Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The study covers 232 patients with chronic calculous cholecystitis, operated in the Surgical Clinic of the Military Hospital--Plovdiv over the period 1991 through August 1995. Bilithiasis (cholenephrolithiasis) is diagnosed in 26 cases (11.2 per cent). This is a condition running a clinical course characterized by pain in the right subcostal and lumbosacral regions, accompanied by nausea and vomit in 57.7 per cent. Eighteen patient sustain renal crisis. Palpatorily, pain is established in the right subcostal region, and positive succussio renalis--in twelve patients. In nine patients there is evidence of albuminuria and leukocyturia (34.6 per cent). In 26 cases the echographic study reveals presence of concretions in the gallbladder, and in all of them-renal calculi too (left kidney--9, right kidney--9, and bilaterally--8 patients). Intraoperatively, concretions in the gallbladder are found in all patients, with hydrops and empyema of the gallbladder documented in five, and vesicoduodenal fistula in one (23 per cent), whereas in the patients free of urolithiasis they amount to 10.8 per cent which points to a reciprocal aggravation of the two pathological conditions. The early, as well as the long-term results of the operative management applied are estimated as very good.
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PMID:[Bilithiasis (cholenephrolithiasis)]. 973 78

To investigate the long-term outcome of the frequency-dysuria syndrome (FDS) with hypercalciuria (HCU), 19 children (15 girls and 4 boys; age range 15 months to 10 years) who presented with FDS alone (N=9) or with other associated clinical features (N=10; 6 with gross hematuria, 3 with microscopic hematuria and 1 with abdominal pain) were followed-up over 720 patient-months. Calcium loading test indicated absorptive HCU in 12 patients, renal HCU in 2, and in 5 the test was inconclusive. All patients were treated with a standard protocol after diagnosis. During follow-up, FDS recurred in 4 children, gross hematuria in 3, lumbar pain in 5, and 7 children developed urolithiasis within 3 to 60 months. The latter 7 children (4 with absorptive HCU and 1 with renal HCU) tended to be older than the other 12 (7.14 vs 5.08 years; p=0.11) and required a longer time to normalize urinary calcium excretion (16 vs 7 months; p <0.01). The initial urinary calcium excretion was similar between the patients with and those without stones (5.53 vs 5.6 mg/kg/d). In all other parameters measured, there were no statistically significant differences between the patients who initially presented with FDS alone and those with FDS accompanied with other urinary symptoms. We conclude that HCU and FDS in children can vary considerably in the clinical mode of presentation as well as its sequels. Significant risk for urolithiasis burdens the children who require a longer time (>12 months) to normalize their hypercalciuria.
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PMID:Symptomatology and development of urolithiasis in children with frequency-dysuria syndrome associated with hypercalciuria. 993 1

Dilatation of the collecting system is a classical phenomenon during pregnancy, due to hormonal and extrinsic compressive factors. Imaging has to differentiate a physiological dilatation and a pathological obstruction due to urolithiasis. Presently, sonography, using both, B-mode and color Doppler, has the potential to demonstrate the physiological compression of ureters at the level of the pelvic brim. A pathological obstruction is considered either when a stone is detected above the usual site of compression or when the ureter appears dilated beyond. Color Doppler helps in localizing the site of ureteral compression against the vessels and in differentiating ureters from veins. Magnetic resonance urography, with strongly T2-weighted sequences, also may show the site and type of obstruction without contrast agent administration. These two non-radiating techniques make it possible to avoid the use of X-rays in most cases for management of these patients. The type of treatment is based mostly on the level of pain and the presence or absence of stone.
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PMID:Dilatation of the collecting system during pregnancy: physiologic vs obstructive dilatation. 1066 56

Symptomatic urolithiasis is usually treated with narcotic pain management. This leads to the potential for use of its symptoms for personal gain. Historically, the typical presentation of a narcotic-seeking "stone patient" was a history of radiolucent stones and an intravenous contrast allergy. With the increased use of non-contrast-enhanced computed tomography to evaluate patients suspected of having acute urolithiasis, we have seen a change in the strategy of narcotic-seeking patients. We report 2 patients with pelvic calcifications on non-contrast-enhanced computed tomography feigning symptoms of urolithiasis to receive narcotic drugs.
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PMID:Drug-seeking behavior in urolithiasis in the noncontrast computed tomography era: 2 cases. 1075 47

Indinavir sulfate is a protease inhibitor that has been found to be extremely effective in increasing CD4+ cell counts and in decreasing HIV-RNA titers in patients with HIV and AIDS. However, patients receiving indinavir also have been noted to have a significant risk for developing urolithiasis. Published reports of indinavir urolithiasis estimate its incidence at between 4 and 13%. Indinavir has a high urinary excretion with poor solubility in a physiologic pH solution. Consequently, patients develop urinary stones that are principally composed of indinavir or of a mixture of indinavir and other substances, such as calcium oxalate. Similar to other forms of urolithiasis, acute flank pain and hematuria are the typical symptoms of indinavir urolithiasis. Indinavir urolithiasis is unique in that computed tomography, which was once thought to be efficacious in identifying all urinary calculi, is not useful in imaging stones that are composed of pure indinavir. Indinavir urolithiasis generally responds to a conservative regimen of hydration, pain control, and the temporary discontinuation of the medication. Only a minority of patients need surgical intervention. Approximately 10% of patients ultimately need to discontinue indinavir therapy altogether. Indinavir is an antiviral agent that has a significant role in the treatment of AIDS. Although urolithiasis is a significant side effect of indinavir use, limiting its clinical application is not the answer. Rather, physicians need to know more about indinavir urolithiasis to help their patients cope with its potential complications.
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PMID:Indinavir urolithiasis. 1114 25

Percussion of the kidney as a diagnostic method was first described by John Benjamin Murphy (1857-1916). The test is rapidly elicited, but can cause severe pain. Considering acute pyelonephritis or acute renal colic, it is common practice to perform fist percussion of the kidney, yet its diagnostic value is unknown. Finnish study results in 1998 suggest that in acute renal colic loin tenderness and erythrocyturia are more significant signs than renal tenderness. There is no scientific evidence for determining renal tenderness in diagnosing urinary tract infections and urolithiasis.
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PMID:[Physical diagnosis--pain elicited by percussion in the kidney area]. 1155 74

Chronic pains typically evaluated by a urologist are discussed from the perspective of a non-urologist pain clinician. The pathophysiology of some pains is understood and so we believe the patient's symptoms: examples are cancer-related pain and recurrent urolithiasis. We treat these pains with traditional analgesics. Other pains, such as those of interstitial cystitis, chronic prostatodynia, and chronic orchialgia are less understood and so are treated in a more conservative and often empiric fashion. Proposed therapies for these disorders are discussed.
Curr Pain Headache Rep 2001 Feb
PMID:Chronic urologic pain syndromes. 1125 35

The diagnosis and initial management of urolithiasis have undergone considerable evolution in recent years. The application of noncontrast helical computed tomography (CT) in patients with suspected renal colic is one major advance. The superior sensitivity and specificity of helical CT allow urolithiasis to be diagnosed or excluded definitively and expeditiously without the potential harmful effects of contrast media. Initial management is based on three key concepts: (1) the recognition of urgent and emergency requirements for urologic consultation, (2) the provision of effective pain control using a combination of narcotics and nonsteroidal anti-inflammatory drugs in appropriate patients and (3) an understanding of the impact of stone location and size on natural history and definitive urologic management. These concepts are discussed with reference to contemporary literature, with the goal of providing tools that family physicians can use in the emergency department or clinic.
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PMID:Diagnosis and initial management of kidney stones. 1131 Jun 48

The analgesic effects of high-energy extracorporeal shock wave therapy (ESWT) were discovered by chance during its application for urolithiasis and for bone pseudarthrosis. Despite the extensive use of ESWT, the mechanisms of its antinociceptive effects are still unclear. A gate control mechanism and other antinociceptive mechanisms have been postulated. The aim of this study was to investigate the possible influence of low-energy ESWT on the expression of the transmitters substance P (SP) and calcitonin gene-related peptide (CGRP) in the lumbar spinal cord of the rat. Immunohistochemical analysis of the expression of the neuropeptides CGRP and SP was performed in rats treated either once with 1000 impulses or three times with 1000 impulses, with two different energy flux densities being used (0.043 and 0.11 mJ/mm2). The animals were killed either 4 or 72 h after the ESWT. No regulatory effect of ESWT on the expression of SP or CGRP in the dorsal horns was found. Because the application of ESWT showed no significant changes in the sensory system, it is unlikely that the application of ESWT triggers the endogenous pain control system of the rat through hyperstimulation analgesia. Furthermore, these results show that low-energy ESWT had no side effects on the rat spinal cord.
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PMID:No influence of low-energy extracorporeal shock wave therapy (ESWT) on spinal nociceptive systems. 1181 40

We study the outcome of 2,700 patients treated for 3,093 urinary calculi over a period of 60 months. All patients underwent Extracorporeal Shock Wave Lithotripsy (ESWL) treatment using the Storz Modulith SL20, predominantly on an outpatient basis (99.9% using intravenous pethidine for analgesia). The treatment outcome of 1,666 renal calculi and 1,427 ureteric calculi were analysed and stratified according to size and site. Follow-up status at 3 months was available for 91.8% of patients. For renal calculi, the overall success rate was 81% (re-treatment rate 29.7%). The majority of failures were stones larger than 2 cm and those situated in the lower pole of the renal calyces. The overall success rate for ureteric calculi is 85% with similar clearance rates throughout the ureter (re-treatment rate 22.8%). Failures were predominantly with stones larger than 2 cm. For the entire series, the morbidity rate requiring hospital admission was 2.9%, there was no mortality. The commonest cause for admission was for pain control (1.8%). To our knowledge, our experience with this lithotriptor is the largest to date. We have demonstrated that ESWL with Storz Modulith SL20 is safe, well tolerated and highly effective for the treatment of urolithiasis.
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PMID:Clinical experience and results of ESWL treatment for 3,093 urinary calculi with the Storz Modulith SL 20 lithotripter at the Singapore general hospital. 1248 41


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