Protocolo de manejo metabólico multidisciplinario de la litiasis urinaria

La enfermedad de cálculos renales, (nefrolitiasis) es un problema común en la atención en salud. Entre algunos de los factores que ayudan a la prevalencia de litiasis se encuentra la obesidad, altas temperaturas ambientales, y los climas secos. La frecuencia de las diferentes composiciones de los cálculos es: Oxalato de calcio entre el 70-80 %, fosfato calcico el 15 % (la apatita es más común y la brushita es menos común), Ácido úrico el 8%, cistina entre el 1-2 %, Estruvita -1%, Varios - <1 %3.No existen muchos datos sobre la recurrencia de los mismos, pero se sabe que la tasa de recurrencia de litiasis urinaria es del 10 al 30% a los 5 años en pacientes que tienen cálculos de oxalato de calcio idiopáticos. Se plantea elaborar un protocolo de manejo metabólico multidisciplinario de la litiasis urinaria en base a la bibliografía actual tomando en cuanto los puntos de vistas de las especialidades destinadas al manejo del paciente con litiasis urinaria. Nuestro objetivo es establecer un protocolo de manejo capaz de identificar y establecer una terapia que pueda prevenir los cálculos urinarios de forma eficiente y económica, mejorando el pronóstico y minimizando las complicaciones.

Kidney stone disease is a common problem in health care. Among the factors that contribute to the prevalence of lithiasis are obesity, high environmental temperatures, and dry climates. The frequency of the different stone compositions is: Calcium Oxalate 70-80%, Calcium Phosphate -15% (Apatite is more common and Brushite is less common), Uric Acid 8%, Cystine - 1-2%, Struvite -1%, Various - <1%3. There are not many data on their recurrence, but it is known that the recurrence rate of urinary lithiasis is 10 to 30% at 5 years in patients with idiopathic calcium oxalate stones. It is proposed to develop a multidisciplinary metabolic management protocol for urinary lithiasis based on the current bibliography, taking the point of specialties dedicated to the management of patients with urinary lithiasis. Our goal is to establish a management protocol capable of identifying and establishing a therapy that can efficiently and economically prevent urinary stones, improving prognosis and minimizing complications.

Secondary oxalate nephropathy complicated with acute kidney injury: a report of two cases and literature review / 中华肾脏病杂志

Acute kidney injury (AKI) caused by oxalate nephropathy is one of the reasons which is easy to be ignored in clinic. The paper reported two cases of secondary oxalate nephropathy complicated by AKI confirmed by renal biopsy, and renal function recovered in patients with active treatment. The literatures on oxalate nephropathy were reviewed to improve clinicians' understanding of oxalate nephropathy.

Neurosensory analysis of tooth sensitivity during at-home dental bleaching: a randomized clinical trial

Abstract Objective The objective of this study was to evaluate dental sensitivity using visual analogue scale, a Computerized Visual Analogue Scale (CoVAS) and a neurosensory analyzer (TSA II) during at-home bleaching with 10% carbamide peroxide, with and without potassium oxalate. Materials and Methods Power Bleaching 10% containing potassium oxalate was used on one maxillary hemi-arch of the 25 volunteers, and Opalescence 10% was used on the opposite hemi-arch. Bleaching agents were used daily for 3 weeks. Analysis was performed before treatment, 24 hours later, 7, 14, and 21 days after the start of the treatment, and 7 days after its conclusion. The spontaneous tooth sensitivity was evaluated using the visual analogue scale and the sensitivity caused by a continuous 0°C stimulus was analyzed using CoVAS. The cold sensation threshold was also analyzed using the TSA II. The temperatures obtained were statistically analyzed using ANOVA and Tukey's test (α=5%). Results The data obtained with the other methods were also analyzed. 24 hours, 7 and 14 days before the beginning of the treatment, over 20% of the teeth presented spontaneous sensitivity, the normal condition was restored after the end of the treatment. Regarding the cold sensation temperatures, both products sensitized the teeth (p<0.05) and no differences were detected between the products in each period (p>0.05). In addition, when they were compared using CoVAS, Power Bleaching caused the highest levels of sensitivity in all study periods, with the exception of the 14th day of treatment. Conclusion We concluded that the bleaching treatment sensitized the teeth and the product with potassium oxalate was not able to modulate tooth sensitivity.

Analysis of the renal calculus composition and urine physical and chemical indexes / 中华检验医学杂志

Objective To explore the proportion of different types of stones in patients with kidney stones in Xinjiang, and to analyze the relationship between stone composition and urine physicochemical properties and protein composition.Methods Through a case-control study, 355 patients with kidney stones who were hospitalized in the Xinjiang Uygur Autonomous Region People′s Hospital from March to November 2010 were enrolled in the same period, and non-urinary tract diseases were hospitalized and excluded from other diseases or complications of the 30 cases of renal impairment in the control group.The composition of the stones was analyzed.The main components of the stones were divided into oxalate group, carbonic acid group, uric acid group and phosphate group.The physicochemical properties and protein composition of 24 h urine were analyzed by ion selective electrode method, enzymatic and immunoturbidimetric assay.The difference between the two samples was analyzed by t test, and the differences between the two groups were analyzed by F-test and LSD-t test.Results Compared with the control group(30 cases), urine pH(5.33±0.32) was significantly lower in the oxalate group (244 cases), 24 h urinary calcium and 24 h uric acid[(7.68±0.35) mmol, (3.48±0.23)mmol (pH=5.874,P9.436, P8.442,P<0.05).Conclusion There may be a correlation between renal stone composition with urine metabolic changes.

Peanut-induced acute oxalate nephropathy with acute kidney injury

Oxalate nephropathy is commonly caused by ethylene glycol, vitamin C, and foods like star fruit that contain a lot of oxalate. Peanuts also have high oxalate contents. However, case reports of peanut-induced oxalate nephropathy are not common. Here, we describe a case of peanut-induced acute oxalate nephropathy with acute kidney injury and intend to demonstrate the conditions under which peanut-induced oxalate nephropathy is likely to occur.

Effect of processing methods on some nutrients, antinutrients and toxic substances in amaranthus cruentus.

The presence of antinutrients and toxic substances severely limits the nutritional benefits of vegetables. The objective of this study was to assess the effects of processing methods on some of these substances. Effects of boiling and sun drying on oxalate, cyanide and nitrate, vitamin C, β-carotene, and the mineral elements Fe, Cu, Mg, Na and K in Amaranthus cruentus were investigated. Both methods significantly (p < 0.05) reduced oxalate, cyanide and nitrate levels. Vitamin C content was significantly (p < 0.05) decreased. β-carotene level increased on boiling but was reduced in sundried vegetable. Boiling exceeding 5 minutes significantly (p < 0.05) reduced β-carotene level. The mineral elements decreased upon boiling but sun drying had no significant effect on their levels. We conclude that both methods are effective means of reducing the levels of antinutrients and toxic substances in Amaranthus cruentus to tolerable levels with boiling being a better method.

Effect of deproteinization and tubular occlusion on microtensile bond strength and marginal microleakage of resin composite restorations

Dentin adhesion procedure presents limitations, especially regarding to lifetime stability of formed hybrid layer. Alternative procedures have been studied in order to improve adhesion to dentin. OBJECTIVE: The aim of this study was to evaluate in vitro the influence of deproteinization or dentin tubular occlusion, as well as the combination of both techniques, on microtensile bond strength (µTBS) and marginal microleakage of composite resin restorations. MATERIAL AND METHODS: Extracted erupted human third molars were randomly divided into 4 groups. Dentin surfaces were treated with one of the following procedures: (A) 35 percent phosphoric acid gel (PA) + adhesive system (AS); (B) PA + 10 percent NaOCl + AS; (C) PA + oxalate + AS and (D) PA + oxalate + 10 percent NaOCl + AS. Bond strength data were analyzed statistically by two-way ANOVA and Tukey's test. The microleakage scores were analyzed using Kruskal-Wallis and Mann-Whitney non-parametric tests. Significance level was set at 0.05 for all analyses. RESULTS: µTBS data presented statistically lower values for groups D and B, ranking data as A>C>B>D. The use of oxalic acid resulted in microleakage reduction along the tooth/restoration interface, being significant when used alone. On the other hand, the use of 10 percent NaOCl alone or in combination with oxalic acid, resulted in increased microleakage. CONCLUSIONS: Dentin deproteinization with 10 percent NaOCl or in combination with oxalate significantly compromised both the adhesive bond strength and the microleakage at interface. Tubular occlusion prior to adhesive system application seems to be a useful technique to reduce marginal microleakage.

Development of Yvrk Gene-Recombinant E. coli Degrading Oxalate

PURPOSE: Recently, the whole DNA sequence of Bacillus subtilis (B. subtilis) was identified, revealing the existence of the YvrK gene encoding a 43 kD oxalate decarboxylase (OXDC), which degrades oxalate by a simple pathway. The objective of this study was to develop recombinant Escherichia coli (E. coli) expressing the Yvrk gene from B. subtilis. MATERIALS AND METHODS: After the extraction of total DNA from B. subtilis, the YvrK gene was cloned by polymerase chain reaction. The cloned DNA encoding OXDC was inserted into the pBAD/gIII-A vector, downstream of the L-arabinose promotor. The plasmid vector was transformed into TOP 10 E. coli, and the transformants were selected with ampicillin. The recombinant E. coli, named pBy, was then analyzed by DNA sequencing and Western blot. To evaluate the oxalate-degrading function of pBy, pBy was cultured in LB broth containing oxalate, and then the amount of oxalate in the medium was assessed. The oxalate-degrading activity of homogenates of pBy was evaluated. RESULTS: DNA sequencing showed the successful transformation of the YvrK gene into TOP 10 E. coli. Western blot analyses showed that pBy expressed OXDC. pBy removed oxalate during the overnight culture in oxalate-containing LB broth, and the homogenate of pBy degraded 90% of oxalate under acidic conditions. CONCLUSIONS: A recombinant E. coli expressing the YvrK gene was successfully produced. The bacteria showed potent oxalate-degrading activity. The results of this study will provide a solution to the treatment of calcium oxalate stones and hyperoxaluria, for which there are few medical treatment modalities.

Effect of vitamin K3 decreasing the urine oxalate excretion in rats / 中华泌尿外科杂志

Objective To investigate the effect of vitamin K3 decreasing the urine oxalate excretion in rats. Methods A total of 80 male Sprague-Dawley rats (body weight, 200-250g) were randomly divided into 8 groups, ie, control group, only vitamin K3 group, stone forming group, stone forming plus 4.0、3.0、2.0、0.8、0.4mg/d Vit K3 group. Each group is 10 rats respectively. The change of urine oxalate was observed. Results Vitamin K3 can reduce the 24h urine oxalate excretion in stone-forming group rats, but there were no effects in control group rats(P