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Early disease progression in the chemotherapy to LR interval occurred in approximately 15% of patients and was associated with extremely poor survival. Even if these data require validation, the risk for early disease progression after chemotherapy should be considered, and, if progression is evident, the indication for surgery should be cautiously evaluated.

IntroductionSchizophrenia can impair functioning and have serious individual and societal impact. Non-adherence rate to anti-psychotics is high due to side effects, raising the importance of adjuvant therapy. Artistic creation can help the patients expressing their illness experience and finding some order in their chaotic psychotic world.AimTo determine the differential effects of group art therapy on clinical symptoms and cognitive functions.MethodsPatients7 female patients symptomatically stable, non-substance abusing with chronic schizophrenia admitted into Mamoura Mental State Hospital in Alexandria, IQ level was determined by the Digit Span Test of Wechsler Adult Intelligence scale (WAIS) with the mean of IQ found = 89.InterventionTechniques taken from both art therapy and art expression provided as 24 group therapy sessions (2 sessions per week).Outcome measuresSymptoms severity measured by the Positive and Negative Symptom Scale (PANSS)Executive functions and set shifting measured by Wisconsin card sorting test (WCST)Visual attention and task switching measured by the Trail making testResultsPost treatment results showed significant decrease in PANSS sub-scales (positive p < 0.0001, negative p < 0.001, general p < 0.001, total p < 0.0001)Also significant increase in cognitive biases in WCST (number of categories) p < 0.05 and significant decrease in WCST (failure to maintain set) p < 0.01 and trail making B test (time spent p < 0.003 and number of errors p < 0.001)ConclusionSymptom severity and cognitive functions in stable schizophrenia can improve when art expression and therapy are provided.

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(1) Background: Anaemia is a common finding in patients with colon cancer and is commonly corrected by blood transfusion prior to surgery. However, the prognostic role of perioperative transfusions is still debated. The aim of the present study was to investigate the role of preoperative anaemia and preoperative blood transfusion in influencing the prognosis in colon cancer. (2) Patients and Methods: Patients undergoing elective surgery for colon cancer at a tertiary referral university hospital between January 2010 and December 2018 were included in a retrospective review of a prospectively collected database. Univariate and regression analyses were performed to identify the prognostic role of preoperative anaemia and preoperative transfusions in this homogeneous cohort of patients. (3) Results: A total of 780 patients were included in the final analysis. The estimated five-year overall survival rate was significantly worse in the anaemic group (83.8% in non-anaemic patients, 60.6% in mild anaemic patients, 61.3% in moderate anaemic patients and 58.4% in severe anaemic patients; log-rank < 0.001 vs. non-anaemic patients). Anaemic status was found to be an independent adverse prognostic factor (hazard ratio (HR): 1.46; 95% confidence interval (CI): 1.02–2.07) during multivariate analysis. Among moderate to severe anaemic patients, no significant association was found between preoperative transfusions and the risk of mortality or recurrence. (4) Conclusions: Preoperative anaemia, regardless of its severity, and not preoperative blood transfusion, was independently associated with a worse prognosis after surgery in patients with colonic cancer.

Background: Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepatic metastases to systemic therapy. Methods: All consecutive patients undergoing simultaneous resection of hepatic and extrahepatic metastases from colorectal cancer after oxaliplatin- and/or irinotecan-based preoperative chemotherapy were analyzed. All specimens were reviewed. Pathological response to chemotherapy was classified according to tumor regression grade (TRG). Results: We analyzed 45 patients undergoing resection of 134 hepatic and 72 extrahepatic metastases. Lung and lymph node metastases had lower response rates to chemotherapy than liver metastases (TRG 4–5 95% and 100% vs. 67%, p = 0.008, and p = 0.006). Peritoneal metastases had a higher pathological response rate than liver metastases (TRG 1–3 66% vs. 33%, p < 0.001) and non-hepatic non-peritoneal metastases (3%, p < 0.001). Metastases site was an independent predictor of pathological response to systemic therapy. Conclusions: Response to chemotherapy of distant metastases from colorectal cancer varies in different organs. Systemic treatment is highly effective for peritoneal metastases, more so than liver metastases, while it has a very poor impact on lung and lymph node metastases.

gradient. LSN measurement was feasible in 144 patients (72.4%) with a mean time of 88 (AE29) seconds. Mean LSN was 2.46 (AE0.37). LSN was significantly increased in patient with cirrhosis (2.68AE0.40 vs. 2.33AE0.29, p=0.001) and CSPH (2.82AE0.29 vs. 2.40AE0.29, p=0.001). Overall and major postoperative complications occurred in 118 (59.3%) and 40 (20.1%) patients, respectively. Mean CCI was 17.18 (AE21.04). The AUROC of LSN for predicting major complications was 0.614 (p=0.044) with a cut-off value of 2.62. On multivariate analysis, LSN ! 2.62 (HR=3.08, 95% CI: 1.21-7.81, p=0.018) and peroperative transfusion (HR=5.89, 95%CI: 2.17-15.99, p=0.001) were independent risk factors for major complications. Conclusion: LSN measurement is feasible in the vast majority of patients and represents a valuable tool in the anticipation of major postoperative complications following hepatectomy for HCC.

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