Is selective therapy of recurrent nephrolithiasis possible?

Background. The present article studies a possible role of parathyroid hormone-related protein (PTHrP) in urolithiasis pathogenesis.Aim. To consider PTHrP level as a predictor of the urolithiasis development.Material and methods. We presented an analysis of treatment in 79 patients with primary and recurrent nephrolithiasis that had underwent surgical treatment in the Uronephrological Center of Scientific Research Institute – Ochapovsky Regional Clinical Hospital #1, Krasnodar from 2017 to 2019. All observed patients were divided in two groups: patients with primary and recurrent nephrolithiasis. A group of 10 relatively healthy people was included in the study as well. All patients and conditionally healthy people had a test for blood parameters; in particular, the level of parathyroid hormone-related protein was assessed in order to compare the indicators in all three groups.Conclusions. The PTHrP level was showed to be statistically significantly different in patients with urolithiasis from the group with relatively healthy people. Groups with primary and recurrent nephrolithiasis show not difference in the level of PTHrP. Further studies are necessary to consider this protein as one of the predictors of urolithiasis and study its role in the pathogenesis of nephrolithiasis.

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Medical management strategies to prevent recurrent nephrolithiasis are stagnant and stronger evidence is needed to reduce morbidity

Evidence-Based Medicine ◽

10.1136/eb-2013-101384 ◽

2013 ◽

Vol 19 (1) ◽

pp. 12-12 ◽

Cited By ~ 1

Author(s):

Yair Lotan

Keyword(s):

Medical Management ◽

Management Strategies ◽

Recurrent Nephrolithiasis

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Gastrointestinal fistula with thigh extension and intractable pain

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2018-001748 ◽

2019 ◽

pp. bmjspcare-2018-001748

Author(s):

Ewa Deskur-Śmielecka ◽

Mateusz Sopata ◽

Michal Chojnicki ◽

Maciej Sopata

Keyword(s):

Quality Of Life ◽

Wound Care ◽

Rare Complication ◽

Enterocutaneous Fistula ◽

Symptom Relief ◽

Advanced Rectal Cancer ◽

Intractable Pain ◽

Gastrointestinal Fistula ◽

Selective Therapy

Spontaneous enterocutaneous fistulae are a rare complication in patients with cancer, especially following irradiation, chemotherapy or cytoreductive operations. They are associated with worse prognosis, higher costs of treatment and impaired quality of life. Proper recognition of the problem and fast implementation of selective therapy including water electrolyte resuscitation, infection control, nutritional support, control of output volume, proper wound care and, ultimately, surgical treatment in selected patients may result in better symptom relief and improved quality of life of patients. We describe a case of a patient with advanced rectal cancer and acute pain in the lateral aspect of thigh caused by the presumptive presence of an enterocutaneous fistula, in whom therapy with antibiotics and surgical incision enabled rapid pain relief and comfort of dying.

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