Search for Crystalline Species of Urinary Stones by Patients in the Region of Tissemsilt, Algeria

Urinary stones are among the most common diseases in the world and in Algeria as well, because it is a complex and multifactorial disease. The saturation of solutes in the urine is considered as the main stage of the deposition of crystals and their rapid growth and aggregation lead to the formation of stones in different places of the urinary system. It is the consequence of excessive urinary supersaturation causing renal complications such as lithiasis, nephrocalcinosis, acute or chronic renal failure which may progress to the terminal stage. The purpose of the study was to identify the most common different forms of crystals in the urine of patients for further measures to prevent more serious complications of crystalluria. Materials and methods. The study focused on all lithiasis patients of the age group "from 20 years to 84 years". Three-day urine samples were collected at different urology departments which were referred by urologists, during the period from February 06, 2020 to March 21, 2020. Being the best method, crystalluria was used to determine the types of crystals, their number and their growth. Three criteria must be met for the study of crystalluria to be clinically interpretable. They are the choice of patients according to their metabolic state; how long urine is stored after it is released, and the storage temperature. Results and discussion. Thanks to this study it was possible to characterize many types of crystals, including calcium oxalates, in particular monohydrate, which is considered as a risk factor for stone formation. Also, the urinary acid crystals indicate a specific environmental pattern in many patients. In addition to the calcium phosphate crystals resulting from microbial infections, the results showed pure crystalline aggregates which will inevitably lead to lithiasis. The microscopic examination of patient urine samples is the preferred method for optimal patient assurance with the cooperation of therapists and doctors in addition to the epidemiological study. Conclusion. The relatively high rate of recurrent lithiasis illustrates the current limits of preventive measures which can be penalized by the lack of patient attendance but whose reduced effectiveness primarily suggests a lack of knowledge of one or more fundamental determinants of the lithogenic process. The experimental part showed a diversity of crystals in the urine of patients, pure calcium oxalate monohydrate, which was noticed in the majority of the subjects analyzed. The detection, in crystalluria, of a single crystal of whewellite can therefore be considered as a marker for hyperoxaluria. Weddellite was more common in the urine of subjects under analysis

Urine stones of different chemical composition occurrence depending on the level of uricuria

Introduction. According to modern concepts one of the key links in the pathogenesis of urolithiasis is metabolic lithogenic disturbances. The study of the complex effect of many factors on the metabolism of urolithiasis patient is the basis of modern scientific research. We studied the frequency of various chemical urinary stones occurrence depending on various levels of uricuria. Materials and methods. Data from of 708 urolithiasis patients (303 men and 405 women) were analized. The results of blood and urine biochemical analysis and chemical composition of urinary stone were studied. The degree of uricuria was ranked by 10 intervals: from 0.4 to 14.8 mmol/day to assess the occurrence of different stones at various levels of uricuria. Results. The incidence of calculi consisting of uric acid also increases with increasing levels of uric acid in the urine. An increase in the level of uricuria above 3.11 mmol/day is observed to increase calcium-oxalate stones occurrence. Decrease in the prevalence of carbonatapatite and struvite stones observed at an increase of urine uric acid excretion. At high levels of uric acid excretion, we found uric acid and calcium oxalate stones most often. Conclusion. Control over the level of urinary acid excretion in urine is important in case of calcium-oxalate and uric acid urolithiasis.

FEATURES OF THE ENDOCRINE AND BIOCHEMICAL STATUS OF THE POPULATION OF THE GEOCHEMICAL PROVINCE WITH AN INCREASED CONTENT OF ARSENIC IN DRINKING WATER

The aim of research is assessing the effect of arsenic contained in water from centralized water supply sources on the parameters of the endocrine system and the biochemical profile of children and adults (ob-jects of study) living in a region with high arsenic content in drinking water. The quality of drinking water was assessed, the arsenic content in the blood, the concentration of hormones and biochemical parameters of the blood were studied. It has been established that the arsenic content in a number of water samples (4.3 mg/dm3) is 86 times higher than the MPC, while in 8% of adults and 19% of children from the ob-servation group an increased arsenic content in the blood was found. The main changes in the metabolic and biochemical contours in children who use water with a high content of arsenic are associated with a change in hepatic and renal markers, and in adults they are more changes (decreased albumin, increased bilirubin, increased not only creatinine, but also urinary acid), also in adults of the observation group, changes in a number of hormonal markers were found. Thus, the use of drinking water increased content of arsenic causes age-dependent changes in biochemical parameters and hormonal regulation, which is confirmed by the presence of causal relationships detected by adequate logistic regression models.

Role of Carbonic Anhydrases and Inhibitors in Acid–Base Physiology: Insights from Mathematical Modeling

Carbonic anhydrases (CAs) catalyze a reaction fundamental for life: the bidirectional conversion of carbon dioxide (CO2) and water (H2O) into bicarbonate (HCO3−) and protons (H+). These enzymes impact numerous physiological processes that occur within and across the many compartments in the body. Within compartments, CAs promote rapid H+ buffering and thus the stability of pH-sensitive processes. Between compartments, CAs promote movements of H+, CO2, HCO3−, and related species. This traffic is central to respiration, digestion, and whole-body/cellular pH regulation. Here, we focus on the role of mathematical modeling in understanding how CA enhances buffering as well as gradients that drive fluxes of CO2 and other solutes (facilitated diffusion). We also examine urinary acid secretion and the carriage of CO2 by the respiratory system. We propose that the broad physiological impact of CAs stem from three fundamental actions: promoting H+ buffering, enhancing H+ exchange between buffer systems, and facilitating diffusion. Mathematical modeling can be a powerful tool for: (1) clarifying the complex interdependencies among reaction, diffusion, and protein-mediated components of physiological processes; (2) formulating hypotheses and making predictions to be tested in wet-lab experiments; and (3) inferring data that are impossible to measure.

Metabolic Acidosis and Subclinical Metabolic Acidosis in CKD

Metabolic acidosis is not uncommon in CKD and is linked with bone demineralization, muscle catabolism, and higher risks of CKD progression and mortality. Clinical practice guidelines recommend maintaining serum total CO2 at ≥22 mEq/L to help prevent these complications. Although a definitive trial testing whether correcting metabolic acidosis improves clinical outcomes has not been conducted, results from small, single-center studies support this notion. Furthermore, biologic plausibility supports the notion that a subset of patients with CKD have acid-mediated organ injury despite having a normal serum total CO2 and might benefit from oral alkali before overt acidosis develops. Identifying these individuals with subclinical metabolic acidosis is challenging, but recent results suggest that urinary acid excretion measurements may be helpful. The dose of alkali to provide in this setting is unknown as well. The review discusses these topics and the prevalence and risk factors of metabolic acidosis, mechanisms of acid-mediated organ injury, results from interventional studies, and potential harms of alkali therapy in CKD.

36 MONTHS SURVIVABILITY AND ITS PREDICTORS IN PATIENTS WITH CHRONIC HEART FAILURE AND DECREASED FRACTION OF LEFT VENTRICULAR EJECTION DEPENDING ON SEX

Aim of the work: to compare survivability parameters during 36 months and their predictors among men and women with chronic heart failure and decreased fraction of left ventricular ejection. Materials and methods: the research included 356 patients with CHF (NYHA ІІ –ІV) with decreased LVEF<40 %, 18–75 years old. Using Kaplan-Meier method, there was analyzed the survivability in men and women during 36 months, then there were analyzed independent factors that influenced survivability terms depending on sex using the multiple logistic regression. Results. Our analysis of the survivability of patients with CHF with decreased LVEF demonstrated that the cumulative survival after 3 years of observation was 49 and 51 % for men and women, respectively. The curves of 36 months survivability didn’t reliably differ. At the analysis of factors, associated with the bad prognosis, there were observed differences between groups of men and women with CHF. Thus, in men the predictors of 36 month survival were: the thickness of the right ventricle wall, size of the right atrium, end-diastolic volume and end-systolic volume of LV, indices of EDV and ESV of LV, urinary acid level, value of LVEF. In women the predictors of survivability during 3 years were the following parameters: BMI, DM type 2 in an anamnesis, end-diastolic size of LV, end-systolic size of LV, blood glucose level, LVEF. Conclusion. The survivability of men and women with CHF with decreased LVEF during 36 months didn’t reliably differ and was 49 and 51 % respectively. But predictors of the lethal outcome in men and women essentially differed during 36 months, and their number is essentially higher in men.