Probiotics in the Prevention of the Calcium Oxalate Urolithiasis

Nephrolithiasis ranks third among urological diseases in terms of prevalence, making up about 15% of cases. The continued increase in the incidence of nephrolithiasis is most probably due to changes in eating habits (high protein, sodium, and sugar diets) and lifestyle (reduced physical activity) in all developed countries. Some 80% of all kidney stones cases are oxalate urolithiasis, which is also characterized by the highest risk of recurrence. Frequent relapses of nephrolithiasis contribute to severe complications and high treatment costs. Unfortunately, there is no known effective way to prevent urolithiasis at present. In cases of diet-related urolithiasis, dietary changes may prevent recurrence. However, in some patients, the condition is unrelated to diet; in such cases, there is evidence to support the use of stone-related medications. Interestingly, a growing body of evidence indicates the potential of the microbiome to reduce the risk of developing renal colic. Previous studies have primarily focused on the use of Oxalobacterformigenes in patients with urolithiasis. Unfortunately, this bacterium is not an ideal probiotic due to its antibiotic sensitivity and low pH. Therefore, subsequent studies sought to find bacteria which are capable of oxalate degradation, focusing on well-known probiotics including Lactobacillus and Bifidobacterium strains, Eubacterium lentum, Enterococcus faecalis, and Escherichia coli.

METAPHYLAXIS OF UROLITHIASIS BY VEGETABLE MEDICINES

Мочекаменная болезнь является одной из главных проблем современной урологии как наиболее часто встречающаяся патология органов мочевой системы и составляющая 30 - 50% всех больных урологических стационаров. Целью настоящего исследования явилось изучение эффективности применения препарата «Фитолизин» у больных мочекаменной болезнью. В основу исследования положены результаты лечения 160 (85 женщин и 75 мужчин) пациентов, находившихся на стационарном лечение, средний возраст больных составил 42,2±12,4 года, длительность заболевания от 1-3 до 72 часов, размер конкрементов, в том числе и дезинтегрированных фрагментов после дистанционной ударно-волновой литотрипсии и контактно-лазерная литотрипсия варьировал от 0,4 до 0,8 см. Все больные были разделены на две группы. В основную группу вошли 70 больных, получавших помимо традиционной симптоматической терапии (спазмолитики и водная нагрузка) «Фитолизин» по 43 мл 3 раза в день. В контрольной группе (90 больных) проводилась только традиционная терапия. При включение в терапию препарата «Фитолизин» самостоятельное отхождение отмечено у 64(91,4%) больных, частота возникновения почечной колики имело место у 7(10%), лейкоцитурия - у 14(20%), бактериурия - у 10(15%). Применение фитопрепарата «Фитолизин» в составе комплексной терапии, является эффективным методом консервативного лечения больных мочекаменной болезнью и после после дистанционной ударно-волновой литотрипсии и контактно-лазерная литотрипсия в 90,9% случаев в отношении самостоятельного отхождения конкрементов. Urolithiasis is one of the main problems of modern urology as the most common pathology of the urinary system and makes up 30 - 50% of all patients in urological hospitals. The purpose of this study was to study the effectiveness of the use of the drug "Phytolysin" in patients with urolithiasis. The study is based on the treatment results of 160 (85 women and 75 men) patients who were hospitalized, the average age of the patients was 42.2 ± 12.4 years, the duration of the disease from 1-3 to 72 hours, the size of the stones and disintegrated fragments after remote shock wave lithotripsy and contact laser lithotripsy ranged from 0.4 to 0.8 cm. All patients were divided into two groups. The main group included 70 patients who received in addition to the traditional symptomatic therapy (antispasmodics and water load) "Phytolysin" 43 ml 3 times a day. In the control group (90 patients), only traditional therapy was performed. When "Phytolysin" was included in the therapy, independent discharge was observed in 64 (91.4%) patients, the incidence of renal colic occurred in 7 (10%), leukocyturia in 14 (20%), bacteriuria in 10 (15%). The use of the phytopreparation "Phytolysin" as a part of complex therapy is an effective method of conservative treatment of patients with urolithiasis and after remote shock-wave lithotripsy and contact laser lithotripsy in 90.9% of cases with regard to self-discharge of calculi.

OVARIAN VEIN SYNDROME: A CASE REPORT

The ovarian Vein Syndrome was first reported in 1964, yet its existence as a true pathophysiological entity remains controversial. It may present as an acute ora chronic disease, typically affecting young, multiparous women. We present in this article a 32-year-old patient with chronic renal colic, ultrasound and CT urography showing an extrinsic compression of the right lumbar ureter by the ovarian vein, a ligation, anda resection of the ovarian vein were performed by transperitoneal laparoscopy.

Causes of Acute Abdominal Pain in Geriatrics: A Review

Background: Aging affects all functions of the gastrointestinal system (GIS). The elderly commonly has atypical presentation of a disease with more subtle symptoms; hence physicians who are not familiar with these might miss the opportunity to make a diagnosis of abdominal pain in timely manner. The main objective of our study is to summarize the current evidence regarding causes and management of acute abdominal pain in elderly. Methodology: MEDLINE, Embolic, CINAHL, PsycInfo, and ASSIA were searched from 2000 until April 2021, and reference lists of included studies were searched. Studies were included that described causes and management of abdominal pain in elderly. No software has been utilized to analyze the data. The data was extracted based on specific form that contains (Author’s name, publication year, country, methodology and results). Results: The study included 7 papers. 2 cross sectional, 2 prospective and 3 retrospective studies all reporting causes and management of acute abdominal pain in elderly. Conclusion: The most common causes of abdominal pain in elderly population were biliary disease, appendicitis and bowel obstruction. Renal colic, hernia and ischemia were also reported in different rates. Diagnosis and management of abdominal pain especially in elderly should be immediate to avoid potential complications.

Ultrasound at the patient’s bedside for the diagnosis and prognostication of a renal colic

Background Diagnosing a ureteral colic is sometimes difficult; however, clinicians should not fail to detect a surgical emergency. This is why diagnostic strategies depend on the imaging examinations, especially ultrasound. Prior studies have investigated the accuracy of Point of Care Ultrasound (PoCUS), but there are relatively few. This study aimed to evaluate the performance of the PoCUS in the diagnosis of renal colic. The secondary objective was to evaluate the relationship between the imaging results and the treatment performed. Methods After the clinical evaluation of patients aged > 18 years with suspected ureteral colic, the Emergency Physician (EP) trained in ultrasound performed PoCUS to conclude whether a diagnosis of “renal colic” should be made. A computed tomography (CT) examination was subsequently performed, to determine whether ureteral or bladder lithiasis was present to diagnose a ureteral colic. The patient’s management was decided according to the to degree of urinary tract dilatation, presence of perinephric fluid, size, and localization of stones. Results Of the 12 Eps in our units, seven met the training criteria for the inclusion of patients. A total of 103 patients were analyzed, and the renal colic diagnosis was retained in 85 cases after the CT examination. The accuracy of PoCUS was 91% (86; 95%) for detecting urinary tract dilatation, 83% (76; 90%) for detecting perinephric fluid, and 54% (44; 64%) for detecting lithiasis. Only high urinary tract stones with ≥ 6 mm diameter were surgically managed (p < 0.01). Conversely, distal ureteral stones with a diameter of < 6 mm were managed with medical ambulatory treatment (p < 0.05). Conclusion PoCUS is a good diagnostic tool, for renal colic, and could help reduce the requirement for the CT examinations and, hence, reduce induced radiation exposure.