Pediatric Urolithiases: A Ten-Year Review

PEDIATRICS ◽  
1980 ◽  
Vol 65 (6) ◽  
pp. 1068-1072 ◽  
Author(s):  
Peter C. Walther ◽  
Donald Lamm ◽  
George W. Kaplan
Keyword(s):  
Recurrence Rate ◽  
Stone Formation ◽  
Urinary Calculi ◽  
Stone Disease ◽  
Careful Consideration ◽  
Common Type ◽  
Presenting Symptoms ◽  
Extensive Evaluation ◽  
Calculus Disease ◽  
High Index Of Suspicion

Sixty-one children who presented with urinary calculi between 1967 and 1977 were reviewed. The overall incidence of calculus disease in our patients was higher than reported previously from other centers in this country. Because presenting symptoms varied, a high index of suspicion was often required for diagnosis. Stones of infection were the most common type identified. Inasmuch as the recurrence rate of calculi in children was low (6.5%), careful consideration of time and cost is warrented before extensive evaluation for metabolic causes of stone formation is undertaken. Immobilization was an important factor in the etiology of stone disease. Most stones less than 5 mm in size passed without surgery.

Changing in gender prevalence of nephrolithiasis

2020 ◽  
pp. 039156032096620
Author(s):  
Elisa Cicerello ◽  
Mario S Mangano ◽  
Giandavide Cova ◽  
Matteo Ciaccia
Keyword(s):  
Risk Factors ◽  
Kidney Stones ◽  
Stone Formation ◽  
Urinary Calculi ◽  
Gender Disparity ◽  
Stone Disease ◽  
Emergency Department Visits ◽  
Common Disease ◽  
Female Ratio ◽  
Male To Female

Although nephrolithiasis is a more common disease in men rather than women, several studies over the last decades show that the male to female ratio 3:1 is narrowing. These finding may be associated to modified risk factors for stone formation between females and males. Changes in lifestyle and increasing obesity in women may play a role in shifting of gender disparity. Furthermore, recent studies have demonstrated an increase of kidney stones in women which have necessitated emergency department visits (ED). Therefore, females show a greater percentage of mortality rate if compared to males, especially if stone disease is associated to urosepsis and requires the admission to the Intensive Care Unit (ICU). This article reviews recent insights into changing gender prevalence in urinary calculi and into identifying the relation between gender and risk factors for stone disease, that in case of severe urosepsis might also lead to mortality.

scholarly journals Evaluation and management of urethral calculi

2017 ◽  
Vol 4 (8) ◽  
pp. 2392 ◽  
Author(s):  
Ali Abdulqader Ameen ◽  
Hrair Haik Kegham ◽  
Ali Hussein Abid
Keyword(s):  
Risk Factor ◽  
Clinical Presentation ◽  
Urinary Calculi ◽  
Renal Calculi ◽  
Common Type ◽  
Recurrent Uti ◽  
Number Of Patients ◽  
Unbalanced Diet ◽  
High Index Of Suspicion ◽  
Additional Role

Background: To evaluate the presentation, management and outcome of patient with urethral calculi in addition todetermine the most common type of calculi encountered in those patients and the chemical composition of those calculi to prevent their recurrence.Methods: Sixty-nine patients with urethral calculi, 63 males and six females were included in this study at Al-Yarmouk teaching hospital, Bagdad, Iraq from April 2016 to April 2017. The diagnosis of urethral calculi was based mainly on the clinical presentation and cystoscopy evaluation in addition to the history, examination and investigations.Results: All together Sixty-nine patients were recruited in this study [63 male (91.3%) and 6 females (8.6%)], regarding sex distributions of patients the largest number of patients with urethral calculi were found in male between 21-40 years old, the most common presenting symptom was dysuria (60.8%), the presentation of pediatric urethral calculi was different (any suspicion of urethral mass on palpation gave high index of suspicion of urethral calculi).Conclusions: Nephrolithiasis especially renal calculi represent a widespread problem, recurrent UTI is one of the leading risk factor in urinary calculi and should be vigorously treated and any case should be in investigated carefully and chemically analysed to prevent further attacks and recurrence in future. Unbalanced diet with poor hygiene especially for the urethral calculi plays an additional role in the pathogenesis of urethra calculi.

scholarly journals Urolithiasis in renal transplantation: Diagnosis and management

2014 ◽  
Vol 86 (4) ◽  
pp. 257 ◽  
Author(s):  
Elisa Cicerello ◽  
Franco Merlo ◽  
Mario Mangano ◽  
Giandavide Cova ◽  
Luigi Maccatrozzo
Keyword(s):  
Renal Transplantation ◽  
Shock Wave Lithotripsy ◽  
Renal Allograft ◽  
Stone Formation ◽  
Urinary Calculi ◽  
The Other ◽  
Ureteral Stent ◽  
Nephrostomy Tube ◽  
Staghorn Calculus ◽  
Multimodal Management

Obiectives: To report our experience of diagnosis and multimodal management of urolithiasis in renal transplantation. Patients and Methods: From January 1995 to December 2012, 953 patients underwent renal transplantation in the Kidney Transplant Unit of Treviso General Hospital. Ten (10%) of them developed urinary calculi and were referred at our institution. Their mode of presentation, investigation and treatment were recorded. Results: Seven had renal and 3 ureteral calculi. Urolithiasis was incidentally discovered on routine ultrasound in 6 patients, 1 presented with oliguria, 1 with anuria and acute renal failure and in 2 urolithiasis was found at removal of the ureteral stent. Nephrostomy tube was placed in 5 patients. Hypercalcemia with hyperparathyroidism (HPT) was present in 5 patients and hyperuricemia in 3. Two patients were primary treated by shock wave lithotripsy (SWL) and one of them was stone-free after two sessions. Two patients, one with multiple pielocaliceal calculi and the other with staghorn calculus in the lower calyx, were treated with percutaneous nephrolitothotomy (PCNL). Three patients were treated by ureteroscopy (URS) and in one of them two treatments were carried out. One patient had calculus impacted in the uretero-vesical anastomosis and surgical ureterolithotomy with re-do ureterocystoneostomy was performed after failure of URS. Two patients with calculi discovered at removal of the ureteral stent were treated by URS. Conclusions: The incidence of urolithiasis in renal transplantation is uncommon. In the most of patients the condition occurs without pain. Metabolic anomalies and medical treatment after renal transplantation may cause stone formation. Advancements in endourology and interventional radiology have influenced the management of urolithiasis that can be actually treated with a minimal incidence of risk for the renal allograft.

scholarly journals Nutrition and Kidney Stone Disease

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1917
Author(s):  
Roswitha Siener
Keyword(s):  
Kidney Stone ◽  
Fluid Intake ◽  
Stone Formation ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Dietary Therapy ◽  
Effective Prevention ◽  
Kidney Stone Disease ◽  
Nutrition And Diet

The prevalence of kidney stone disease is increasing worldwide. The recurrence rate of urinary stones is estimated to be up to 50%. Nephrolithiasis is associated with increased risk of chronic and end stage kidney disease. Diet composition is considered to play a crucial role in urinary stone formation. There is strong evidence that an inadequate fluid intake is the major dietary risk factor for urolithiasis. While the benefit of high fluid intake has been confirmed, the effect of different beverages, such as tap water, mineral water, fruit juices, soft drinks, tea and coffee, are debated. Other nutritional factors, including dietary protein, carbohydrates, oxalate, calcium and sodium chloride can also modulate the urinary risk profile and contribute to the risk of kidney stone formation. The assessment of nutritional risk factors is an essential component in the specific dietary therapy of kidney stone patients. An appropriate dietary intervention can contribute to the effective prevention of recurrent stones and reduce the burden of invasive surgical procedures for the treatment of urinary stone disease. This narrative review has intended to provide a comprehensive and updated overview on the role of nutrition and diet in kidney stone disease.

Unusual Nasogastric Tube Position Leading to Delay in Diagnosis of Tracheoesophageal Fistula

2021 ◽  
pp. 097321792110367
Author(s):  
Monika Kaushal ◽  
Saima Asghar ◽  
Ayush Kaushal
Keyword(s):  
Early Diagnosis ◽  
Nasogastric Tube ◽  
Common Type ◽  
X Ray ◽  
Delay In Diagnosis ◽  
Atypical Symptoms ◽  
Tube Position ◽  
Esophageal Pouch ◽  
High Index Of Suspicion ◽  
Surgical Unit

Aim: This case highlights the importance of high index of suspicion for early diagnosis and thorough clinical examination of a newborn with tracheoesophageal atresia and fistula. Case Report: We report a case of most common type of tracheoesophageal atresia with fistula where diagnosis was missed due to unusual gastric position of nasogastric tube. Nasogastric tube reached stomach in esophageal atresia with fistula, delaying the diagnosis and management of condition. After accidental removal of tube and failure to pass again raised suspicion and was confirmed with coiled tube in esophageal pouch in X-Ray chest. Baby shifted to surgical unit for treatment, fortunately baby recovered and discharged home after surgical correction. Conclusion: Tracheoesophageal atresia with fistula can present with atypical symptoms and unusual events, challenging the early diagnosis and treatment of common types of conditions. Other association like VACTERL should be looked for, in patients.

scholarly journals Challenges in the Diagnosis of Giant Cell Arteritis Before Visual Loss

2020 ◽  
pp. 1-5
Author(s):  
Purnima Mehta ◽  
Faaiq Hassan ◽  
Muhammed Omar Qadir ◽  
Shirish Dubey ◽  
Sergio Pagliarini ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss ◽  
Systemic Vasculitis ◽  
The Elderly ◽  
Common Type ◽  
Atypical Presentation ◽  
Delay In Diagnosis ◽  
Atypical Presentations ◽  
High Index Of Suspicion

Background: Giant cell arteritis (GCA) is the most common type of systemic vasculitis affecting the elderly. Ophthalmic presentations of GCA in particular can be difficult to identify prior to permanent visual loss occurring. Methods: Here, we present 3 challenging cases as a retrospective series to highlight the variable presentations of GCA with ophthalmic involvement, but GCA was not suspected due to atypical presentation. Results: Unfortunately, all 3 cases went on to develop visual loss in the affected eye due to a delay in diagnosis or treatment. The authors wish to highlight the challenges posed to the referring clinicians, when patients had systemic/ocular co-morbidities, which delayed the suspicion of GCA Conclusion with a Practical Point: Our cases highlight the variable presentations of this condition as well as the devastating ophthalmic implications that GCA can have. A high index of suspicion must be maintained; particularly in elderly patients with atypical presentations.

scholarly journals Conus medullaris intramedullary arachnoid cyst- case report and review of the literature

2021 ◽  
Vol 12 ◽  
pp. 370
Author(s):  
Vishal Vishnu Thakur ◽  
Ranjit Devidas Rangnekar ◽  
Shashank Aroor ◽  
Krishnakumar Kesavapisharady ◽  
Mathew Abraham
Keyword(s):  
Arachnoid Cyst ◽  
Rare Case ◽  
Conus Medullaris ◽  
Radical Excision ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Presenting Symptoms ◽  
High Index Of Suspicion ◽  
Urinary Dribbling ◽  
Intramedullary Cyst

Background: Spinal intramedullary cysts present a radiological dilemma. We present a rare case of a conus intramedullary arachnoid cyst and report on its differentiating features and management. Case Description: We report a case of a 30-month-old child who presented with decreased gluteal sensation and urinary dribbling for 6 months. Apart from some slowness in walking, the power was normal in all four limbs. Imaging showed a non-enhancing, T2-weighted hyperintense 12 × 8 mm conus intramedullary cyst without any edema. A T12-L1 laminotomy followed by marsupialization of the cyst was done. Histopathology was suggestive of an arachnoid cyst. The postoperative course was uneventful with improvement in muscle strength and achievement of regular milestones. We also present the pertinent review of the literature to date. Conclusion: Intramedullary arachnoid cysts are a rare entity and should form the differential diagnosis for cysts presenting in the conus medullaris. Simple decompressive options may suffice for symptomatic cases and radical excision may be avoided. A high index of suspicion is essential considering the subtle nature of presenting symptoms.

Spinal infections

2018 ◽  
Vol 11 (8) ◽  
pp. 448-451
Author(s):  
Shrijit Panikkar ◽  
Chitra V Nair
Keyword(s):  
Primary Care ◽  
Back Pain ◽  
Small Proportion ◽  
Delayed Diagnosis ◽  
Spinal Infection ◽  
Significant Morbidity ◽  
Presenting Symptoms ◽  
Underlying Causes ◽  
High Index Of Suspicion ◽  
Spinal Infections

Spinal infection is a rare cause of back pain that can have devastating consequences if left untreated. Since back pain can be the only symptom in early spinal infection diagnosing it is a major challenge in primary care, where back pain accounts for 6–9% of consultations. Most episodes of back pain, which has an annual incidence of 2–5%, are mechanical in nature and are self-limiting. Only a small proportion of back pain is due to serious underlying causes such as infection, neoplasia and fractures. GPs need to be aware of the presenting symptoms of spinal infection and who is at risk, as a high index of suspicion is needed to avoid the significant morbidity and mortality associated with delayed diagnosis.

scholarly journals Cardiac mucormycosis: a case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Darshan Krishnappa ◽  
Sanjeev Naganur ◽  
Dinesh Palanisamy ◽  
Ganesh Kasinadhuni
Keyword(s):  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Interatrial Septum ◽  
Needle Aspiration ◽  
Predisposing Factors ◽  
Diffuse Infiltration ◽  
Extensive Evaluation ◽  
Mediastinal Involvement ◽  
High Index Of Suspicion

Abstract Background Mucormycosis is an invasive fungal infection (IFI) most commonly seen in immunocompromised patients. Diabetic ketoacidosis, haematopoietic transplantation, iron overload states, and deferoxamine therapy are considered to be some of the classical risk factors. While cutaneous and rhino-sinusoidal forms may be seen in immunocompetent (IC) individuals, cardiac and mediastinal involvement is rare. In this report, we describe a young patient without predisposing factors who presented as mediastinal mucormycosis with extensive cardiac involvement. Case summary A 19-year-old male presented with complaints of dry cough and dyspnoea on exertion over the last 4 months. Echocardiography showed diffuse infiltration of both atria along with multiple pedunculated freely mobile masses. A computed tomography chest was done to further delineate the true extent of the disease and revealed diffuse infiltration of the mediastinum, bilateral atria and interatrial septum, pulmonary veins, and superior vena cava. A fine needle aspiration cytology from a mediastinal mass revealed broad aseptate fungal hyphae with right angled branching consistent with Mucor. Extensive evaluation could not find any predisposing factors. The patient was started on Amphotericin B and surgical debridement was contemplated. However, owing to the diffuse infiltration around the heart and mediastinal vasculature, debridement could not be performed and the patient eventually succumbed to the illness. Discussion Mediastinal mucormycosis though rare in IC patients, is a rapidly progressive condition with a high fatality. A high index of suspicion needs to be maintained in individuals presenting with infiltrative disorders of the mediastinum for early diagnosis and prompt treatment.

Urine protein markers distinguish stone-forming from non-stone-forming relatives of calcium stone formers

2006 ◽  
Vol 291 (3) ◽  
pp. F530-F536 ◽  
Author(s):  
Kristin J. Bergsland ◽  
Jennifer K. Kelly ◽  
Brian J. Coe ◽  
Fredric L. Coe
Keyword(s):  
Discriminant Analysis ◽  
Stone Formation ◽  
Stone Disease ◽  
Small Subset ◽  
Protein Markers ◽  
Urine Protein ◽  
Multivariate Discriminant Analysis ◽  
Stone Formers ◽  
Calgranulin B ◽  
Multivariate Discriminant

We have investigated urine protein inhibitors of calcium oxalate crystallization to determine whether variations in these proteins are associated with kidney stone disease and whether protein measurements improve the identification of stone formers compared with conventional risk factors (RF). Using Western blotting, we studied variations in the electrophoretic mobility patterns and relative abundances of crystallization-inhibitory proteins in urine from 50 stone-forming (SF) and 50 non-stone-forming (NS) first-degree relatives of calcium SF patients, matched by gender and age. Standard urine chemistry stone risk measurements were also made. Multivariate discriminant analysis was used to test the association of these proteins with nephrolithiasis. Differences in form and abundance of several urine proteins including inter-α-trypsin inhibitor (ITI), prothrombin fragment 1 (PF1), CD59, and calgranulin B (calB) were found to be associated with stone formation. By multivariate discriminant analysis, measurements of forms of PF1, ITI, and calB in men and ITI and CD59 in women, classified 84% of men and 76% of women correctly by stone status. In contrast, standard urine chemistry RF identified only 70% of men correctly and failed to distinguish female SF from NS. Thus a small subset of protein measurements distinguished SF from NS far better than conventional RF in a population of relatives of calcium SF, illustrating the significant association of these proteins with stone disease. Variations in these proteins may serve as markers of stone disease activity or vulnerability to recurrence and may provide new insights into mechanisms of stone formation.

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