review Board and released. Each CO-OLDER collaborator is asked to enroll ≥25 patients over a study period from 1st January 2018 to 30th October 2023. Data will be analyzed comparing two periods of study: before and after the COVID-19 pandemic. A sample size of 240 prospectively enrolled patients with obstructed colorectal cancer in a 5-month period was calculated. The secured database for entering anonymized data will be available for the period necessary to achieve the highest possible participation. RESULTS: One hundred eighty hospitals asked to be a CO-OLDER collaborator, with 36 potentially involved countries over the world. CONCLUSIONS: The CO-OLDER project aims to improve the management of elderly people presenting with a complicated colorectal cancer in the emergency setting. Our observational global study can provide valuable data on the effectiveness of different management strategies in improving primary assessment, management and outcomes for elderly patients with obstructed or perforated colorectal cancer in the emergency setting, guiding clinical decision-making. This information can help healthcare providers make informed decisions about the best course of action for these patients