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Colon cancer is the uncontrolled growth of cells in the colon, the first and longest section of the large intestine.

Hepatic encephalopathy (HE) is a serious and potentially life-threatening condition that occurs when the liver can no longer remove toxins from the blood, especially ammonia produced in the intestines. When these toxins build up, they impair brain function. Without prompt treatment, HE can progress to coma or death. HE most often develops in people with advanced liver disease, particularly cirrhosis, but it can also occur with acute liver failure, liver cancer, or after certain liver procedures. It affects 30–40% of people with cirrhosis. Alcohol use, infections, medications, internal bleeding, and blood flow abnormalities can trigger episodes. ⚠️ HE is a medical emergency. Sudden confusion, extreme sleepiness, or unresponsiveness requires immediate emergency care. Types of Hepatic Encephalopathy Type A: Caused by acute liver failure, developing rapidly over days or weeks Type B: Caused by abnormal blood flow (portosystemic shunts) that bypasses the liver Type C: Occurs in people with cirrhosis or acute-on-chronic liver failure HE may be: Overt: Symptoms are clearly noticeable Covert: Subtle cognitive changes detectable only with testing Symptoms Difficulty concentrating or confusion Disorientation (not knowing where you are) Daytime sleepiness or insomnia Memory problems Flapping hand tremor (asterixis) Personality or mood changes Slurred speech or poor coordination Coma in severe cases These symptoms can significantly reduce quality of life and daily functioning. Causes and Triggers Liver failure or cirrhosis Alcohol use Infections Gastrointestinal bleeding Electrolyte imbalances (low sodium or potassium) Dehydration or constipation Certain medications (sedatives, opioids, diuretics) Complications after liver transplant Risk Factors Advanced liver disease Diabetes or kidney disease Older age Low muscle mass (sarcopenia) High blood ammonia levels Alcohol use Poor nutrition Possible Complications Falls and injuries Long-term memory and attention problems Driving impairment Frequent hospitalizations Coma Death Prevention You can lower the risk of HE by: Taking medications exactly as prescribed Eating plant-based and dairy protein instead of excessive animal protein Avoiding alcohol, sedatives, and opioids Staying well hydrated Preventing constipation Treating infections promptly Attending regular liver checkups Early recognition and treatment of hepatic encephalopathy can be lifesaving. If you or someone with liver disease develops sudden mental changes, seek emergency medical care immediately.

Ewing sarcoma is a rare cancer that most often affects children and teenagers aged 10–20. It usually starts in the bone (about 87% of cases) and less commonly in nearby soft tissues such as muscle or cartilage. The most frequent locations are the pelvis, chest wall and long bones of the legs. In the United States, around 200 children and young adults are diagnosed each year. There are several related forms of Ewing sarcoma, including Askin tumor, extraosseous Ewing sarcoma and peripheral primitive neuroectodermal tumor (pPNET). These tumors share the same genetic origin and are treated as one disease group. At Sheba Medical Center, patients with Ewing sarcoma receive comprehensive, multidisciplinary care. As the largest medical center in the region, Sheba brings together internationally trained pediatric oncologists, orthopedic surgeons, radiologists and radiation oncologists to deliver personalized treatment plans. Each case is carefully evaluated to ensure accurate diagnosis, staging and the most effective therapy. Symptoms Persistent or intermittent bone pain Swelling, tenderness or a lump near the tumor Limping or reduced movement if a limb is affected Fever, fatigue, weight loss Unexplained fractures Advanced disease may cause shortness of breath or chest pain if the lungs are involved Diagnosis & Staging Diagnosis includes imaging (X-ray, MRI, CT, PET), biopsy, and molecular genetic testing to confirm the characteristic chromosomal changes. Disease is classified as localized, regional, metastatic or recurrent, which guides treatment decisions. Treatment Treatment typically combines chemotherapy, surgery and radiation therapy, with options such as targeted therapy, immunotherapy or bone marrow transplantation in selected cases. Sheba’s approach addresses both medical outcomes and quality of life. Prognosis When diagnosed early, outcomes are favorable. Localized Ewing sarcoma has a 5-year survival rate of up to 82%, while prognosis depends on stage, tumor size, location, age and response to therapy. Early expert care makes a critical difference in Ewing sarcoma outcomes.