Differences in outcomes between cholecalciferol and ergocalciferol supplementation in veterans with inflammatory bowel disease

Aim: Vitamin D deficiency is a global health issue associated with increased health‐care costs, and could play a role in the pathogenesis and management of inflammatory bowel disease. Prior studies show a high prevalence of vitamin D deficiency in veterans with inflammatory bowel disease. We aimed to examine the outcome differences in patients with inflammatory bowel disease, comparing treatment with ergocalciferol to cholecalciferol. Methods: A retrospective review of electronic medical records of patients with inflammatory bowel disease at a Veterans Affairs Medical Facility in the Southeastern United States was carried out. Those with at least one serum 25(OH) vitamin D level were included. Initial and follow‐up vitamin D values were recorded. The type of vitamin D supplementation, whether cholecalciferol or ergocalciferol, was documented. Costs in the year after measurement of vitamin D were divided into separate inpatient and outpatient categories. Results: Veterans (n = 108) with ulcerative colitis or Crohn's disease and an available 25(OH) vitamin D level were studied. There were differences in follow‐up vitamin D levels; those who received weekly ergocalciferol had higher subsequent levels than those who received cholecalciferol, especially at a second follow up, although differences did not achieve statistical significance. However, those who received vitamin D3 were less likely to use laboratory, pharmacy, radiology and fee‐based services, and had lower laboratory and pharmacy costs. Conclusions: Our data suggest that cholecalciferol replacement might improve outcomes to a greater extent than ergocalciferol, and might be better in limiting health‐care costs and expenses in patients with inflammatory bowel disease. Geriatr Gerontol Int 2012; 12: 475–480.     

Post-remission retinal microvascular and choroidal thickness changes in eyes with Behḉet’s disease posterior uveitis: an OCTA longitudinal study

International Ophthalmology - To investigate the retinal microvascular and choroidal thickness changes in eyes with active Beh?et’s disease posterior uveitis and post-remission. A...     

Renal impairment in children with posterior urethral valves

Background

Posterior urethral valves (PUV) are a common cause of end-stage renal failure in childhood. Our aim was to describe a cohort of patients with PUV and to investigate the predictors of renal impairment.

Methods

We performed a retrospective chart review of children with PUV who were followed at King Abdulaziz University hospital between 2002 and 2011.

Results

The cohort comprised 68 boys. There was a significant difference in the duration of follow-up (p?=?0.024), nadir serum creatinine (p?<?0.001), and last known serum creatinine level (p?=?0.001) between the patients with and without renal impairment. The duration of follow-up appeared to be a significant predictor for serum creatinine doubling (p?=?0.003; odds ratio, 1.8). There was no difference in the age of presentation, age at the time of the study, and first or last serum creatinine between children who initially had vesicostomy and children who had ablation.

Conclusions

Ablation of PUV or vesicostomy did not influence kidney function in our study cohort. Children with a normal nadir serum creatinine who presented early had a better outcome.     

Urothelial carcinoma at the uretero-enteric junction: Multi-center evaluation of oncologic outcomes after radical nephroureterectomy

ObjectiveThe natural history of urothelial carcinoma arising at the uretero-enteric junction (UEJ) is poorly defined, and the data guiding clinical management of these patients is limited. Therefore, we evaluated oncologic outcomes of patients treated for urothelial carcinoma at the UEJ.MethodsUtilizing a multi-institutional database of patients treated with radical nephroureterectomy (RNU), we assessed the clinicopathologic parameters and oncologic outcomes of UEJ tumors compared with other upper tract urothelial carcinomas (UTUC). Survival analyses were performed to determine independent predictors of disease recurrence and cancer-specific mortality after RNU.ResultsThe study included 1,363 patients, 921 men and 442 women with 36 months median follow-up after RNU. Compared with UTUC in the kidney or ureter, UEJ tumors (n = 22) were more likely to demonstrate features of advanced disease, which were proved to be independent predictors of disease recurrence and cancer-specific mortality after RNU. The 5 year disease-free survival (DFS) and cancer-specific survival (CSS) rates were 25% and 39% in those with UEJ tumors vs. 69% and 73% in those with UTUC in the kidney or ureter (P = 0.001 and P = 0.008, respectively).ConclusionsUEJ tumors harbor features of locally advanced disease associated with high risk of systemic recurrence and death from cancer after RNU. Our findings suggest the need for integration of systemic therapy into the management paradigm of these patients.     

Long-term skeletal stability after maxillary advancement with distraction osteogenesis in cleft lip and palate patients: A systematic review

Objective:To systematically review the long-term skeletal stability after maxillary advancement with distraction osteogenesis (DO) in cleft lip and palate (CLP) patients.Materials and Methods:Electronic databases, grey literature, and reference list searches were conducted. The inclusion criteria were stability of maxillary advancement with distraction osteogenesis assessed at the posttreatment follow-up ≥ 1 year in CLP patients. Full articles were retrieved from abstracts or titles that appear to meet the inclusion criteria or lacked sufficient detail for immediate exclusion. Once full articles were collected, they were again reviewed considering more detailed inclusion criteria for a final selection decision. A methodologic quality assessment tool was utilized.Results:Thirty abstracts/titles met the initial search criteria, and 13 articles were finally selected. Overall, methodologic quality scores were high in only one randomized clinical trial. After maxillary advancement with DO in CLP patients, the long-term horizontal relapse in A-point was less than 15% in eight studies and between 20% and 25% in four studies. The study that was judged as a high-quality study reported 8.2% horizontal relapse in A-point. The relapse rate was higher in DO with external distracter device than DO with internal distracter device.Conclusions:Current evidence suggests maxillary advancement with DO has good stability in CLP patients with moderate and severe maxillary hypoplasia.     

Experimental and theoretical investigations of benzoic acid derivatives as corrosion inhibitors for AISI 316 stainless steel in hydrochloric acid medium: DFT and Monte Carlo simulations on the Fe (110) surface

The inhibition efficiency of benzoic acid (C1), para-hydroxybenzoic acid (C2), and 3,4-dihydroxybenzoic acid (C3) towards enhancing the corrosion resistance of austenitic AISI 316 stainless steel (SS) has been evaluated in 0.5 M HCl using weight loss (WL), open circuit potential (OCP), potentiodynamic polarization method, electrochemical impedance spectroscopy (EIS), and scanning electron microscopy (SEM) analysis. The results obtained from the different experimental techniques were consistent and showed that the inhibition efficiency of these inhibitors increased with the increase in concentration in this order C3 > C2 > C1. In addition, the results of the weight loss measurements showed that these inhibitors followed the Villamil isotherm. Quantum chemical calculations and Monte Carlo simulations have also been used for further insight into the adsorption mechanism of the inhibitor molecules on Fe (110). The quantum chemical parameters have been calculated by density functional theory (DFT) at the B3LYP level of theory with 6-31G+(2d,p) and 6-31G++(2d,p) basis sets in gas and aqueous phase. Parameters such as the lowest unoccupied (E_LUMO) and highest occupied (E_HOMO) molecular orbital energies, energy gap (ΔE), chemical hardness (η), softness (σ), electronegativity (χ), electrophilicity (ω), and nucleophilicity (ε) were calculated and showed the anti-corrosive properties of C1, C2 and C3. Moreover, theoretical vibrational spectra were calculated to exhibit the functional hydroxyl groups (OH) in the studied compounds. In agreement with the experimental data, the theoretical results showed that the order of inhibition efficiency was C3 > C2 > C1.

The corrosion inhibition efficiencies of benzoic acid (C1), para-hydroxybenzoic acid (C2), and 3,4-dihydroxybenzoic acid (C3) have been evaluated in 0.5 M HCl toward protecting AISI 316 stainless steel (SS).