Investigation of the link between the type and concentrations of heavy metals and other elements in blood and urinary stones and their association to the environmental factors and dietary pattern.

BACKGROUND: Kidney and urinary tract stones are among the most common and important health problems, the prevalence of which is increasing nowadays due to a sedentary lifestyle, improper nutrition, destructive habits in fluid consumption, and improper use of medications. One of the causing factors in the formation of urinary stones is heavy metals. These metals present in tiny amounts in the environment and enter the nature and food cycle due to industrial activities and practices that are not compliant with environmental laws. METHODS: In this context, the present case-control study was conducted to determine the concentrations of heavy metals and other urinary stone-forming elements in both blood and urinary stones and investigate their relationship with environmental factors and dietary patterns in people with urinary stones in Ardabil city in 2022. The sampling of blood and urinary stones was done randomly from patients with urinary stones who were admitted to the Urology Clinic of Imam Reza Hospital, Ardabil. ICP-MS was used to measure the concentrations of heavy metals in the samples. The obtained data were analysed by chi-square test, ANOVA test, t-test, and Tukey test. RESULTS: The body mass index (BMI) was 27.39 ± 3.72 in the case group and 26.37 ± 2.95 in the control group. The copper and selenium concentrations in blood and urinary stones were higher than in other metals. There was a significant relationship between the history of kidney stones and the probability of developing kidney stones. Moreover, a meaningful relationship was found between the concentration of lead element and the formation of kidney stones. The results showed a significant difference in the concentration of nickel and copper in people who consumed vegetables on a daily basis with those with different types of kidney stones. CONCLUSION: The comparison amongst the concentration of heavy metals in various kinds of urinary stones showed that the amount of lead metal was higher in calcium phosphate stones than in calcium oxalate stones.

Protective Effect of Wharton's Jelly-derived Mesenchymal Stem Cells on Renal Fibrosis in Rats with Unilateral Ureteral Obstruction.

BACKGROUND: Renal failure is a global medical problem. The use of mesenchymal stem cells (MSCs) for preservation and regeneration of renal tissue in acute and chronic kidney diseases has recently been the focus of investigation. OBJECTIVE: To evaluate the protective effect of MSC injections in a rat model of kidney obstruction. DESIGN SETTING AND PARTICIPANTS: We assigned 15 male Wistar rats to three separate groups: the normal group underwent left nephrectomy; the control group underwent laparotomy and left ureter ligation followed by saline injection into the aorta; and the study group received MSCs injected into the aorta inferior to the left renal artery after ligation of the left ureter. Kidneys were harvested 4 wk later and renal parenchyma samples were used for trichrome staining and for expression analyses. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The degree of kidney fibrosis was assessed on pathology. Real-time polymerase chain reaction was used to determine expression levels of VEGF, TNF-α, and E-cadherin, and ΔCT and ΔΔCT values were calculated. Data were analyzed using SPSS v19 with paired t tests and nonparametric independent-sample Kruskal-Wallis tests. RESULTS AND LIMITATIONS: Fibrosis in the study group decreased from grade 3 or 4 to grade 1. In the control group, TNF-α expression increased and E-cadherin expression decreased. After MSC injection into obstructed kidneys, TNF-α and E-cadherin expression levels decreased and increased respectively, reaching similar levels to those in the normal group. No correlation between tissue regeneration and VEGF levels was observed. More research is needed to focus on other angiogenic factors. CONCLUSIONS: MSC injection could prevent fibrosis in obstructed rat kidney via alterations in TNF-α and E-cadherin expression. PATIENT SUMMARY: We investigated the effect of stem cell injection in rats with kidney obstruction. The treatment led to changes in the levels of two biomarkers and reduced the amount of kidney fibrosis caused by kidney obstruction.

Role of Chronic Inflammation as a Predictor of Upstaging/Upgrading in Prostate Cancer: Finding a New Group Eligible for Active Surveillance.

PURPOSE: We aimed to investigate the correlation between presence of inflammation and pathology upgrading/upstaging in patients with prostate cancer. MATERIALS AND METHODS: A retrospective study was accomplished on 315 patients with prostate cancer, eligible for active surveillance except prostate-specific antigen (PSA) level (PSA<30ng/dL), who underwent radical prostatectomy between 2005 and 2015. Patients were divided into two groups based on needle biopsy: A; with evidence of inflammation (chronic prostatitis) and B; without inflammation. The frequency of upstaging and upgrading in both groups was compared in different ranges of PSA level (<10, 10-20 and 20-30ng/dL). Upgrading/Upstaging was defined as increase from one prognostic grade group to another. Statistical analyses were performed to investigate the relation between inflammation and upgrading/upstaging. RESULTS: The mean age of the patients was 68.2 years and the mean PSA level was 10.2 ng/mL. Chronic prostatitis was identified in 82 of 315 cases therefore upgrading/upstaging were seen in only three patients (3.7%) while 39 of 233 (16.7%) patients without inflammation had upgrading/upstaging in final pathology (P = 0.003). Other variables including the patient's PSA before surgery, PSA density, and the presence of hypoechoic areas in ultrasound had a significant relationship with the incidence of postoperative upgrading/upstaging. Among studied variables, presence of inflammation in biopsies was found to be the most important predictor of upstaging/upgrading (OR: 0.205). CONCLUSION: Our data demonstrated that patients with concurrent prostatitis and PCa may have a better prognosis even if the PSA level is higher than 10ng/mL.

Radical cystectomy for management of inflammatory myofibroblastic tumor of the urinary bladder: A rare case report.

Inflammatory myofibroblastic tumor (IMT) of the bladder also known as pseudosarcomatous myofibroblastic proliferation is a rare lesion in the genitourinary tract was first described in 1980 by Roth. We herein report a case of urinary bladder IMT in a 42-year-old female patient presented with gross hematuria. The hematuria was difficult to control and radical treatment has been done. Monitoring for recurrence is strongly advisable.