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1.  21-Hy­droxy­pregna-1,4-diene-3,20-dione 
The title compound, C21H28O3, is a fungal transformed metabolite of decoxycorticosterone acetate, consisting of four fused rings A, B, C and D. Ring A is nearly planar, with a maximum deviation of 0.010 (3) Å from the least-squares plane, while the trans-fused rings B and C adopt chair conformations. The five-membered ring D is in an envelope conformation. The orientation of the side chain is stabilized by an intramolecular O—H⋯O hydrogen bond. In the crystal, adjecent mol­ecules are linked by C—H⋯O hydrogen bonds into extended zigzag chains along the a axis.
PMCID: PMC3213563  PMID: 22091140
2.  Repair of Parastomal Hernias with Biologic Grafts: A Systematic Review 
Journal of Gastrointestinal Surgery  2011;15(7):1252-1258.
Biologic grafts are increasingly used instead of synthetic mesh for parastomal hernia repair due to concerns of synthetic mesh-related complications. This systematic review was designed to evaluate the use of these collagen-based scaffolds for the repair of parastomal hernias.
Studies were retrieved after searching the electronic databases MEDLINE, EMBASE and Cochrane CENTRAL. The search terms ‘paracolostomy’, ‘paraileostomy’, ‘parastomal’, ‘colostomy’, ‘ileostomy’, ‘hernia’, ‘defect’, ‘closure’, ‘repair’ and ‘reconstruction’ were used. Selection of studies and assessment of methodological quality were performed with a modified MINORS index. All reports on repair of parastomal hernias using a collagen-based biologic scaffold to reinforce or bridge the defect were included. Outcomes were recurrence rate, mortality and morbidity.
Four retrospective studies with a combined enrolment of 57 patients were included. Recurrence occurred in 15.7% (95% confidence interval [CI] 7.8–25.9) of patients and wound-related complications in 26.2% (95% CI 14.7–39.5). No mortality or graft infections were reported.
The use of reinforcing or bridging biologic grafts during parastomal hernia repair results in acceptable rates of recurrence and complications. However, given the similar rates of recurrence and complications achieved using synthetic mesh in this scenario, the evidence does not support use of biologic grafts.
PMCID: PMC3116129  PMID: 21360207
Biologic graft; Allograft; Xenograft; Parastomal hernia

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