Urolithiasis in Italy: an epidemiological study.

OBJECTIVES: Worldwide the urolithiasis is the third most frequent urological disease affecting both males and females. In literature there are not recent Italian epidemiological data about stone disease. The objective of this study is the evaluation of current epidemiology of urolithiasis in Italy using the Health Search/CSD Longitudinal Patient Database (HS) database. MATERIAL AND METHODS: An observational, descriptive, retrospective trial was conducted. Inclusion criteria were: family physician- assisted Italian living population member of HS database within 31 December 2012, both genders, age over 17 years, at least two years of clinical history recorded from the beginning the trial. Data were collected by HS database and elaborated by its software Millewin®. RESULTS: In Italy prevalence of urolithiasis in 2012 was 4.14%, it was higher in males than in females (4.53% versus 3.78%) with a positive relation with increasing age. The highest prevalence rate of urolithiasis was reported in the region Campania (6.08%). The general incidence was 2.23 * 1000, with the highest incidence in the region Sicilia (3.15 * 1000). Incidence was higher in group age 65-74 years (3.18 * 1000). CONCLUSIONS: In Italy the incidence and prevalence of urolithiasis is increasing with particular distribution in relation to gender, age and regional position.

Serum fetuin-A and recurrent urolithiasis in young adults.

OBJECTIVE: Recurrence of urolithiasis is frequent. There are no reliable markers able to indicate recurrent stone former patients. Fetuin-A inhibits hydroxyapatite crystals formation and expansion. This study aims at evaluating whether serum fetuin-A may predict recurrent urolithiasis in young adults. MATERIALS AND METHODS: This is a multicentre study. Young adults patients with recurrent urolithiasis attending 3 urology clinics were enrolled from July 2011 to December 2012. Inclusion criteria were: age 18-40 years, presence of more than one kidney stone. Exclusion criteria were: diabetes mellitus, metabolic disorders, obesity, hypertension, cardiovascular disease, infection diseases. Controls were participants without history of urolithiasis and currently undetected stones. Routine biochemistry, serum concentration of oxalate, fetuin-A, and parathyroid hormone (PTH) were assessed; 24/h urinary excretion of creatinine, uric acid, calcium, sodium, phosphorus, potassium, magnesium, glucose, oxalate, amylase, and protein was measured. Kidney ultrasonography and plain X-ray examination was performed. RESULTS: The total cohort was represented by 120 young adults participants (90 patients, and 30 controls). Clinical characteristics were not different between patients and controls. No significant differences were found in serum concentrations as well as in 24/h urinary excretion of recorded variables. No significant difference was found in serum concentration of fetuin-A (median 35.1 ± 18.62 SD Vs 35.12 ± 14.12, µg/ml; p = 0,908). CONCLUSIONS: The data of present study do not substantiate the hypothesis that serum fetuin-A may be a reliable predictor of recurrent urolithiasis in young adults.

Changes in genetic structure of Posidonia oceanica at Monterosso al Mare (Ligurian Sea) and its resilience over a decade (1998-2009).

Genetic differences in the Posidonia oceanica meadow of Monterosso al Mare (NW Mediterranean, Marine Protected Areas (MPAs) "Cinque Terre") were compared in three stations, at an increasing distance from a source of impact (beach nourishment) in the recent decade. Random amplified polymorphic DNA analysis showed a higher genetic variability (>20 %) in the area directly subjected to the stress, increasing with time. Clone integration, confirmed by phenotypic analysis, showed increases both in shoot density and leaf length connected to genetic differences observed in DNA fingerprints of new shoots. Analysis of molecular variance (AMOVA) showed 45 % individual differences within populations and 54 % among the populations. The fixation index (F (ST) = 0.54), of the genetic differentiation, showed a marked difference between the populations at different temporal scales. Over a decade AMOVA indicated genetic variations from 28 % (1998) to 54 % (2009). These results make it clear that in the P. oceanica population examined the environment had, in ten years, selected those clones which were more resistant to the anthropogenic impact, despite being subjected to the effects of the resuspension of fine sediments. These findings could help to explain both the survival of the regressed Mediterranean P. oceanica meadows in areas subjected to moderate impacts and the extreme variability in success of revegetation experiments. Management of the ecological disturbance here described indicates also the timescale in population response to stress and its increased resilience in MPAs.

Ecosystem functioning approach applied to a large contaminated coastal site: the study case of the Mar Piccolo of Taranto (Ionian Sea).

Knowledge on ecosystem functioning can largely contribute to promote ecosystem-based management and its application. The Mar Piccolo of Taranto is a densely populated area at a high risk of environmental crisis. Here, planktonic primary production (PP) and heterotrophic prokaryotic production (HPP) were measured as proxies of functioning in three sampling sites located in two inlets at different levels of industrial contamination, during three sampling surveys (June 2013, February and April 2014). To have a better overall view and provide some insights into the benthic-pelagic coupling, we integrated PP and HPP in the water column with those in the sediments and then discussed this with the origin of the organic matter pools based on analysis of stable isotopes. Heavy metals and polychlorobiphenyls (PCBs) were also analysed in the surface (1 cm) sediment layer and related to the overall ecosystem functioning. Multidimensional scaling (MDS) analysis, based on the main data, clearly separated the second inlet from the first one, more severely impacted by anthropogenic activities. The stable isotope mixing model suggested the prevalent terrestrial/riverine origin of the particulate organic matter pools (mean 45.5 %) in all sampling periods, whereas phytoplankton contributed up to 29 % in February. Planktonic PP and HPP rates followed the same pattern over the entire study period and seemed to respond to phytoplankton dynamics confirming this community as the main driver for the C cycling in the water column. On the contrary, benthic PP rates were almost negligible while HPP rates were lower or comparable to those in the water column indicating that although the Mar Piccolo is very shallow, the water column is much more productive than the surface sediments. The sediment resuspension is likely responsible for a pulsed input of contaminants into the water column. However, their interference with the proper functioning of the pelagic ecosystem seems to be limited to the bottom layers.

Genetic diversity and structure in two protected Posidonia oceanica meadows.

Posidonia oceanica meadows growing along the west Mediterranean coastline are under continuous anthropogenic pressure. The way meadow health correlates with genetic and genotypic diversity in P. oceanica, is still under debate. Here we report a microsatellite analysis of two P. oceanica meadows living in protected areas of the Ligurian (Monterosso al Mare, MPA of "Cinque Terre") and central Tyrrhenian Sea (Santa Marinella, regional Site of Community Importance). Both meadows were recently classified as "disturbed", according to shoot density and other phenological parameters. Between the two meadows, Santa Marinella showed higher genetic diversity, while clear genetic substructure was present in both sites, reflecting high spatial heterogeneity. The present study suggests that genetic diversity does not match unequivocally with shoot density and leaf morphology and that small scale intra-meadow heterogeneity is an important factor to consider for establishing the relation between genetic/genotypic variability and health of natural seagrass meadows.

Características microbiológicas, físico-químicas e sensoriais de "almôndegas" à base de polpa de Tilápia (Oreochromis niloticus) / Microbiological, physicochemical and sensory characteristics of pulp-of-Tilapia-based (Oreochromis niloticus) meatballs

O consumo mundial per capita de pescado e produtos derivados vem crescendo gradualmente nas últimas décadas. Este trabalho teve como objetivo elaborar um reestruturado, tipo almôndegas, utilizando-se polpa bruta de tilápia (Oreochromis niloticus - PBT) e proteína texturizada de soja (PTS). Para obtenção do reestruturado, o PTS, de coloração marrom e sabor carne, teve sua concentração variada nos diferentes tratamentos: 0, 5 e 2,5% de PTS em T1, T2 e T3, respectivamente. Foram realizadas análises microbiológicas e físico-químicas da matéria prima e das ?almôndegas?; a análise sensorial foi realizada somente no produto final. Os resultados das análises microbiológicas da polpa e das ?almôndegas? estavam dentro dos padrões exigidos pela legislação brasileira. Os parâmetros físico-químicos não apresentaram muitas alterações e também estavam de acordo com os padrões exigidos para alimentos. As ?almôndegas? elaboradas com 5% PTS (T2) mostraram menores valores para a capacidade de retenção de água e perda de peso por cocção. No teste de aceitação das ?almôndegas? não houve diferença significativa (p? 0,05) entre os tratamentos, com aceitabilidade acima de 70% para todos os atributos avaliados. O teste de intenção de compra mostrou que mais de 50% dos consumidores que participaram do teste tinham a intenção de comprar os produtos, se os encontrasse à venda. O processo de elaboração das ?almôndegas? à base polpa de tilápia foi obtido com sucesso, sendo que o melhor tratamento foi o que continha 5%de PTS.

Worldwide per capita consumption of fish and derivative products has been increasing gradually in the last few decades. This study aimed to formulate a restructured product, like meatballs, using gross pulp of tilapia (Oreochromis niloticus ? GPT) and textured protein of soybean (TPS). In order to achieve the restructured product, brown-colored and meat-flavored, TPS had its concentration diversified in the different treatments: 0.5 and 2.5% of TPS in T1, T2 and T3, respectively. Microbiological and physiochemical analyses of raw material and meatballs were carried out; the sensory analysis was carried out only with the final product. The results of microbiological analyses of the pulp and meatballs fit the patterns demanded by Brazilian legislation. Physiochemical parameters did not show many alterations and also fit the patterns demanded for food. ?Meatballs? formulated with 5% TPS (T2) showed lower values for the capacity of water and cooking-loss-of-weight retention. In the acceptance test of ?meatballs? there was no significant difference (p? 0,05) among treatments, with acceptability higher than 70% for all the evaluated attributes. The test of purchase intent showed that over 50% of consumers who took part in the test had the intention of buying the products if they were for sale. The process of elaboration of the pulp-of-tilapia-based ?meatballs? was successful, once the best treatment was the one which contained TPS 5%.

Pain killers and antibacterial therapy for kidney colic and stones.

In 85% of patients, renal colic is caused by renal-ureteral stones with extrinsic obstructions such as pelvic, retroperitoneal or intestinal abnormalities, and intrinsic reno-ureteral obstructions, e.g. junction pathologies and malformation, accounting for only 10 and 5%, respectively. The objectives of therapy for renal colic therapy are to eliminate pain, preserve renal function and eliminate the obstruction by the excretory pathway. Many drugs can be used to relieve pain: non-steroid anti-inflammatory agents (NSAIDs), opioid analgesics, antidiuretic hormone (ADH), loco-regional anesthesia and acupuncture. Opiates are the first-choice therapy during pregnancy as no other drug is indicated because of tetragenic potential. Paracetamol (N-acetyl-p-aminophenol) is the only NSAID that is registered for pediatric use because it has none of the adverse side effects that are associated with NSAIDs. Tamsulosin, an alpha-lithic drug, has very recently been included among the drugs that are used for stone expulsion. The rationale underlying its use is that a high concentration of alpha-1D adrenergic receptors has been recently detected in the terminal ureter, especially in the intramural tract. Inhibition of alpha-1D receptor stimulation should relax smooth muscle in the intramural ureteral tract, making stone expulsion easier.