Biliary stents are forgotten more frequently in elderly patients

Background/aim: Plastic biliary stents that remain in situ for more than 12 months, called forgotten biliary stents (FBSs), can cause complications such as cholangitis, stent migration, stent occlusion, and perforation. Materials and methods: The medical records of patients who underwent ERCP procedures from December 2016 to December 2020 were analysed retrospectively. Data on patient characteristics, indications for ERCP and stenting, stent types, stenting duration, complications, and causes of FBSs were obtained from the hospital's database. Results: A total of 48 cases with FBSs were analysed. The mean age (SD) of the patients was 71.23 years (±12.165), the male-to-female ratio was 23/25 (0.92), and the mean stenting duration was 27.12 months (range: 12­84 months). The most common indication for biliary stenting was irretrievable choledochal stones (40/48). Stone formation (79%) and proximal stent migration (26.4%) were the most frequent complications. The patients in the FBS group were significantly older than those from whom stents were removed in a timely manner (71.23 vs. 62.43 years, p < 0.001). Endoscopic treatment was possible in all cases; surgery was not required in any case. The most common cause of FBSs cited by patients was not having been informed about the need for long-term management of their stents (n = 14, 29.2%) Conclusion: FBSs are potentially problematic particularly in elderly patients. Communication with the patient to remind them of the need for stent management is important for preventing FBSs.

Comparison of an inactivated Covid19 vaccine-induced antibody response with concurrent natural Covid19 infection.

OBJECTIVES: The risk of contracting SARS-CoV-2 is high among the health care workers (HCW). The comparison between the antibody response to an inactivated Covid19 vaccine and the antibodies that developed during Covid-19 infection has not been elucidated. In this study, vaccine-induced antibody levels were compared with the antibodies developed in naturally infected HCWs. METHODS: Eighty vaccinated individuals and 80 Covid-19 patients enrolled to the study. Both groups were matched on age, gender and antibody testing time. Anti-SARS-CoV-2 total Ig (Roche) and Anti-SARS-CoV-2 ELISA (IgG) (Euroimmun, Germany) were used to detect antibodies. RESULTS: The anti-S positivity were determined to be 96.2% and 92.5% in vaccinated and patient groups (p=0.303) while the anti-N positivity was 51.2% and 98.8%, respectively (p=<0,0001). The median values for anti-S and anti-N antibodies were statistically significant between both groups. When the vaccinated group was compared with the severe and non-severe patient groups, statistically significant differences were found for both regarding anti-S1 and anti-N antibody titers (p=0,012, p=<0,0001, respectively). For the patient group, there was a positive correlation between the age and anti-S1 antibody titers (r=0.333; p=0.003) and there was also a statistically significant increase in anti-N antibody titers in time (r=0.505; p=0.0001). CONCLUSION: The anti-S seroconversion ratio in vaccinated individuals were higher than what was reported by the vaccine manufacturer. The antibody titers in the vaccinated group were lower than the patients group. The decrease in anti-S1 antibody titers in time were considered to be a disadvantage and an undesired phenomenon.