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to document the usefulness of self-expanding metal stents in patients with malignant dysphagia.from January 1992 to January 1997 we implanted 75 Wallstent prostheses (28 uncovered AV, 20 uncovered Unistep, 15 covered Telestep, and 2 covered double-mesh Permalume stents) in 65 patients with malignant dysphagia.mean survival time was 100 days in patients with uncovered stents, and 215 days in patients with covered stents. Oral feeding was possible throughout the post-implantation course in 58 of 65 patients. Only two severe complications occurred: esophageal perforation with mediastinitis, and migration of the stent from the distal esophagus into the stomach. All implantation procedures were done under radiological guidance. For AV and Unistep prostheses we used a nasal approach without sedation, and for Telestep and Permalume stents we used an oral approach with sedation.Wallstent self-expanding metal stents are useful in palliating malignant dysphagia. The placement and implantation of these stents are straightforward.

The geriatric population consumes greater numbers of medicines than other age groups. We compared drug prescription and consumption in elderly persons residing in a nursing home or living in their own home.We studied 366 elderly men and women (older than 65 years) who lived either in nursing homes or in their own home. The variables recorded were the most frequent diseases, number and types of drugs prescribed per person, and adverse reactions of the most frequently prescribed drugs.The most common diseases recorded among subjects living at home were arterial hypertension and rheumatic diseases; among those in nursing homes, the most common ailment was dementia. Subjects in nursing homes were prescribed more different drugs (2.8 +/- 1/person) than individuals living on their own (1.8 +/- 1/person). The percentage of adverse reactions was highest in ambulatory patients (64%) and in patients taking benzodiazepines (56%). A large proportion of all prescriptions (74.5%) were for solid galenic forms.We draw attention to the greater consumption of drugs by elderly persons residing in nursing homes, as well as the prescription of benzodiazepines and analgesic-antiinflammatory drugs within old age.