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Urolithiasis is quite prevalent in Satpura belt of Central India. Forty five children with urolithiasis were studied in Jawahar Medical Foundations Hospital, Dhule, Maharashtra over a period of three years. The mean age was 7.1 +/- 3.2 (range 18 months-15 years). The chief presenting complaints were dysuria and lower abdominal pain. The physical, laboratory and radiographic findings were evaluated. Calculi were located in the bladder (80%), urethra (9%), kidney (6.6%) and ureter (4.4%). Calculi were mainly composed of calcium oxalate (65.7%) and calcium phosphate (34.3%). The predominant urinary tract stones in the tribal Satpura belt are bladder stones and may be related to poor nutrition, low socioeconomic status and consumption of bajra (millet) as staple food as found in this region (93.5%).
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PMID:Urolithiasis: a tribal scenario. 1079 52

Development of an automated system to identify renal calculi based on its physical characteristics is proposed. Calculi are due to abnormal collection of certain chemicals like oxalate, phosphate and uric arid. Renal calculi may be present in kidney, ureter or in urinary bladder. An algorithm is proposed to detect calculus using its shadow. The system also extracts the properties of calculi such as size, shape and location, which are vital for reliable diagnosis. This method has been implemented in the MATLAB/IDL platform and a considerable success rate is obtained.
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PMID:Automatic segmentation of medical images for renal calculi and analysis. 1134 25

Structure of stones influences effects and sequelae of extracorporeal shock-wave lithotripsy (ESWL). Clinical sequelae of ESWL in oxalate stones are the worst because of the fragments size and physical qualities of these stones. Oxalates are firm and sharp. Such qualities may cause injury and swelling of the ureter when the fragments pass it. A JJ stent and catheter are proposed to prevent complications of oxalate stone ESWL in the stones size more than 1.5 cm.
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PMID:[Effects of calculi structure on the results of ESWL lithotripsy]. 1156 38

An algorithm proposed by Sridhar and Kumaravel is extended to include a framework for the detection of renal calculi. Calculi occur due to abnormal collection of certain chemicals like oxalate, phosphate and uric acid. These calculi can be present in the kidney, ureter or urinary bladder. Performance analysis is done to a set of five known algorithms using parameters such as success rate in calculi detection, border error metric and time. The framework is constructed by combining the best algorithm based on the performance analysis and a procedure to validate the detected calculi using the shadow it casts in ultrasound images. Ultrasound images of 37 patients are used for testing the algorithm. The detected calculi based on the framework match those determined by expert clinicians in more than 95% of the cases.
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PMID:Segmentation of renal calculi in ultrasound images. 1274 4

A retrospective review was performed of the records of 148 Croatian children with urolithiasis treated between 1989 and 2003. The study evaluated age, gender, family history, clinical symptoms, location of stone, laboratory findings, stone composition, mode of treatment and compared our results with data from higher and lower socio-economic countries. The mean age of our patients was 9.38 years (10 months to 18 years). Thirty-seven children (25%) were less than 5 years (group 1), 44 (29.7%) were between 5 and 10 years (group 2) and 67 (45.3%) were older than 10 years of age (group 3). There were 60 girls and 88 boys with overall male to female ratio of 1.47. Abdominal pain (83%) and haematuria (59.5%) were the main symptoms in the groups 2 and 3. Urinary tract infection was predominant symptom in the group 1 (62.1%). Calculi were located in the kidney in 90 children (60.8%), in the ureter in 39 (26.4%), in the bladder in 8 (5.4%). Urinary tract anomalies with or without infection were associate with a greater frequency of urolithiasis in the youngest age group and hypercalciuria was predominant cause in children over 5. Stone analysis was performed in 80 children. Predominant constituent of stones was calcium oxalate (48.7%), followed by struvite (25%), calcium phosphate (13.7%), cystine (10%) and uric acid (1.2%). Calcium oxalate stones were most common in all age groups. Struvite stones were most prevalent in the children younger than 5 years of age. Most patients (33.1%) underwent surgery for removal of their calculi. In 31.8% of children stones were passed spontaneously and the highest spontaneous passage rate was in the group 3 (37.3%). Stone composition, location and etiology in Croatian children are similar to those in developed Western countries.
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PMID:Pediatric urolithiasis in Croatia. 1474 67

Urolithiasis is a common urologic disease. Stones may occur in the kidney, ureter, or urinary bladder. We collected 1,000 stone samples in the subtropical area of southern Taiwan. Stone components were analyzed by Fourier transform infrared spectroscopy. Mixed components of calcium oxalate and calcium phosphate were the most common form of stones (52.3%), followed by calcium oxalate (27.8%) and calcium phosphate (9.3%). Uric acid stones accounted for 7.6%. Magnesium ammonium phosphate stones accounted for 3.0%. Only one cystine stone was found. In the study of urinary stone formation mechanism and prevention of recurrent urolithiasis, knowing the stone composition is important.
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PMID:Urinary stone analysis of 1,000 patients in southern Taiwan. 1733 67

Ureterolithotomy has an alternative which is much less invasive --retroperitoneoscopic ureterolithotomy (RU). Nineteen cases of RU are reported (15 males, 4 females). Thirteen patients have undergone RU as monotherapy, 5 patients--after ineffective sessions of extracorporeal shock wave lithotripsy, 1 patient--after contact ureterolithotripsy. Mean size of the stones was 12.8 (9.5-30) mm. All the stones were eliminated for one procedure. Duration of surgery in the first 5 operations was 1.5-2 hours, in subsequent ones--65-70 min. The number of bed-days varied from 2 to 10 days (4.2 days). One male had a postoperative attack of pyelonephritis which was treated with antibacterial drugs. RU is a safe and effective operation, it is justified when previous surgery was ineffective, in large, longstanding concrements of the upper and middle third of the ureter, monohydrate-oxalate concrements.
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PMID:[Retroperitoneoscopic ureterolithotomy]. 1791 44

Urolithiasis is the most common cause of urological-related abdominal pain in pregnant women after urinary tract infection. The disease is not uncommon during pregnancy occurring in 1/200 to 1/2,000 women, which is not different from the incidence reported in the nonpregnant female population of reproductive age. During pregnancy, the frequency of stone localization is twice as higher in the ureter than in the renal pelvis or calyx, but there is no difference between the left and right kidney or ureter. Urinary stones during pregnancy are composed mainly of calcium phosphate (hydroxyapatite) in 74% of cases and calcium oxalate in the remaining 26% (Ross et al., Urol Res 36:99-102, 2008). In conclusion, urolithiasis during pregnancy can be serious, causing preterm labor in up to 40% of affected women. The pathogenesis, diagnosis, and management are analyzed.
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PMID:Urolithiasis in pregnancy. 1954 77

This is a rare case of adult primary obstructive megaureter complicated by combined uric acid-oxalate lithiasis of the ureter and renal stones. A 24-year-old male patient presented with frank hematuria on exercise of 4 years duration. The patient had an open surgery in the form of excision of stenotic segment of ureter and left ureteric re-implantation with removal of ureteric and renal stones. Congenital megaureter is a diagnosis that urologists and radiologists need to consider in the setting of isolated distal ureteral dilation, as the diagnosis of adult megaureter may require more involved surgical measures to prevent recurrence of adverse symptoms.
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PMID:Urolithiasis in an adult with primary obstructive megaureter: a case report. 2404 65

The aim of this study was to assess demographic data, clinical presentation, metabolic features, and treatment in 76 children with urolithiasis presented from 2002 to 2011. Urolithiasis is responsible for 2.5/1,000 pediatric hospitalizations, with new cases diagnosed in 1.1/1,000 admissions. From the observed period, two-fold rise of incidence rate was observed. Compiling the data from other pediatric institutions in our country, we estimated present overall incidence rate in Croatia as 6.5/100,000 children under 18 years. There were 41 boys and 35 girls (ratio 1.17:1). The mean age at diagnosis was 9.7 (range 0.8-16) years and follow-up duration was 5.3 (range 1.8-10) years. Renal colic (75.0 %) and hematuria (57.89 %) were the main symptoms. In 65.78 % of children, stones were unilateral. Stones were located in kidney in 52.63 %, in the ureter in 26.32 %, and in bladder in 6.58 % cases. Stone analysis showed calcium oxalate in 75.0 % of the cases. Associated urinary tract abnormalities were found in 19.73 % children. Most common metabolic disturbances were hypercalciuria (47.37 %) and idiopathic or mild hyperoxaluria (18.42 %). Urine saturation (EQUIL2) was elevated in 61.84 % cases. Spontaneous stone evacuation occurred in 51.21 % children. Extracorporeal shock wave lithotripsy, surgical evacuation, and endoscopic removal of calculi were performed in 21.0, 6.58, and 5.26 % of cases, respectively. Follow-up conservative therapy, consisting of fluid/diet recommendations and additional potassium citrate and/or chlorothiazide in children with increased risk, was sufficient for stone recurrence prevention in 92.1 % of children. In conclusion, the study gave insight in epidemiology and metabolic disturbances of urinary stone disease in Croatian children.
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PMID:Demographic characteristics and metabolic risk factors in Croatian children with urolithiasis. 2409 20


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