<b><i>Objective:</i></b> Kidney stones are a common medical condition that is increasing in prevalence worldwide. Approximately, ∼80% of urinary calculi are composed of calcium oxalate (CaOx). There is a growing interest toward identifying therapeutic compounds that can inhibit the formation of CaOx crystals. However, some chemicals (e.g., antibiotics and bacterial metabolites) may directly promote crystallization. Current knowledge is limited regarding crystal promoters and inhibitors. Thus, we have developed an in vitro gel-based diffusion model to screen for substances that directly influence CaOx crystal formation. <b><i>Materials and Methods:</i></b> We used double diffusion of sodium oxalate and calcium chloride-loaded paper disks along an agar medium to facilitate the controlled formation of monohydrate and dihydrate CaOx crystals. A third disk was used for the perpendicular diffusion of a test substance to assess its influence on CaOx crystal formation. <b><i>Results:</i></b> We confirmed that citrates and magnesium are effective inhibitors of CaOx crystals. We also demonstrated that 2 strains of uropathogenic <i>Escherichia coli</i> are able to promote crystal formation. While the other tested uropathogens and most antibiotics did not change crystal formation, ampicillin was able to reduce crystallization. <b><i>Conclusion:</i></b> We have developed an inexpensive and high-throughput model to evaluate substances that influence CaOx crystallization.
Urethral stricture is defined as any abnormal narrowing throughout the entire length of the male urethra. Anterior urethral stricture is the most common site which accounts for more than 90% of cases in developed countries. One of the possible long-term outcomes of urethral stricture treatment is stricture recurrence. Refractory urethral strictures to initial management present surgical challenges to the reconstructive surgeon. It has been reported in the literature that buccal mucosal grafts in complex anterior urethral strictures have lately become a well-established management modality for bulbar and penile urethral strictures. Here, we are presenting an interesting case of a patient with a dual lumen urethra due to recurrent urethral stricture.
Introduction
Excessive dietary sodium (Na) consumption is a major health care issue in the developed world and linked to many poor health outcomes. Elevated urinary Na may lead to hypercalciuria and an increase in urinary stone risk. Our study aimed to assess the impact of targeted dietary counseling, and its effect on normalizing urinary Na levels in hypercalciuric stone patients.
Methods
A retrospective analysis of a prospectively collected metabolic stone clinic database was performed. Patients with hypercalciuria and elevated urine Na on 24-hour urine collection (24-HUC) were counselled by the attending nephrologist, urologist or a registered dietician to limit their intake of dietary Na to < 2g/day in addition to receiving general dietary advice. Repeat metabolic testing was performed at least 6 months later. Logistic regression was used to determine correlations between elevated urinary Ca and Na to other urinary abnormalities and to evaluate the effect of normalizing urinary Na on other urinary parameters.
Results
Metabolic evaluations from 1184 patients were analyzed. The ninety-eight patients with concomitant hypercalciuria and hypernatriuria were predominantly male (67.3%) and had a higher median BMI than the entire cohort. The presence of elevated urinary Na was also associated with hyperuricosuria (p < 0.001) and hyperphosphaturia (p < 0.001). In follow-up, 59.4% corrected their urinary Na, and 43.8% also had their urinary Ca corrected. Patients who corrected their urinary Na were also more likely to have normal urinary values for volume (p = 0.045), oxalate (p = 0.004), and urate (p = 0.008).
Conclusions
Targeted dietary counseling can be effective in normalizing both elevated urinary Na and Ca levels in stone patients and may obviate the need for pharmacotherapy for the treatment of hypercalciuria in some patients.
found in the parenchymal tissue of any kidney by gross, MRI, or histologic examination, although petechial damage and erosion were identified to the urothelium of the collecting system limited to the area directly around the stone. CONCLUSIONS: Burst wave lithotripsy can produce consistent stone fragmentation with use of appropriate ultrasound parameters. Such exposures cause minimal injury to the kidney and urinary tract during treatment.
Cryptorchidism is a common condition among children; however, it is rare in adults and is associated with an increased risk of malignancy. The development of secondary undescended testes is recognized as a complication following inguinal surgeries such as hernia repair and orchidopexy. Herein, we describe the case of a 64-year-old male with a known past surgical history of right indirect inguinal hernia repair complaining of penile swelling. The patient was diagnosed with a penile fracture, and a genital examination further revealed a right undescended testis. The patient underwent penile fracture repair and right orchiectomy. Histopathology examinations showed classic seminoma. These findings show that the position of each testis should always be documented before, during, and after inguinal hernia repair due to the increased risk of undescended testis. Histopathological confirmation is necessary for such patients so that malignancy can be identified in its early stages and cured subsequently.
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