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Importance Evidence emerged concerning how inflammatory arthritis and mood disorders can often occur in the same patient and show a similar clinical pattern. An overview of the rheumatological and psychiatric aspects of these diseases can certainly be useful for the improvement of patients' clinical and therapeutic management. Objective The aim of this narrative review was to summarize existing literature about common pathogenetic and clinical aspects as a means of improving management and therapeutic approach in patients affected by rheumatoid arthritis, psoriatic arthritis and spondyloarthritis. Outcomes such as disease activity indexes and patient reported outcomes (PROs) were considered. Findings Common pathogenetic pathways emerged between inflammatory arthritis and mood disorders. Pro-inflammatory mechanisms, such as TNFα, IL-6, IL-17 and oxidative stress factors as well as neurotransmitter alterations at the level of CNS and blood–brain barrier (BBB) cells are involved. The activation of these common pathogenetic pathways is, also, affected by the same triggers, such as smoking, stress, lifestyle, and evidence has emerged concerning the possibility of the clinical efficacy of using the same therapeutic approaches. Conclusions The main causes of the variability in clinical studies outcomes are the rheumatological diseases considered, the prevalence of depression in the general population and in patients with rheumatological diseases and the type of depressive symptom examined. Patients affected by inflammatory arthritis can present symptoms and signs in common with mood disorders, leading to possible clinical overlap. There are still few studies analyzing this concept: they are extremely heterogeneous, both in the characteristics of the population taken into consideration and in the methods used for the definition of depressive disorder, but the suggestions of the data obtained so far are promising and deserve to be pursued.

Background. The prognosis of gastric cancer patients still remains poor. The aim of this study was investigating the prognostic value of several clinical/pathological/molecular features in a consecutive series of gastric cancers. Methods. 150 R0 gastrectomies plus 77 gastric cancer patients evaluated for the HER2 overexpression were selected. Survival was calculated and patients stratified according to the stage, the T-stage, the LNRs, the LNH, and the HER2 scoring system. ROC curves were calculated in order to compare the performance of the LRN and LNH systems. Results. Prognosis correlated with the stage and with the T-stage. We documented a statistical correlation between the LNRs and the survival. Conversely, a LNH > 15 did not correlate with the outcomes. The ROC curves documented a significant performance of the LRN system, whereas a statistical correlation was documented for the LNH exclusively with the endpoint of disease-free survival. We documented a trend of worse prognosis for patients with an HER2 overexpression, even though it was not of statistical value. Conclusion. The LNR and the evaluation of the HER2 overexpression might be useful since they correlate with survival, might identify patients with a higher risk of recurrence, and might select patients for a tailored medical treatment.

Background Laparoscopic resections for rectal cancer are routinely performed in high-volume centres. Despite short-term advantages have been demonstrated, the oncological outcomes are still debated. The aim of this study was to compare the oncological adequateness of the surgical specimen and the long-term outcomes between open (ORR) and laparoscopic (LRR) rectal resections. Methods Patients undergoing laparoscopic or open rectal resections from January 1, 2013, to December 31, 2019, were enrolled. A 1:2 propensity score matching was performed according to age, sex, BMI, ASA score, comorbidities, distance from the anal verge, and clinical T and N stage. Results Ninety-eight ORR were matched to 50 LRR. No differences were observed in terms of operative time (224.9 min. vs. 230.7; p = 0.567) and postoperative morbidity (18.6% vs. 20.8%; p = 0.744). LRR group had a significantly earlier soft oral intake (p < 0.001), first bowel movement (p < 0.001), and shorter hospital stay (p < 0.001). Oncological adequateness was achieved in 85 (86.7%) open and 44 (88.0%) laparoscopic resections (p = 0.772). Clearance of the distal (99.0% vs. 100%; p = 0.474) and radial margins (91.8 vs. 90.0%, p = 0.709), and mesorectal integrity (94.9% vs. 98.0%, p = 0.365) were comparable between groups. No differences in local recurrence (6.1% vs.4.0%, p = 0.589), 3-year overall survival (82.9% vs. 91.4%, p = 0.276), and disease-free survival (73.1% vs. 74.3%, p = 0.817) were observed. Conclusions LRR is associated with good postoperative results, safe oncological adequateness of the surgical specimen, and comparable survivals to open surgery.

R ecently, a 55-year-old afebrile female presented to the emergency department of our hospital with serous discharge from a small skin opening in the right hypochondrium. Her medical history included a by removal of a hydatid cyst from the right hepatic lobe laparotomy 16 y previously; since then, occasional discharge was noted. This time, a contrastenhanced thoraco-abdominal computed tomography scan showed a 10 · 6-cm hypodense lesion of the right hepatic lobe compatible with abscess ( Fig. 1A). Fistulography was carried out by injecting some non-ionic radiopaque contrast medium into the cutaneous opening, permitting the discovery of a communication among the skin, liver, and subsegmental bronchi of the right lower lobe (Fig. 1B). Analysis of the discharge was non-contributory, but serology was weakly positive for echinococcal antigens; a diagnosis of broncho-hepato-cutaneous fistula arising from a liver abscess of hydatid origin was made. Pondering the patient's otherwise good health and the potentially major complications deriving from an extensive resection (liver, lung, and skin), we opted for non-operative management, and the patient was dismissed with a 3-mo antihelmintic treatment course.Cystic echinococcosis of the liver is a form of parasitic disease that is endemic world-wide [1]. Generally asymptomatic, on occasion, it can manifest with complications. Rupture and fistulization into the biliary tract, bronchi, or skin are the complications described most frequently [1,2]. The development of a fistula arising from a liver abscess of hydatid origin communicating with the bronchi as well as the skin is a rare phenomenon, as only one previous case has been reported. In that instance, a 70-year-old febrile female was treated with thoracotomy and excision of the entire fistulous complex together with pericystectomy of the liver lesion [3]. In our case, considering both the absence of complaints apart FIG. 1. Images of abscess. (A) Contrast-enhanced computed tomography scan of abdomen showing large intraparenchymal abscess of right hepatic lobe (within purple ring). (B) Fistulogram depicts broncho-hepato-cutaneous communication (bronchial filling can be observed inside purple ring).