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)

Indinavir sulphate 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 of developing urolithiasis. Indinavir has high urinary excretion with poor solubility in a physiologic pH solution. The typical symptoms of indinavir urolithiasis are similar to other forms of 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 temporary discontinuation of the medication. Only a minority of patients need surgical intervention.
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PMID:[Renal lithiasis due to indinavir]. 1268 14

Urolithiasis is the formation of stones in the urinary tract, causing pain and bleeding, and may lead to secondary infection. It is the third most common affliction of the urinary tract. Of many types of stones that are formed, the most common are calcium oxalate. The formation of such concretion encompasses several physico-chemical events beginning with crystal nucleation, growth, aggregation, and ending by retention within urinary tract. The mechanisms governing the induction of all these processes remain speculative. One of the important phenomena that characterizes urolithiasis is its high recurrence. Thus, a protective system is required including extracorporeal shock wave lithotripsy and medicament treatment. Unfortunately, these means remain costly and in most cases are invasive and with side effects. Therefore, it is worthwhile to look for an alternative to these conventional methods by using medicinal plants or phytotherapy. In fact, many developing countries including China use herbal medicines which have gained popularity in Europe and are becoming increasingly in the United States as well. As far as urolithiasis is concerned, several herbal treatments seem to cure lithiasis patients. Nevertheless, the effectiveness and the mechanism by which these plants work has not been fully undertaken by using scientific and objective methods. Therefore, it is highly recommended to explore new drugs coming from medicinal plants to treat and prevent the formation of kidney stones. Ideally, conventional and phytotherapy should supplement one another and have all the need available for lithiasis patients.
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PMID:Medical management of urolithiasis, what opportunity for phytotherapy? 1270 97

Shock waves are high-energy acoustic waves generated under water with high voltage explosion and vaporization. Shock wave in urology (lithotripsy) is primarily used to disintegrate urolithiasis, whereas shock wave in orthopedics (orthotripsy) is not used to disintegrate tissues, rather to induce neovascularization, improve blood supply and tissue regeneration. The application of shock wave therapy in certain musculoskeletal disorders has been around for approximately 15 years, and the success rate in non-union of long bone fracture, calcifying tendonitis of the shoulder, lateral epicondylitis of the elbow and proximal plantar fasciitis ranged from 65% to 91%. The complications are low and negligible. Recently, shock wave therapy was extended to treat other conditions including avascular necrosis of femoral head, patellar tendonitis (jumper's knee), osteochondritis dessicans and non-calcifying tendonitis of the shoulder. Shock wave therapy is a novel therapeutic modality without the need of surgery and surgical risks as well as surgical pain. It is convenient and cost-effective. The exact mechanism of shock wave therapy remains unknown. Based on the results of animal studies in our laboratory, it appears that the mechanism of shock waves first stimulates the early expression of angiogenesis-related growth factors including eNOS (endothelial nitric oxide synthase), VEGF (vessel endothelial growth factor) and PCNA (proliferating cell nuclear antigen), then induces the ingrowth of neovascularization that improves blood supply and increases cell proliferation and eventual tissue regeneration to repair tendon or bone tissues. The rise of angiogenic markers occurred in as early as one week and only lasted for approximately 8 weeks, whereas the neovascularization was first noted in 4 weeks and persisted for 12 weeks or longer along with cell proliferation. These findings support the clinical observation that the effect of shock wave therapy appears to be dose-dependent and symptom improvement with time. Additional information including the cellular and molecular changes after shock wave therapy are needed for further clarification on the mechanism of shock wave therapy in musculoskeletal system.
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PMID:An overview of shock wave therapy in musculoskeletal disorders. 1284 21

We report a case of 2,8-dihydroxyadenine (DHA) urolithiasis in a 28-year old female. She was admitted to our hospital complaining of a sudden pain in the left lumbar region. Abdominal X-ray (kidney-ureter-bladder; KUB) and computed tomography (CT) demonstrated a radiolucent left ureteral (8 x 6 mm2) and a renal (15 x 10 mm2) stone. In the repetitive procedure of transurethral ureterolithothripsy (TUL) and extracorporeal shock wave lithotripsy (ESWL), the stones had been removed successfully. The spectrophotometric analysis of the stone fragments revealed an absorption spectrum for 2,8-DHA. Adenine phosphoribosyltransferase (APRT) enzyme activity was lowered to 0.8 nmol/hr/mg protein. Thus, we diagnosed the illness as 2,8-DHA urolithiasis originating from APRT deficiency. A molecular analysis of the APRT gene by the polymerase chain reaction (PCR) method revealed the genotype to be APRT*J/APRT*Q0.
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PMID:[2,8-dihydoroxyadenine (DHA) urolithiasis: a case report]. 1451 91

OBJECTIVE: To analyze the clinical history and evolution of children and adolescents with IH, emphasizing some of their peculiar features. METHODS: We followed 471 patients with IH at an outpatient clinic. Patients were submitted to the following protocol: abdominal X-ray, kidney and urinary tract ultrasonography; urinary ionogram, blood gas and biochemical analyses; 24-hour urine for measurement of calcium and other electrolytes and creatinine; urinalysis, urine culture and phase-contrast microscopy; second morning urine collected after fasting for measurement of calcium and creatinine. RESULTS: At the time of diagnosis, 6% of the patients were infants, 15% pre-school children, 55% school children, and 24% adolescents; 56% of them were boys. Clinical and laboratory findings were: 47% had hematuria and abdominal pain, 31% had isolated hematuria, 14% isolated abdominal pain, and 8% had urinary tract infection, nocturnal enuresis, suprapubic pain or urethralgia, or the frequency/urgency syndrome with urinary incontinence. Hypercalciuria was associated with urolithiasis in 56% of patients. There was association with hyperuricosuria in 18.5% of the cases, and hypocitraturia in 8.5% of the cases. Evolution was poor for 33% of the patients, with recurrence of nephrolithiasis, persistence of hematuria, and abdominal pain. CONCLUSIONS: IH must be diagnosed and treated with criteria in order to reduce consequences such as hematuria, abdominal pain, urinary stone formation and possible bone involvement. Signs and symptoms such as urgency and urinary incontinence, suprapubic pain and nocturnal enuresis may result from renal hyperexcretion of calcium.
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PMID:[Idiopathic hypercalciuria: presentation of 471 cases] 1464 99

Massive urolithiasis of the penile urethra was observed in an adult pygmy sperm whale (Kogia breviceps) stranded on Topsail Island, North Carolina, USA. Calculi occupied the urethra from just distal to the sigmoid flexure to the tip of the penis for a length of 43 cm. A urethral diverticulum was present proximal to the calculi. The major portion of the multinodular urolith weighed 208 g and was 16 cm long x 3.7 cm diameter at the widest point. The urolith was composed of 100% struvite (magnesium ammonium phosphate) and on culture yielded Klebsiella oxytoca, a urease-positive bacterium occasionally associated with struvite urolith formation in domestic animals. Reaction to the calculi was characterized histologically by moderate multifocal to coalescing plasmacytic balanitis and penile urethritis. Role of the urethrolithiasis in the whale's stranding is speculative but could have involved pain or metabolic perturbations such as uremia or hyperammonemia.
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PMID:Struvite penile urethrolithiasis in a pygmy sperm whale (Kogia breviceps). 1546 32

This study was conducted to evaluate the etiological and clinical characteristics of urolithiasis in Iraqi children. From 1999 to 2004, 204 children with renal calculi were evaluated. The age range of the patients was 4 months to 14 years, 61.3% of the patients were under 5 years. Male to female ratio was 2.8:1. The mean age at onset of symptoms was 3.2 years, and stone disease was diagnosed at a mean of 3.5 years. Hematuria (44.6%) and pain (28.4%) were the main clinical presentation. Of the 204 patients 45.1% had a family history of stones. Consanguinity was recorded in 72%; 75.5% had metabolic disorders. Stones were located at multiple sites in 80 patients, or 39.2%; 58 of these 80, or 72.5%, had metabolic disorders. Multiple stones were present in 47 (23%); 72.3% were related to metabolic disorders. In 126 patients, or 61.8%, both kidneys were involved equally. Bladder stones were found in 11.3%. Staghorn calculi occurred in 29 patients, or 14.2%; 27 of these had recurrent urinary tract infection (UTI). Nephrocalcinosis was diagnosed in 7, or 3.4%; all had metabolic disorders. Etiology of stone formation was established in 189 patients, or 92.6%, whereas 15, or 7.4%, had idiopathic stones. Metabolic disorders were the commonest cause in 106 patients (52%); 52 patients were classified as infective (25.5%). Anatomical defects were present in 25 (12.2%) and 6 children (2.9%) with primary endemic bladder calculi. Coexisting UTI was common (36.8%) in the metabolic group. We concluded that urolithiasis is a serious problem among Iraqi children, with early onset of presentation. Metabolic disorders were the major causes, but can be masked by associated UTI. Proper management of UTI with a careful metabolic assessment of young stone formers is valuable in combating urolithiasis.
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PMID:Etiological and clinical patterns of childhood urolithiasis in Iraq. 1601 May 96

Ten clinical cases of neuromuscular dysplasia of the ureter (NMDU) are reported. Eight patients were young (24-38 years), two--of the middle age (41-58 years). NMDU was bilateral in two patients. Ureteral achalasia of the congenital solitary kidney occured in one case. One 28-year-old female with megaureter of the solitary kidney had interstitial cystitis. Clinical picture of the disease was characterized primarily with acute pyelonephritis, pain and secondary urolithiasis. Surgical treatment consisted in resection of the affected part of the ureter with modeling of the lumen of the latter on the drainage and Boari plastic repair. Bilateral Boari operation was made in 2 patients. In one case of ureteral achalasia and ureterocele direct ureterocystoanastomosis was created with good result. Sigmocystoplasty with transplantation of the solitary kidney ureter into the intestinal transplant was made in the patient with scar contracture of the detrusor and megaureter. Functional result of the operation was good. Complications were registered in 4 patients, 2 of which were reoperated. In nine patients of ten good and satisfactory functional results were obtained.
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PMID:[Surgical treatment of neuromuscular dysplasia of the ureter]. 1609 12

Urethral calculus is a rare form of urolithiasis with an incidence lower than 0.3%. We determined the outcomes of 15 patients with urethral stone, of which 8 were pediatric, including an undiagnosed primary fossa navicularis calculus. Fifteen consecutive male patients, of whom eight were children, with urethral calculi were assessed between 2000 and 2005 with a mean of 19 months' follow-up. All stones were fusiform in shape and solitary. Acute urinary retention, interrupted or weak stream, pain (penile, urethral, perineal) and gross hematuria were the main presenting symptoms in 7 (46.7%), 4 (26.7%), 3 (20%) and 1 (6.6%) patient, respectively. Six of them had accompanying urethral pathologies such as stenosis (primary or with hypospadias) and diverticulum. Two patients were associated with upper urinary tract calculi but none of them secondary to bladder calculi. A 50-year-old patient with a primary urethral stone disease had urethral meatal stenosis accompanied by lifelong lower urinary tract symptoms. Unlike the past reports, urethral stones secondary to bladder calculi were decreasing, especially in the pediatric population. However, the pediatric patients in their first decade are still under risk secondary to the upper urinary tract calculi or the primary ones.
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PMID:Outcomes of urethral calculi patients in an endemic region and an undiagnosed primary fossa navicularis calculus. 1643 90

Crossed renal ectopia its a rare congenital malformation and in most cases it presents with fusion of both kidneys. Patients should be asynptomatic until 4a-5a decade and at that time they unfold urinary infection, urolithiasis, abdominal mass or pain that simulates a gastric disease. We report a case of renal cell carcinoma in a patient with crossed fused renal ectopia, showed in a Scan that was performed for gastric disease suspicion.
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PMID:[Renal cell carcinoma in crossed fused renal ectopia]. 1644 1


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