The use of a covered expandable metal stent for the management of esophageotracheal fistula resulting from esophageal carcinoma: A case report

Malignant esophagorespiratory fistula is a rare condition that is difficult to manage. Palliative treatment by surgical bypass is often unjustified, and the use of esophageal stents has been shown to be more appropriate. We describe a 64-year-old man with inoperable esophageal carcinoma presenting with symptoms of an esophagorespiratory fistula. A covered expandable metallic stent was successfully inserted into the esophagus. The patient's symptoms improved dramatically and he survived for 16 months. The use of a covered expandable metal stent is a safe and practical alternative treatment for palliating inoperable esophageal carcinomas in patients with esophagorespiratory fistulas

An Ankylosing Spondylitis Case Which Accompanies Portal Hypertension and Lichen Amyloidosis

In this paper, we present a case that has been followed with Ankylosing Spondylitis (AS) for forty years and developed diabetes, iridocyclitis, lichen amyloidosis and hypertension over time. A 73-year-old male patient presented to our hospital with dyspnea and massive ascites with portal hypertension in the last one year. Cardiac and hepatic venous pressure measurements revealed mild pericardial thickening and intrahepatic sinusoidal portal hypertension in the liver. An infiltrative reason as metabolic, viral, autoimmune to develop portal hypertension was not found and systemic inflammation and vascular involvement due to AS was thought. TIPS was applied to the patient due to resistant ascites. After this operation, albumin was not needed, acid regressed and general condition improved. We aimed to present a very rarely seen association of AS, lichen amyloidosis and portal hypertension, and the curative result of TIPS operation in this case

Physician and patient preferences for oral anticoagulation therapy decision-making in atrial fibrillation: Results from a national best-worst scaling survey in Turkey (PREF-AF)

Objectives Cost-utility modeling informs reimbursement decisions and is based on the premise that health outcome improvements can be expressed as disease-independent utility scores. Previous cost-utility analyses of anti-calcitonin gene-related peptide therapies expressed the utility gain as a function of monthly migraine days (MMDs). Exploring the presence of an additional treatment effect on utility after controlling for MMDs can be insightful. This post hoc analysis of the DELIVER clinical trial (NCT04418765) for the preventive treatment of migraine aims to communicate the impact of eptinezumab on health utility scores. Methods Utility scores were estimated using data from study visits at which the Migraine-Specific Quality of Life Questionnaire (MSQ) was completed. MSQ scores were then mapped to EQ-5D-3L using previously published algorithms. A linear mixed model evaluating the effect of eptinezumab compared to placebo using change from baseline at week 12 and 24, adjusted for MMDs, was generated, and a fixed intercept for each study arm was used to estimate if eptinezumab effected points compared to placebo beyond MMD reduction

The influence of ethnicity on disease outcome in patients with chronic hepatitis B infection

Since the cultural diversity in Western Europe is growing, this study assessed whether foreign-born chronic hepatitis B (CHB) patients have more cirrhosis than Dutch- or Belgian-born patients, with a main focus on the Turkish population. Baseline characteristics (eg, socioeconomic status [SES]), biological characteristics, and disease outcome (eg, cirrhosis) were collected for all patients. Between December 2009 and January 2015, 269 CHB patients participated from the outpatient departments of three hospitals in the Netherlands, Belgium, and Turkey. Out of the 269 CHB patients, 210 were foreign-born and 59 were Dutch- or Belgian-born. Compared with Dutch- or Belgian-born patients, foreign-born patients had a higher prevalence of low SES (58% vs 31%; P = 0.001) and cirrhosis (27% vs 10%; P = 0.007). Among the Turkish population, there were no significant differences regarding the prevalence of low SES (73% vs 61%; P = 0.170), alcohol abuse (1% vs 5%; P = 0.120), anti-hepatitis C virus positivity (4% vs 0%; P = 0.344), anti-hepatitis D virus positivity (1% vs 6%; P = 0.297), and cirrhosis (37% vs 27%; P = 0.262) between patients (n = 102) living in Turkey (local) and Turkish CHB (n = 38) patients living in the Netherlands or Belgium (immigrant). In multivariate analysis, low SES (odds ratio, 5.7; 95% confidence interval, 2.3-14.5; P <0.001) was associated with cirrhosis. In this study, foreign-born CHB patients were associated with more advanced HBV-related liver disease with 27% having cirrhosis. However, ethnicity was not associated with cirrhosis when SES was included in the multivariate analysis. The similar prevalence of cirrhosis in local Turkish compared to immigrant Turkish CHB patients is novel and warrants further investigation