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is among malignancies with poor prognosis due to the late onset symptoms
related with large submucosal involvement, early lymphatic metastasis and its
majority of the patients decrease within the first year of diagnosis. However,
bone metastasis is uncommon and reported to be 1% to 14% in autopsy series.
Herein we report a case that was admitted to our outpatient clinics with severe
neck and arm pain as presenting symptoms and diagnosed as metastatic oesophageal carcinoma afterwards.
Objectives: This study aimed to evaluate the fatigue in patients with undifferentiated spondyloarthritis [USpA], and its relationship with disease-specific variables, spinal mobility measures and healthy related quality of life [HRQOL]. Methods: Eighty patients with USpA and forty healthy subjects were included in this study. The multidimensional assessment of fatigue [MAF] and the generic instrument Short Form 36 [SF 36] were used in patient and control groups to assess fatigue and [HRQOL]. Fatigue was also assessed with the Bath ankylosing spondylitis disease activity index [BASDAI] fatigue item. The evaluation included the activity of the disease [BASDAI], functional status [Bath ankylosing spondylitis functional index], and visual analog scale [VAS] of axial and joint pain. Demographics and disease-related data were obtained. Results: Patients with USpA had higher scores in MAF total and in all MAF subgroup scales than controls. All SF-36 subgroups scores were also found to be significantly lower in patients. Severe fatigue experienced 60% in patients. MAF total scores were found to be significantly correlated with morning stiffness, BASDAI, Bath ankylosing spondylitis functional index (BASFI), BASDAI fatigue, VAS-axial, and SF-36 subgroups scores in patients [p < 0.05]. Conclusions: The patients with USpA defined significantly more fatigue and lower HRQOL when compared with healthy persons. MAF was found to be related with the clinical and functional status and health-related quality of life of patients with USpA.
The local and global behavior of the positive solutions of the difference equation
was investigated, where the parametersα,βandγand the initial conditions are arbitrary positive numbers. Furthermore, the characterization of the stability was studied with a basin that depends on the conditions of the coefficients. The analysis about the semi-cycle of positive solutions has end the study of this work.