ABSTRACT
@#Oesophageal strictures often occur following esophagectomy which is performed for cases of oesophageal cancer. These patients require repeated dilation procedures. The aim of this study is to investigate the effects of dietary regimens, which are changed because of stenosis, caused by Helicobacter pylori (H. pylori). In this retrospective study, 28 patients who had operation for oesophageal cancer and underwent dilation due to development of stricture were studied. 30 female and 30 male patients who were admitted to the Gastroenterology Clinic with complaints of dyspepsia and did not receive treatment for the eradication of H. pylori were randomly selected and included in this study as a control group. Patients’ histopathological records on the hemogram, biochemistry, and endoscopic biopsy were analysed. There were 26 H. pylori (+) cases (92.8 %) in the stenosis group consisting of 28 patients, and 37 H. pylori (+) cases (61.6%) in the control group consisting of 60 patients. These results were found to be statistically significant (P=0.003). The albumin level in the stenosis group was reported to be statistically low (P=0.002). The incidence of H. pylori was found to be significantly higher in patients with stenosis. We ascribed this outcome due to changes in dietary regimens. Our findings showed that the dietary regimens of all patients who underwent esophagectomy should be regulated during the postoperative period considering H. pylori. The relationship between H. pylori and stenosis was significant, there is a need for further research with a larger sample size to enrich the findings.
ABSTRACT
Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients' and clinicians' values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR.(AU)