Liver concentrations of copper, zinc, iron and molybdenum in sheep and goats from northern Greece, determined by energy-dispersive X-ray fluorescence spectrometry.

Energy-dispersive X-Ray fluorescence spectrometry was used to determine the concentrations of copper (Cu), zinc, iron and molybdenum in the liver of 76 sheep and goats from the regions of Macedonia-Thrace, northern Greece. In general, metal concentrations were in the adequate range, with one main exception of Cu-deficiency observed in all of the examined goat liver samples and Cu-toxicity found in 4 % of the sheep liver samples. One-way analysis of variance was carried out to determine significant differences among means depending on animal species, sex and age. Pearson correlation analysis was used to explore correlations between metal concentrations. The results obtained in the present study are discussed in the framework of diagnostic ranges, suggested for classifying the metal status of sheep and goats, and are compared with liver metal concentrations reported world-wide.

Two-step minipercutaneous ureterolithotripsy under multimodal analgesia for complicated impacted calculi in proximal ureter.

OBJECTIVE: To suggest minipercutaneous ureterolithotripsy using the mininephroscope as an alternative process for impacted stones of the upper ureter because these stones can be challenging to treat and can produce severe symptoms. MATERIALS AND METHODS: We report our results of cases in which the percutaneous approach using 2-step minipercutaneous ureteroscopy with the mininephroscope was used to achieve relief from the stone, with minimal anesthesia risks. A total of 54 patients (33 men and 21 women) presented with impacted stones in the proximal ureter. The mean stone size was 16.2 mm (range 10-21). All patients were treated with 2-step minipercutaneous antegrade ureterolithotripsy under multimodal analgesia. RESULTS: The mean operative time was 49 minutes (range 40-110). Placement of the percutaneous drainage tube was quick and was performed with the patient under local anesthesia. The minipercutaneous session followed several days later, with the patient under multimodal anesthesia. The initial stone-free rate was 94%. The stone-free rate 2 months after the procedure was 100%. All procedures were well tolerated by the patients (group mean visual analog scale score 3.1 ± 0.7 standard deviation). No severe adverse events were noted. The mean hospital stay was 5.3 days (range 3-12). CONCLUSION: In selected emergency cases of impacted proximal ureteral stones, the approach of the initial insertion of a nephrostomy tube followed by a second session of antegrade ureterolithotripsy using the mininephroscope is a safe and effective alternative treatment, especially, because it can be accomplished with minimal anesthesia requirements.