Aya Ajmi Blout

Background: Right‐sided colon cancer (RSCC) exhibits distinct characteristics, yet specific prognostic determinants remain insufficiently defined. This multicentre retrospective study evaluated clinicopathological and surgical factors influencing survival in a real‐world cohort undergoing curative resection for non‐metastatic RSCC. Methods: We analysed 800 adults undergoing curative‐intent resection for non‐metastatic RSCC across 28 centres (2018–2024). The primary outcome was 3‐year overall survival (OS). Multivariate Cox model identified prognostic factors. An exploratory, post hoc subgroup analysis evaluated the impact of complete mesocolic excision (CME) on OS, stratified by tumour anatomical subsite. Results: The mean age was 62.8 years, and 24% required emergency surgery. CME was performed in 57.1% of patients, with baseline characteristics reflecting significant real‐world selection bias against CME in complex clinical presentations. At 3 years (OS: 86%), multivariate analysis identified age (HR 1.071, 95% CI: 1.023–1.122, p = 0.004) and adjacent organ invasion (HR 3.642, 95% CI: 1.360–9.750, p = 0.010) as independent mortality predictors. Unadjusted post hoc analysis suggested CME was associated with improved OS for ascending colon and hepatic flexure tumours ( p = 0.003). Conclusion: Although CME showed an exploratory site‐specific survival advantage, the critical lack of molecular profiling (MSI, RAS, BRAF) prevents adjustment for major biological confounders. Consequently, these findings are strictly hypothesis‐generating, highlighting real‐world surgical bias and require prospective multi‐institutional validation before altering standard practice.

Introduction: The increasing rate of incarceration represents a significant public health issue worldwide. However, focusing on mental health issues and exploring gender differences among this vulnerable population is lacking in the literature. We aimed to assess differences in childhood trauma, substance use, and mental health among two Tunisian jails. Materials and methods: Two cross-sectional studies were conducted in two Tunisian prisons with different gender compositions, one involving male prisoners in April 2023 and the other involving female prisoners in July 2024. We used Arabic-validated versions of the Adverse Childhood Experiences-International Questionnaire, the Hospital Anxiety and Depression Scale, and the Rosenberg Self-Esteem Scale. Substance use and suicidal thoughts were assessed through a yes or no question. The questionnaire was anonymous and participation was voluntary. Results: A total of 568 prisoners answered the questionnaire. The majority were males (71%) with a median age of 31 years [2640]. We found that participants from female prison reported higher rates of childhood sexual abuse (25.6% vs 7.8%, p < 0.001). Physical abuse was more common among the male prison population (74.6% vs 58.8%, p < 0.001). Community and collective childhood violence were significantly more prevalent among participants from the male prison (94.8% vs 74.5%, p < 0.001 and 57.3% vs 43.6%, p = 0.003, respectively). Substance use was more prevalent among participants in the male prison across all substance types assessed. The female prison population reported more severe anxiety symptoms (69.1% vs 23.6%, p < 0.001) and depressive symptoms (96.4% vs 80.1%, p < 0.001). About 46% of participants in the female prison reported suicidal thoughts during incarceration, compared with 35.1% in the male prison (p = 0.014). The male prison population was more likely to have lower self-esteem (87.4% vs 69.1%, p < 0.001). Conclusion: Implementing rehabilitation programs for prisoners is essential to reduce incarceration rates and mitigate these alarming negative outcomes.