Upper urinary tract stone compositions: the role of age and gender

ABSTRACT Objective: To analyze the compositions of upper urinary tract stones and investigate their distributions in different gender and age groups. Materials and Methods: Patients diagnosed with upper urinary tract stone disease between December 2014 and March 2018 were retrospectively reviewed. Patient's age, gender, BMI, comorbidities, stone event characteristics, and compositions were collected, and proportions of stone components in different gender and age groups were analyzed. Results: A total of 1532 stone analyses were performed (992 from males and 540 from females). The mean age was younger in males (p <0.001). Males included more cases with larger BMI, hyperuricemia, and obesity, while females had more urinary tract infections. Multiple components were present in 61.8% of stones. Calcium oxalate (CaOx) (67.0%) was the most common component, followed by uric acid (UA) (11.8%), infection stone (11.4%), calcium phosphate (CaP) (8.0%), cystine (1.1%), brushite (0.4%), and 2, 8-dihydroxyadenine (0.2%). Men contributed with more CaOx stones than women at age 30-49 years (all p <0.01) and more UA stones at 30-59 years (all p <0.05). Women contributed with more infection stones than men in age groups 30-49 and 60-69 years (all p <0.05), and more CaP stones at 30-49 years. The prevalence peak was 50-59 years in men and 60-69 years in women. Both genders had the lowest prevalence in adolescence. Prevalence of UA stones increased while that of infection stones decreased with aging in both genders. Conclusions: Age and sex had a strong association with distribution of stone compositions in this Chinese cohort.

Caracterização de biocerâmica de fosfatos de cálcio microestruturada em diferentes composições em ovinos / Bioceramic characterization of calcium phosphates microstructured in different composition in sheep

RESUMO: As biocerâmicas microporosas de fosfatos de cálcio e bifásicas de hidroxiapatita e fosfato tricálcico beta (HA/TCP-β) na forma de biomateriais granulados microporosos, são temas de pesquisas e se destacam como substitutos ósseos em aplicações biomédicas. As biocerâmicas bifásicas são biocompatíveis, bioativas, osteoindutoras e promovem a osteointegração, quando aplicados in vivo ou em meio simulado. Outro ponto diferencial dessas biocerâmicas está associado à capacidade de solubilidade que esses biomateriais apresentam quando aplicados em meio biológico, permitindo a liberação gradual de íons cálcio e fosfatos para o meio biológico, estes são absorvíeis e promovem a neoformação de um novo tecido ósseo. As biocerâmicas bifásicas de fosfatos de cálcio também se apresentam promissores em aplicações traumatológicas na reparação do tecido ósseo traumatizado e na liberação controlada de medicamentos, em tratamentos da estrutura óssea. O desempenho desses biomateriais como substitutos ósseos e na liberação controlada de medicamentos, estão associados, as suas características físicas, químicas, morfológicas e de superfície. O objetivo desse estudo foi realizar a caracterização morfológica, microestrutural dos biomateriais pela técnica de microscopia eletrônica de varredura (MEV), física com difratometria de raios X (DRX) e método de Arthur para determinação da porosidade aberta. A densidade teórica dos biomateriais bifásicos foi determinada pelo método teórico das concentrações bifásicas. Por fim, se realizou avaliação do comportamento da neoformação óssea e osteointegração dos diferentes biomateriais de fosfatos de cálcio em testes in vivo em ovinos. Os testes in vivo foram realizados em tíbias de ovinos com tempo de implantação de 03 meses. Os biomateriais implantados foram hidroxiapatita (HA), fosfato tricálcico-β (TCP-β) e composições bifásicas HA/TCP-β nas proporções: 80/20, 20/80, 70/30 e 30/70. Foram utilizadas 08 ovelhas mestiças Texel, com 12 meses de idade e peso médio de 30 kg (±5 kg), nas quais foram produzidos três defeitos ósseos em cada tíbia, sendo que quatro desses defeitos foram preenchidos por biomateriais, e dois por fragmentos ósseos (autoenxerto), grupo controle. Os animais foram eutanasiados aos 03 meses após a implantação dos biomateriais. Após a eutanásia, foram coletadas as tíbias para avaliação com o uso da técnica de microscopia eletrônica de varredura (MEV). Os resultados encontrados mostram que os biomateriais granulados microporosos são formados por uma morfologia irregular com tamanho de grânulos entre 200 μm e 500μm, outra constatação foi microestrutura microporosa interconectada dos biomateriais. O resultado obtido da porosidade aberta mostrou que os biomateriais apresentam porosidade superior a 68%. A densidade teórica se apresentou semelhante entre os biomateriais granulados de fosfatos de cálcio e sugerem boa capacidade de neoformação óssea para todos os biomateriais, sendo que o bifásico 20/80 apresentou absorção do biomaterial e neoformação óssea mais rápida quando comparada com os outros biomateriais avaliados neste estudo.

ABSTRACT: Microporous bioceramics of calcium phosphate and biphasic hydroxyapatite and tricalcium phosphate beta (HA/TCP- β) in the form of microporous granules biomaterials are research subjects and stand out as bone substitutes in biomedical application. The biphasic bioceramics are biocompatible, bioactive, osteoinductive and promote osseointegration when applied in vivo or through simulated. Another aspect of such differential solubility bioceramics is associated with the capacity that these biomaterials exhibit when applied in biological environment, enabling the gradual release of calcium and phosphate ions to the biological environment they are absorbable and promote neogenesis of new bone tissue. The biphasic bioceramics of calcium phosphate also have promising applications in traumatology in the repair of injured bone and controlled release of drugs in the bone structure treatments. The performance of these biomaterials as bone substitutes and controlled release of drugs, are associated, their physical, chemical, morphological and surface. The aim of this study was to make morphological, microstructural of biomaterials by the technique of scanning electron microscopy (SEM), physics with X-ray diffraction (XRD) and Arthur method for determination of open porosity. The theoretical density of biphasic biomaterials was determined by theoretical method of biphasic concentrations. Finally, we conducted evaluation of osteogenesis and osseointegration behavior of different biomaterials of calcium phosphates in vivo tests on sheep. In vivo tests were performed on tibias of sheep up to of 03 months. The biomaterials implanted were hydroxyapatite (HA), tricalcium phosphate-β (β-TCP) and biphasic compositions as HA/TCP-β in rates: 80/20, 20/80, 70/30 and 30/70. Eight crossbred Texel sheep, with 12 months of age and average weight of 30 kg (±5 kg) were used, in which were produced three bone defects in the tibia, four of these defects were filled with biomaterials, and two by bone fragments (autograft), as control group. The animals were euthanized at 03 months after implantation of biomaterials. After euthanasia, the tibias were collected for evaluation using the scanning electron microscopy technique (SEM). The results show that the microporous biomaterial granules are formed by an irregular morphology with grain size between 200 μm and 500μm, another finding was microporous interconnected microstructure of biomaterials. The result showed that the open porosity of the biomaterials exhibit porosity greater than 68%. The theoretical density was relatively similar between the granulates biomaterials of calcium phosphates and suggest good capacity of osteogenesis for all biomaterials, with the biphasic absorption of the biomaterial introduced 20/80 and more rapid bone formation when compared with other biomaterials evaluated in study.

Biocompósitos eletrofiados de PLLA com alto conteúdo de partículas de fosfatos de cálcio funcionalizados para regeneração óssea / Electrospun PLLA biocomposites with high content of calcium phosphates functionalized for bone regeneration

Este trabalho visou a produção de suportes para crescimento celular constituídos de compósitos de poli(L-lactídeo) (PLLA) e diversos tipos de fosfatos de cálcio (CaP). A hidroxiapatita deficiente em cálcio (HAD) e o fosfato octacálcico (OCP) em tamanhos submicrométricos foram sintetizados. Hidroxiapatita (HA) e o ß-fosfato tricálcico (ß-TCP) foram adquiridos da Sigma-Aldrich. Uma mistura de HAD:ß-TCP (7:3) também foi preparada. Para melhorar a dispersão da fase mineral em uma matriz polimérica de PLLA, utilizou-se cloreto de lauroíla para funcionalizar a superfície dos CaP. Os espectros de infravermelho e a análise termogravimétrica confirmaram a presença de laurato na superfície de partículas de CaP. As partículas de HA pura também foram funcionalizadas com cloreto de lauroíla para fins comparativos. Compósitos de PLLA/CaP-laurato foram fabricados utilizando a técnica de eletrofiação. A funcionalização da superfície do CaP com laurato resultou em uma melhoria significativa na dispersão de partículas de CaP na matriz polimérica, permitindo a inclusão de até 40% da fase mineral sem comprometer as propriedades mecânicas. Microscopia eletrônica de varredura (SEM) e microscopia eletrônica de transmissão (TEM) foram utilizadas para investigar a morfologia da fibra. A perda de massa e a liberação de cálcio dos suportes durante a degradação em uma solução salina tamponada com fosfato (PBS) foram medidas. HAD e OCP se mostraram ser mais solúveis do que HA e HAD:ß-TCP (7:3). A bioatividade dos compósitos foi investigada por imersão das fibras em um fluido corporal simulado (SBF) a 37 °C e pH 7.4. Embora todos os suportes de PLLA/CaP-laurato foram capazes de formar uma camada de apatita em sua superfície após a exposição em SBF, os resultados demonstraram um aumento significativo na mineralização quando HAD, OCP e HAD:ß-TCP (7:3) são a fase mineral no compósito em vez da HA. Além disso, malhas produzidas a partir das fibras eletrofiadas de PLLA/CaP-laurato, utilizadas como suporte para crescimento celular, favoreceram a adesão e proliferação de células de fibroblastos de camundongo (NIH-3T3) e células tronco mesenquimais de dentes decíduos humanos (SHED). Finalmente, suportes a partir das malhas PLLA/HAD-laurato e PLLA/OCP-laurato apresentaram melhor desempenho para acelerar a calcificação in vitro como resultado da osteoindução de células SHED e de células pré-osteoblásticas derivadas de calvária de rato (MC3T3-E1) se comparados aqueles contendo HA e HAD:ß-TCP (7:3). Esses novos materiais são propostos como biocompósitos de rápida degradação de CaP, para serem utilizados em aplicações de regeneração óssea em ortodontia e ortopedia

This work aimed at the generation of scaffolds for cellular growth constituted by poly(L-lactide) (PLLA) and several types of calcium phosphate (CaP). Calcium deficient hydroxyapatite (HAD) and octacalcium phosphate (OCP) were synthesized in submicrometer sizes. Hydroxyapatite (HA) and ß-tricalcium phosphate (ß-TCP) were purchased from Sigma-Aldrich. A mixture of HAD:ß-TCP (7:3) also was prepared. In order to improve the dispersion of the mineral phase in a PLLA polymeric matrix, lauroyl chloride was used to functionalize the surface of CaP. Infrared spectra and thermal gravimetric analysis confirmed the presence of laurate on the surface of CaP particles. Neat HA particles were also functionalized with lauryl chloride for comparative purposes. Composites of PLLA/CaP-laurate were fabricated by electrospinning method. The functionalization of CaP surfaces resulted in significant improvement of the dispersion of CaP particles into the polymeric matrix, allowing inclusion of up to 40% of mineral phase without compromising its mechanical properties. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were employed to investigate the morphology of the fibers. The mass loss and calcium release of the scaffolds during degradation in phosphate buffered saline (PBS) were measured. HAD and OCP are more soluble than HA and HAD:ß-TCP (7:3). The bioactivity of the composites was investigated by immersing the fibers in a simulated body fluid (SBF) at 37°C and pH 7.4. Although all PLLA/CaP-laurate can form apatite precipitation on their surface after exposition to SBF, the results demonstrate a significant enhancement in the mineralization when HAD, OCP and HAD:ß-TCP (7:3) are the mineral phase in the composite instead of HA. Furthermore, mats obtained from PLLA/CaP-laurate electrospun fibers favored the mouse fibroblast cells (NIH-3T3) and stem cells from human exfoliated deciduous teeth (SHED) attachment and proliferation. Finally, PLLA/HAD-laurate and PLLA/OCP-laurate meshes showed better performance in accelerate the calcium phosphate mineralization on its surface as a result of the in vitro osteoinduction of SHEDs and calvaria derived mouse preosteoblastic cells (MC3T3-E1) if compared of those containing HA and HAD:ß-TCP (7:3). These new materials are proposed as fast degradation CaP biocomposites to be used in bone regeneration applications in orthodontics and orthopedics

Sterilisation effect study on granular hydroxyapatite (HA)

Hydroxyapatite is a calcium phosphate bioceramic that has been shown by many authors to be biocompatible with bioactive properties. It is widely accepted as the best synthetic material available for surgical use as a bone graft substitute. HA granules produced by AMREC-SIRIM from local materials underwent 5 types of sterilisation techniques with different ageing periods. Samples were tested for chemical and phase composition and microbial contamination before and after being sterilised. From the microbiological tests done, none of the unsterilised positive control yielded a positive culture. Results from X-Ray diffraction studies found that all the sterilisation techniques did not chemically degrade or structurally change the HA granules significantly.

Biochemical and bacteriological study of urinary calculi.

Biochemical and bacteriological study of urine, nidus and chemical analysis of 100 calculi from 100 patients admitted in the Regional Institute of Medical Sciences, Imphal from November, 1997 to October 1999 were done. About 47% of the cases had positive urine culture and nidus culture. Escherichia coli was the commonest bacteria isolated both in the urine and nidus of calculi. The commonest radical present in the calculi was calcium while the rarest was uric acid. The stones were composed mainly of calcium oxalate and/or phosphate followed by struvite, then mixed stone.

Calcium and phosphate solubility curves for parenteral nutrient solutions containing Vaminolact.

Calcium and phosphate incompatibility in the total parenteral nutrient (TPN) solutions is a common problem especially in neonates. Their combinations in TPN admixture must be tested before use. We here investigated the compatibility of calcium and phosphate in TPN solutions containing a newborn amino acid product, Vaminolact. The TPN test-solutions contained 10 per cent dextrose, 1, 2, or 3 per cent Vaminolact, 4 mmole/L of magnesium sulphate and various combinations of calcium gluconate and dipotassium phosphate. Precipitations and crystallizations were inspected visually and microscopically after 24 hours standing at room temperature. Solubility curves were made by plotting the maximum concentrations of calcium and phosphate at which both were still compatible in the solution. Such curves are extremely helpful for clinicians and pharmacists to administer maximum calcium and phosphate dose for individual patient requirement.

Chemical components of gallstone in southern Thailand.

The gallstones from 55 patients in Southern Thailand were analyzed to disclose the chemical components using infrared grating spectrophotometry. The main components were calcium bilirubinate, calcium phosphate, calcium carbonate, choleterol and protein inproportions 52.6, 5.5, 5.5, 30.9 and 5.5 per cent of stones, respectively. These proportions are not different from those of gallstones in the northern or central regions of Thailand.

Análisis de cálculos urinarios por el método de espectroscopía de rayos infrarrojos / Urinary calculi analysis by infrared spectroscopy technique

Se analizaron 437 cáclculos por el método de espectroscopia de rayos infrarrojos, los principales componentes químicos encontrados fueron: oxalato de calcio, oxalato y fosfato de calcio, ácido úrico, fosfato amónico magnésico y fosfato de calcio. El método utilizado es uno de los más recomendables para el análisis de estos cálculos en un laboratorio clínico, por lo que se debe descartar el método químico cualitativo, pues sus resultados no son confiables

Cálculos urinarios en habitantes de la ciudad de Antofagasta: identificación y prevalencia quimica / Urinary calculi in the inhabitants of the city of antofagasta: chemical identification and prevalence

En formación de los cálculos en el riños y vías urinarias, influyen, entre otras causas, la dieta, agua, condiciones climáticas y ubicación geográfica. Estos cálculos pueden ser desde arenilla fácilmente eliminables a grandes núcleos, generalmente únicos. Pueden estar formados por uno o más compuestos químicos, estando descrito Oxalato de Calcio, Fosforo de Calcio y Acido Urico entro los más frecuentemente encontrados. En este trabajo se estudia la identificación y prevalencia química de los cálculos de vías urinarias de los habitantes de la ciudad de Antofagsta. Para tal efecto, se analizaron químicamente 43 cálculos urinarios, provenientes tanto de hombres como de mujeres, por método de SIMMONS y GENTZKO, 1944, los cuales se recolectaron en el Hospital Dr Leonardo Guzmán de Antofogasta y en Clínicas privadas de la ciudad, desde enero de 1983 a enero de 1985. De acuerdo a los resultados obtenidos se postula que la mayor incidencia química en la composición de los cálculos urinarios de los habitantes de la ciudad de Antofagsta corresponde a Fosforo de Calcio y Oxalato de Calcio