920 resultados para (13)CD(3) OH


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Postoperative endoscopic recurrence (PER) occurs in nearly 80% of patients 1 year after ileocecal resection in patients with Crohn's disease (CD). Biological agents were more effective in reducing the rates of PER in comparison with conventional therapy, in prospective trials. The aim of this study was to compare the PER rates of biological versus conventional therapy after ileocecal resections in patients with CD in real-world practice. The MULTIPER (Multicenter International Postoperative Endoscopic Recurrence) database is a retrospective analysis of PER rates in CD patients after ileocecal resection, from 7 referral centers in 3 different countries. All consecutive patients who underwent ileocecal resections between 2008 and 2012 and in whom colonoscopies had been performed up to 12 months after surgery, were included. Recurrence was defined as Rutgeerts' score ≥i2. The patients were allocated to either biological or conventional therapy after surgery, and PER rates were compared between the groups. Initially, 231 patients were evaluated, and 63 were excluded. Of the 168 patients in the database, 96 received anti-tumor necrosis factor agents and 72 were treated with conventional therapy after resection. The groups were comparable regarding age, gender, and perianal disease. There was longer disease duration, more previous resections, and more open surgical procedures in patients on biologicals postoperatively. PER was identified in 25/96 (26%) patients on biological therapy and in 24/72 (33.3%) patients on conventional therapy (P=0.310). In this retrospective observational analysis from an international database, no difference was observed between biological and conventional therapy in preventing PER after ileocecal resections in CD patients.

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Mejillonesite, ideally NaMg(2)(PO(3)OH)(PO(4))(OH)center dot H(5)O(2), is a new mineral approved by the CNMNC (IMA 2010-068). It occurs as isolated crystal aggregates in thin zones in fine-grained opal-zeolite aggregate on the north slope of Cerro Mejillones, Antofagasta, Chile. Closely associated minerals are bobierrite, opal, clinoptilolite-Na, clinoptilolite-K, and gypsum. Mejillonesite forms orthorhombic, prismatic, and elongated thick tabular crystals up to 6 mm long, usually intergrown in radiating aggregates. The dominant form is pinacoid {100}. Prisms {hk0}, {h0l}, and {0kl} are also observed. The crystals are colorless, their streak is white, and the luster is vitreous. The mineral is transparent. It is non-fluorescent under ultraviolet light. Mohs' hardness is 4, tenacity is brittle. Cleavage is perfect on {100}, good on {010} and {001}, and fracture is stepped. The measured density is 2.36(1) g/cm(3); the calculated density is 2.367 g/cm(3). Mejillonesite is biaxial (-), alpha= 1.507(2), beta= 1.531(2), gamma= 1.531(2), 2V(meas) = 15(10)degrees, 2V(calc) = 0 degrees (589 nm). Orientation is X= a, Z= elongation direction. The mineral is non-pleochroic. Dispersion is r> v, medium. The IR spectrum contains characteristic bands of the Zundel cation (H(5)O(2)(+), or H(+)center dot 2H(2)O) and the groups P-OH and OH(-). The chemical composition is (by EDS, H(2)O by the Alimarin method, wt%): Na(2)O 9.19, MgO 26.82, P(2)O(5) 46.87, H(2)O 19, total 101.88. The empirical formula, based on 11 oxygen atoms, is Na(0.93)Mg(2.08)(PO(3)OH)(1.00) (PO(4)) (OH)(0.86) .0.95H(5)O(2) The strongest eight X-ray powder-diffraction lines [d in angstrom(I)(hkl)] are: 8.095(100)(200), 6.846(9) (210), 6.470(8)(111), 3.317(5)(302), 2.959(5)(132), 2.706(12)(113), 2.157(19)(333), and 2.153(9) (622). The crystal structure was solved on a single crystal (R = 0.055) and gave the following data: orthorhombic, Pbca, a = 16.295(1), b = 13.009(2), c = 8.434(1) angstrom, V= 1787.9(4) angstrom(3), Z = 8. The crystal structure of mejillonesite is based on a sheet (parallel to the b-c plane) formed by two types of MgO(6) octahedra, isolated tetrahedra PO(4) and PO(3)OH whose apical vertices have different orientation with respect to the sheet. The sheets are connected by interlayer, 5-coordinated sodium ions, proton hydration complexes, and hydroxyl groups. The structure of mejillonesite is related to that of angarfite, NaFe(5)(3+)(PO(4))(4)(OH)(4).4H(2)O and bakhchisaraitsevite, Na(2)Mg(5)(PO(4))(4)center dot 7H(2)O.

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Background: Endoscopic retrograde cholangiopancreatography may fail because of malignant involvement of the second portion of the duodenum and the major papilla. Alternatives include percutaneous transhepatic biliary drainage (PTBD) or surgical bypass. Endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CD) has been reported as an alternative. Objective: To prospectively compare EUS-CD and PTBD in patients with unresectable malignant biliary obstruction. Design: Prospective and randomized study. Setting: Tertiary center. Main Outcome Measurements: Success and efficacy comparison EUS-CD with PTBD. Results: Twenty-five subjects were randomized (13 EUS-CD and 12 PTBD). Mean age was 67 years (SD, 11.9). The 2 groups were similar before intervention in terms of quality of life [EUS-CD (58.3) vs. PTBD (57.8); P = 0.78], total bilirubin (16.4 vs. 17.2; P = 0.7), alkaline phosphatase (539 vs. 518; P = 0.7), and gamma-glutamyl transferase (554.3 vs. 743.5; P = 0.56). All procedures were technically and clinically successful in both groups. At 7-day follow-up there was a significant reduction in total bilirubin in both the groups (EUS-CD, 16.4 to 3.3; P = 0.002 and PTBD, 17.2 to 3.8; P = 0.01), although no difference was noted comparing the 2 groups (EUS-CD to PTBD; 3.3 vs. 3.8; P = 0.2). There was no difference between the complication rates in the 2 groups (P = 0.44), EUS-CD (2/13; 15.3%) and PTBD (3/12; 25%). Costs were similar in the 2 groups also ($5673-EUS-CD vs. $7570-PTBD; P = 0.39). Limitations: Small sample size and single center study. Conclusions: EUS-CD can be an effective and safe alternative to PTBD with similar success, complication rate, cost, and quality of life.