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Life (Basel, Switzerland) Aug 2022Approximately 1 in 20 people develops kidney stones at some point in their life. Although the surgical removal of stones is common, the recurrence rate remains high and...
Approximately 1 in 20 people develops kidney stones at some point in their life. Although the surgical removal of stones is common, the recurrence rate remains high and it is therefore important to prevent the occurrence of kidney stones. We chose (AM), which is a traditional Chinese medicine, to study the prevention of urolithiasis using a model based on our previous screening of traditional Chinese herbs. Wild-type Canton-S adult fruit flies were used in this study. Ethylene glycol (EG, 0.5%) was added to food as a lithogenic agent. The positive control agent (2% potassium citrate (K-citrate)) was then compared with AM (2, 8, and 16 mg/mL). After 21 days, the fruit flies were sacrificed under carbon dioxide narcotization, and the Malpighian tubules were dissected, removed, and processed for polarized light microscopy examination to observe calcium oxalate (CaOx) crystallization. Then, the ex vivo dissolution of crystals in the Malpighian tubules was compared between K-citrate and AM. Survival analysis of the EG, K-citrate, and AM groups was also performed. Both 2% K-citrate and AM (16 mg/mL) significantly inhibited EG-induced CaOx crystal formation. Mean lifespan was significantly reduced by the administration of EG, and the results were significantly reversed in the AM (8 and 16 mg/mL) groups. However, AM extract did not directly dissolve CaOx crystals in Malpighian tubules ex vivo. In conclusion, AM extract decreased the ratio of CaOx crystallization in the Malpighian tubules and significantly ameliorated EG-induced reduction of lifespan. AM prevented CaOx crystal formation in the model.
PubMed: 36013429
DOI: 10.3390/life12081250 -
Dentistry Journal Aug 2022Toothpastes and mouth rinses contain fluoride as a protective agent against caries. The aim of this study was to determine the degree of fluoride-uptake by human tooth...
Toothpastes and mouth rinses contain fluoride as a protective agent against caries. The aim of this study was to determine the degree of fluoride-uptake by human tooth mineral during immersion into fluoride-containing aqueous solutions as different pH. Human teeth were immersed in fluoride-containing solutions to assess the extent of fluoride incorporation into tooth enamel. A total of 16 extracted teeth from 11 patients were immersed at 37 °C for one minute into aqueous fluoride solutions (potassium fluoride; KF) containing either 250 ppm or 18,998 ppm fluoride (1-molar). Fluoride was dissolved either in pure water (neutral pH) or in a citrate buffer (pH 4.6 to 4.7). The elemental surface composition of each tooth was studied by energy-dispersive X-ray spectroscopy in combination with scanning electron microscopy and X-ray powder diffraction. The as-received teeth contained 0.17 ± 0.16 wt% fluoride on average. There was no significant increase in the fluoride content after immersion in 250 ppm fluoride solution at neutral or acidic pH values. In contrast, a treatment with a 1-molar fluoride solution led to significantly increased fluoride concentrations by 0.68 wt% in water and 9.06 wt% at pH 4.7. Although such fluoride concentrations are far above those used in mouth rinses or toothpastes, this indicates that fluoride can indeed enter the tooth surface, especially at a low pH where a dynamic dissolution-reprecipitation process may occur. However, precipitations of calcium fluoride (globuli) were detected in no cases.
PubMed: 36005251
DOI: 10.3390/dj10080153 -
Die Anaesthesiologie Nov 2022The transfusion of packed red blood cells (PRBC) is associated with various side effects, including storage damage to PRBCs. The cells change their structure, releasing...
BACKGROUND
The transfusion of packed red blood cells (PRBC) is associated with various side effects, including storage damage to PRBCs. The cells change their structure, releasing potassium as well as lactate. Mechanical rinsing, available in many hospitals, is able to remove toxic substances and possibly minimizes the negative side effects of transfusion.
OBJECTIVE
The primary aim of our study was to improve the quality of PRBCs before transfusion. The effects of different washing solutions on PRBC quality were analyzed.
MATERIAL AND METHODS
This in vitro study compares 30 mechanically washed PRBCs. They were either processed with standard normal saline 0.9% (n = 15, N group) or a hemofiltration solution containing 4 mmol/l potassium (n = 15, HF group) by a mechanical rinsing device (Xtra, LivaNova, Munich, Germany). A subgroup analysis was performed based on the storage duration of the processed PRBCs (7, 14, 37 days). Samples were taken before washing (EKprä), immediately after washing (EKpost) and 10 h later (EKpost10h), after storage in the "wash medium" at room temperature. Concentrations of ATP (probability of survival in transfused erythrocytes), lactate, citrate and electrolytes (potassium, sodium, chloride, calcium) were tested.
RESULTS AND CONCLUSION
Mechanical rinsing improves pretransfusion quality of PRBC. Washing with a hemofiltration solution results in a more physiological electrolyte composition. Even 10 h after mechanical rinsing with a hemofiltration solution, the quality of 37-day-old PRBC is comparable to young PRBC that have been stored for 7 days and have not been washed. Washing stored PRBC increases the ATP content, which subsequently leads to an increased probability of survival of red cells after transfusion.
Topics: Blood Preservation; Erythrocytes; Potassium; Electrolytes; Adenosine Triphosphate; Lactates
PubMed: 35969253
DOI: 10.1007/s00101-022-01189-6 -
British Journal of Clinical Pharmacology Jan 2023We aimed to assess the eradication efficacy and factors that influencing it of high-dose dual therapy (HDDT) in Gansu region, Northwest China. (Randomized Controlled Trial)
Randomized Controlled Trial
High-dose amoxicillin-proton pump inhibitor dual therapy as first-line treatment for Helicobacter pylori infection in Northwest China: A prospective, randomised controlled trial.
AIMS
We aimed to assess the eradication efficacy and factors that influencing it of high-dose dual therapy (HDDT) in Gansu region, Northwest China.
METHODS
A total of 216 treatment-naive patients with Helicobacter pylori infection were randomly assigned to two groups for the 14-day eradication treatment: the HDDT group (amoxicillin 750 mg q.i.d. and esomeprazole 40 mg t.i.d.) and the amoxicillin and clarithromycin-containing bismuth quadruple therapy group (ACBQT: esomeprazole 20 mg, bismuth potassium citrate 2 g, amoxicillin 1 g, and clarithromycin 500 mg; b.i.d.). The eradication rates, adverse effects and patient compliance of these two groups were compared. Eradication efficacy was determined by C urea breath test ( C UBT) 4-8 weeks after finishing treatment. Antibiotic resistance was determined by the Epsilometer testing (E-test) method.
RESULTS
The eradication rates for the HDDT and ACBQT groups were 71.0% and 74.7% (P = .552) by per-protocol analysis, and 65.7% and 68.5% (P = .664) by intention-to-treat analysis. The overall adverse event rates in the HDDT and ACBQT groups were 2.0% and 43.4% (P < .001), respectively. The resistance rates to amoxicillin, clarithromycin, tetracycline, levofloxacin and metronidazole were 15.2%, 42.0%, 5.4%, 35.7% and 83.0%, respectively. Amoxicillin resistance and delta over baseline (DOB) of C UBT ≥ 20 before treatment significantly reduced the eradication rate in 112 participants with H. pylori cultured.
CONCLUSION
The HDDT as first-line treatment for H. pylori was unsatisfactory in Gansu. Amoxicillin resistance and DOB of C UBT ≥ 20 before treatment were significantly correlated with H. pylori eradication failure.
Topics: Humans; Helicobacter Infections; Amoxicillin; Helicobacter pylori; Proton Pump Inhibitors; Clarithromycin; Esomeprazole; Bismuth; Prospective Studies; Drug Therapy, Combination; Anti-Bacterial Agents; China; Treatment Outcome
PubMed: 35947524
DOI: 10.1111/bcp.15488 -
American Journal of Clinical and... 2022To evaluate the correlation between the pH readings in 24-h urine and the random fasting specimen in patients with urolithiasis using 2 methods.
PURPOSE
To evaluate the correlation between the pH readings in 24-h urine and the random fasting specimen in patients with urolithiasis using 2 methods.
METHODS
A total of 114 patients with urinary lithiasis using potassium citrate were prospectively analyzed. All patients collected 24-h urine and an additional sample, after nocturnal fasting, collected on the day they brought the 24-h sample at the lab. Two different methods (test strip and digital meter) were used to determine pH values.
RESULTS
The pH analysis using strips in the 24-h urine presented a mean value similar to the one obtained in the fasting sample (6.07 ± 0.74 vs. 6.02 ± 0.82, respectively; P > 0.05). The same behavior was seen considering the readings with a digital pH meter (5.8 ± 0.78 vs. 5.75 ± 0.83; P > 0.05). However, readings conducted in the same specimen with pH meter and test strip were dissonant (P < 0.05), suggesting that the colorimetric method is not reliable in the assessment of urinary pH in this population.
CONCLUSION
pH assessment in a random urinary specimen proved as efficient as the 24-h urine standard method to monitor patients with kidney stones in the use of potassium citrate. Classical test strip analysis is not sensitive enough to evaluate the urine pH in this population and digital pH meter reading is preferred.
PubMed: 35874289
DOI: No ID Found -
Journal of Investigative Medicine High... 2022A 62-year-old man with a past medical history of recently diagnosed type II diabetes mellitus presented for multiple episodes of nephrolithiasis after stopping Diet...
A 62-year-old man with a past medical history of recently diagnosed type II diabetes mellitus presented for multiple episodes of nephrolithiasis after stopping Diet Mountain Dew ingestion. Stone analysis confirmed calcium oxalate stones. It was theorized that the high citrate in Diet Mountain Dew was protective against his newly recurrent nephrolithiasis. For lifestyle preference, the patient chose lemonade-flavored Crystal Light-known to be high in citrate-instead of potassium citrate 30-40 mEq supplementation. To date, the patient's nephrolithiasis has not recurred. Potassium citrate is a preventive strategy against calcium oxalate stones in patients with suspected or confirmed hypocitraturia. Citrate binds calcium, therefore, preventing the interaction between calcium and oxalate. Alternative supplementation strategies, such as citrus-flavored sodas (eg, Diet Mountain Dew), powdered drinks (eg, Crystal Light), and natural juices (eg, lemon juice), may be plausible alternatives to potassium citrate. Patient lifestyle and the risks and benefits to a particular supplemental choice must be considered for every patient.
Topics: Calcium; Calcium Oxalate; Citrates; Citric Acid; Diabetes Mellitus, Type 2; Diet; Humans; Kidney Calculi; Potassium Citrate
PubMed: 35866199
DOI: 10.1177/23247096221114518 -
Bone Reports Jun 2022Hereditary Hypophosphatemic Rickets with Hypercalciuria (HHRH) ( gene, OMIM 241530) is an autosomal recessive disorder that results in a loss of function of the...
BACKGROUND
Hereditary Hypophosphatemic Rickets with Hypercalciuria (HHRH) ( gene, OMIM 241530) is an autosomal recessive disorder that results in a loss of function of the sodium-phosphate NPT2c channel at the proximal tubule. Phosphate supplementation rarely improves serum phosphate, hypercalciuria, nephrocalcinosis, 1,25(OH) vitamin D (1,25(OH)D) levels or short stature.
METHODS
We describe Na MRI and the successful use of recombinant human growth hormone (rhGH) and Fluconazole to improve growth (possibly confounded by puberty) and hypercalciuria in a now 12-year-old male with HHRH (novel homozygous mutation, c.835_846 + 10del.T).
RESULTS
The patient had chronic bone pain, hypophosphatemia (0.65 mmol/L[reference interval 1.1-1.9]), pathological fractures and medullary nephrocalcinosis/hypercalciuria (urinary calcium/creatinine ratio 1.66 mol/mmol[<0.6]). TmP/GFR was 0.65 mmol/L[0.97-1.64]; 1,25(OH)D was >480 pmol/L[60-208]. Rickets Severity Score was 4. Treatment with 65 mg/kg/day of sodium phosphate and potassium citrate 10 mmol TID failed to correct the abnormalities.Adding rhGH at 0.35 mg/kg/week to the phosphate therapy, improved bone pain, height z-score from -2.09 to -1.42 over 6 months, without a sustained effect on TmP/GFR. Fluconazole was titrated to 100 mg once daily, resulting for the first time in a reduction of the 1,25(OH)D to 462 and 426 pmol/L; serum phosphate 0.87 mmol/L, and calcium/creatinine ratio of 0.73.Na MRI showed normal skin (z-score + 0.68) and triceps surae muscle (z-score + 1.5) Na levels; despite a defect in a sodium transporter, hence providing a rationale for a low sodium diet to improve hypercalciuria.
CONCLUSIONS
The addition of rhGH, Fluconazole and salt restriction to phosphate/potassium supplementation improved the conventional therapy. Larger studies are needed to confirm our findings.
PubMed: 35663378
DOI: 10.1016/j.bonr.2022.101591 -
Healthcare (Basel, Switzerland) May 2022Kidney stone disease represents a rare cause of chronic kidney disease (2−3%) but has severe clinical consequences. Type 1 renal tubular acidosis is a strong...
Kidney stone disease represents a rare cause of chronic kidney disease (2−3%) but has severe clinical consequences. Type 1 renal tubular acidosis is a strong lithogenic condition mainly related to primary Sjögren syndrome. This study aimed to illustrate an unusual presentation of Sjögren syndrome to improve the knowledge about rare kidney stone diseases, and to provide clues for the diagnostic approach in this specific condition. We report the case of a 35-year-old Indian woman with severe nephrocalcinosis and chronic kidney disease with tubular proteinuria who presented for metabolic assessment. We found advanced chronic kidney disease, low serum bicarbonate, permanent alkaline urine with pH at ~7.1, and severe hypocitraturia corresponding to type 1 renal tubular acidosis. The erythrocyte sedimentation rate was high. Serological screening for HAV, HBV, HCV, HIV, EBV was negative and complement was normal. Autoimmune screening showed antinuclear antibodies (>1/1.280) with anti-SSA, anti-SSA/Ro52 and anti-SSB antibodies. Genetic testing excluded an inherited cause of renal tubular acidosis. A renal biopsy showed moderate chronic tubulo-interstitial nephritis without any glomerular involvement. Primary Sjögren syndrome with significant renal involvement was considered, and corticosteroids were then subsequently initiated in combination with potassium citrate with vitamin D substitution. Only partial improvement was observed in electrolytes disturbance. After 15 months, her renal function remained stable. In conclusion, nephrocalcinosis could be the first manifestation of severely impacting diseases such as primary Sjögren syndrome. Chronic kidney disease, bilateral nephrocalcinosis, and metabolic acidosis can be linked through type 1 renal tubular acidosis. Therefore, autoimmune screening for Sjögren syndrome should be considered in such cases.
PubMed: 35627973
DOI: 10.3390/healthcare10050836 -
Antibiotics (Basel, Switzerland) May 2022bacteria produce a wide number of antibiotics and antitumor compounds that have attracted the attention of pharmaceutical and biotech companies. In this study, we...
bacteria produce a wide number of antibiotics and antitumor compounds that have attracted the attention of pharmaceutical and biotech companies. In this study, we provide evidence showing that the xylem sap from grapevines has a positive effect on the production of different antibiotics by several species, including ATCC 23877 and ATCC 12596 among others. The production of several already known compounds was induced: actinomycin D, chromomycin A3, fungichromin B, mithramycin A, etc., and four compounds with molecular formulas not included in the Dictionary of Natural Products (DNP v28.2) were also produced. The molecules present in the xylem sap that acts as elicitors were smaller than 3 kDa and soluble in water and insoluble in ether, ethyl acetate, or methanol. A combination of potassium citrate and di-D-fructose dianhydrides (related to levanbiose or inulobiose) seemed to be the main effectors identified from the active fraction. However, the level of induction obtained in the presence of these compounds mix was weaker and delayed with respect to the one got when using the whole xylem sap or the 3 kDa sap fraction, suggesting that another, not identified, elicitor must be also implied in this induction.
PubMed: 35625316
DOI: 10.3390/antibiotics11050672 -
Journal of Pharmacy & Bioallied Sciences 2021was reported to have diuretic effects in experimental rats, and this leads to inhibition of kidney stones through the abundant levels of minerals and flavonoids in it....
BACKGROUND
was reported to have diuretic effects in experimental rats, and this leads to inhibition of kidney stones through the abundant levels of minerals and flavonoids in it. This study aimed to determine the effects of water extract as a potential chemolytic agent in urolithiasis.
MATERIALS AND METHODS
In this prospective experiment, a total of 15 stone samples collected from patients who underwent stone extraction were used in each concentration (4 mg/ml, 2 mg/ml, and 1 mg/ml) of the extract and control solution. The effects of pH change in the chemolysis of the stones were assessed using the extract 4 mg/ml under pH 7 and 8.
RESULTS
The percentage weight reduction of calcium oxalate stone was highest in the 4 mg/ml concentration. extract 4 mg/ml showed a better effect in terms of chemolytic action on calcium oxalate stone than the potassium citrate solution (70% vs. 41%). Regarding the calcium oxalate stone, the percentage weight reduction has shown about 70% in the pH 5, 48% in pH 7, and <10% in pH 8. The percentage weight reduction of uric acid stone was determined as 47%, 11%, and 14% for pH 5, 7, and 8, respectively. The percentage weight reduction of combination stone was 40%, 60%, and 80% in the pH 5, pH 7, and pH 8, respectively. Data analysis showed that the percentage weight reduction of combination stone was significantly different between acidic, neutral, and alkaline conditions ( = 0.027).
CONCLUSIONS
In this study, we are able to show that water extract do have some dissolving capability of urinary stones.
PubMed: 35399798
DOI: 10.4103/jpbs.jpbs_526_21