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Sgorbini M, Marmorini P, Rota A, Briganti A, Corazza M. Ultrasound Measurements of the Dorsal Subarachnoid Space Depth in Healthy Trotter Foals during the First Week of Life. J Equine Vet Sci 2011. [DOI: 10.1016/j.jevs.2010.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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402
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Portela DA, Otero PE, Tarragona L, Briganti A, Breghi G, Melanie P. Combined paravertebral plexus block and parasacral sciatic block in healthy dogs. Vet Anaesth Analg 2010; 37:531-41. [DOI: 10.1111/j.1467-2995.2010.00572.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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403
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Abdollah F, Briganti A, Suardi N, Gallina A, Capitanio U, Salonia A, Cestari A, Guazzoni G, Rigatti P, Montorsi F. Does diabetes mellitus increase the risk of high-grade prostate cancer in patients undergoing radical prostatectomy? Prostate Cancer Prostatic Dis 2010; 14:74-8. [PMID: 20956995 DOI: 10.1038/pcan.2010.41] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The objective was to test the hypothesis that in patients with prostate cancer undergoing radical prostatectomy (RP), diabetic patients are at a higher risk of harboring a high-grade tumor than non-diabetic patients. We examined 2060 consecutive men who underwent RP between 2001 and 2009. Of them, 7.1% had type 2 diabetes mellitus (DM). A high-grade tumor was defined as having a Gleason score ≥ 8. Univariable and multivariable logistic regression analyses were used to test the relationship between type 2 DM and high-grade tumor. Mean patient age was 64 years (range: 45-85). Mean total PSA level was 9 ng ml(-1) (range: 1-89.5). A significantly higher percentage of diabetic patients had high-grade tumor on biopsy (16.3 vs 7.6%; P = 0.001) and on RP specimen (21.1 vs 11.7%; P = 0.001) in comparison with non-diabetic patients. In multivariable analyses, DM was an independent predictor of high-grade tumor on biopsy (odds ratio = 2.31, P = 0.001) and on final pathological specimen (odds ratio = 2.22, P = 0.002). In patients undergoing RP, those with type 2 DM had a higher risk of harboring a poorly differentiated tumor on final pathological examination.
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404
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Briganti A, Melanie P, Portela D, Breghi G, Mama K. Continuous positive airway pressure administered via face mask in tranquilized dogs. J Vet Emerg Crit Care (San Antonio) 2010; 20:503-8. [DOI: 10.1111/j.1476-4431.2010.00579.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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405
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Barsotti G, Briganti A, Spratte JR, Ceccherelli R, Breghi G. Mydriatic effect of topically applied rocuronium bromide in tawny owls (Strix aluco): comparison between two protocols. Vet Ophthalmol 2010; 13 Suppl:9-13. [DOI: 10.1111/j.1463-5224.2010.00773.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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406
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Barsotti G, Briganti A, Spratte JR, Ceccherelli R, Breghi G. Bilateral mydriasis in common buzzards (Buteo buteo) and little owls (Athene noctua) induced by concurrent topical administration of rocuronium bromide. Vet Ophthalmol 2010; 13 Suppl:35-40. [DOI: 10.1111/j.1463-5224.2010.00808.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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407
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Buffi N, Gallina A, Gadda G, Scapaticci E, Zanoni M, Cestari A, Lazzeri M, Suardi N, Briganti A, Rigatti P, Montorsi F, Guazzoni G. 81 PREDICTING FACTORS FOR ERECTILE FUNCTION RECOVERY FOLLOWING INTRAFASCIAL BILATERAL NERVE-SPARING RADICAL PROSTATECTOMY. A COMPARATIVE STUDY BETWEEN THE OPEN AND ROBOTIC APPROACH. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1569-9056(10)60087-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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408
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Gontero P, Spann M, Briganti A, Marchioro G, Tombal B, Hsu C, Vander EK, Bader P, Walz J, Frohneberg D, Graefen M, Montorsi F, Tizzani A, Van Cangh P, Van Poppel H, Joniau S. 679 IS SURGERY FOR HIGH-RISK LOCALIZED PROSTATE CANCER VALID IN THE ELDERLY POPULATION? AN ANALYSIS OF THE INFLUENCE OF AGE AN CANCER-SPECIFIC AND OVERALL SURVIVAL. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1569-9056(10)60666-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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409
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Gallina A, Briganti A, Suardi N, Salonia A, Barbieri L, Villa L, Gandaglia G, Bianchi M, Gadda G, Di Trapani D, Losa A, Rigatti P, Montorsi F. 836 LONG-TERM OUTCOME OF GLEASON 8-10, NODE NEGATIVE PROSTATE CANCER: THE IMPORTANCE OF LOCAL CONTROL. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1569-9056(10)60819-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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410
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Deho F, Gallina A, Salonia A, Briganti A, Suardi N, Zanni G, Guazzoni G, Rigatti P, Montorsi F. Prophylaxis of Erectile Function After Radical Prostatectomy with Phosphodiesterase Type 5 Inhibitors. Curr Pharm Des 2009; 15:3496-501. [DOI: 10.2174/138161209789206999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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411
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Suardi N, Gallina A, Salonia A, Briganti A, Cestari A, Guazzoni G, Rigatti P, Montorsi F. Open prostatectomy and the evolution of HoLEP in the management of benign prostatic hyperplasia. MINERVA UROL NEFROL 2009; 61:301-308. [PMID: 19773730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Trans-urethral resection of the prostate (TURP) and other minimally invasive therapies are the most common surgical procedures used to treat benign prostatic hyperplasia today. However, many patients with a markedly enlarged prostate are often not amenable to these treatment options. In these patients open prostatectomy has been representing a viable and preferred treatment. Despite the morbidity of open enucleation is substantial, until recently no other options were available when the size of the prostate approached 100 g and beyond. The use of holmium laser for the treatment of benign prostatic hyperplasia was first reported in 1996. Holmium laser enucleation of the prostate (HoLEP) has been proposed as an alternative to TURP and to open prostatectomy for patients with lower urinary tract symptoms (LUTS) due to large benign prostatic enlargement. In this manuscript, the development of HoLEP from the initial reports to the long-term follow-up data which demonstrate the effectiveness of the technique in treating patients affected by LUTS secondary to large adenomas has been reviewed. HoLEP seems to represent a valid alternative to both TURP and OP, with valid long-term functional results, a low rate of short-term and long-term complications, and very low rates of reintervention. In conclusion, HoLEP can be offered as the size-independent gold standard treatment of patients with LUTS due to benign prostatic enlargement.
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412
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Gallina A, Briganti A, Salonia A, Deho' F, Zanni G, Suardi N, Cestari A, Guazzoni G, Rigatti P, Montorsi M. DEVELOPMENT AND INTERNAL VALIDATION OF A NOMOGRAM PREDICTING ERECTILE FUNCTION RECOVERY AFTER BILATERAL NERVE SPARING RETROPUBIC RADICAL PROSTATECTOMY FOR CLINICALLY LOCALISED PROSTATE CANCER. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60365-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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413
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Cestari A, Sangalli M, Buffi N, Lughezzani G, Riva M, Rigatti L, Nava L, Briganti A, Bertini R, Roscigno M, Montorsi F, Rigatti P, Guazzoni G. LAPAROSCOPIC RENAL CRYOABLATION (LRC) OF SMALL RENAL MASSES: LESSONS LEARNED FROM 104 CASES IN A 7-YEAR EXPERIENCE. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60484-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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414
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Briganti A, Karnes J, Da Pozzo L, Gallina A, Salonia A, Suardi N, Montorsi F, Rigatti P, Blute M. TWO POSITIVE NODES REPRESENT A SIGNIFICANT CUT-OFF VALUE FOR CANCER SPECIFIC SURVIVAL IN PATIENTS WITH NODE POSITIVE PROSTATE CANCER. A NEW PROPOSAL BASED ON A TWO INSTITUTION EXPERIENCE ON 784 CONSECUTIVE N+ PATIENTS. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60926-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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415
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Edwards CD, Briganti A. P‐04 Erectile dysfunction. J Sex Med 2008. [DOI: 10.1111/j.1743-6109.2008.661_4.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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416
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Raber M, Abdollah F, Matloob R, Briganti A, Dempegiotis T, Castillejos Molina R, Salonia A, Saccà A, Sozzi F, Rigatti P, Montarsi F. 290 COMPARISON OF HOLMIUM LASER, COLD KNIFE AD DIATERMIC INCISION FOR THE ENDOSCOPIC TREATMENT OF ANASTOMOTIC STRICTURE AFTER RADICAL RETROPUBIC PROSTATECTOMY. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1569-9056(07)60289-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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417
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Marberger M, Briganti A. P-06Erectile Dysfunction following Radical Prostatectomy. J Sex Med 2007. [DOI: 10.1111/j.1743-6109.2007.00390_6.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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418
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Salonia A, Munarriz RM, Naspro R, Nappi RE, Briganti A, Chionna R, Federghini F, Mirone V, Rigatti P, Goldstein I, Montorsi F. Women's sexual dysfunction: a pathophysiological review. BJU Int 2004; 93:1156-64. [PMID: 15142131 DOI: 10.1111/j.1464-410x.2004.04796.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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419
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Montorsi F, Salonia A, Briganti A, Dehò F, Zanni G, Da Pozzo L, Rigatti P. 123 Five year follow-up of plaque incision and vein grafting for Peyronie's disease. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s1569-9056(04)90125-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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420
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Montorsi F, Briganti A, Salonia A, Deho' F, Zanni G, Cestari A, Guazzoni G, Rigatti P, Stief C. The ageing male and erectile dysfunction. BJU Int 2003; 92:516-20. [PMID: 12930410 DOI: 10.1046/j.1464-410x.2003.04378.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Erectile dysfunction is common in the ageing man and reliable therapies are needed. The pathophysiology of erectile dysfunction in this group mainly includes chronic ischaemia, which triggers the deterioration of cavernosal smooth muscle and the development of corporeal fibrosis. Assessing the ageing man with erectile dysfunction who seeks medical treatment should comprise a thorough medical and sexual history, a systemic and focused physical examination and selected blood tests. Oral drug therapy represents a safe and effective option for most ageing men.
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421
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Schianchi T, Meschi T, Briganti A, Novarini A, Donati A, Pieroni G, Borghi L. [Post-acute long stay and extensive rehabilitation: study of the first year of work at a long stay university hospital unit]. ANNALI ITALIANI DI MEDICINA INTERNA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI MEDICINA INTERNA 2001; 16:32-7. [PMID: 11688348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Long stay is a new type of hospital admission geared to internal medicine patients requiring long-term stays in hospital and prolonged treatment for the purposes of stabilization or clinical rehabilitation. Given the lack of specific experience, we monitored the progress of a Long-Stay Unit with the aim to estimate the clinical and organizational impact. We studied 263 patients (59.3% females, 40.7% males; mean age 76.3 +/- 11.5 years, 42.2% all in their late eighties) coming from medical wards (75%) and from surgical wards (25%). The clinical complexity was prospectively estimated by a form divided into 3 sections: the first part was filled out at the time of transfer, the second part at set intervals throughout the period and the third at the end of the stay. Mean length of stay for medical patients was 33.2 days, for surgical patients 28.6 days (NS). Main transfer diagnosis: 50% of the patients fell into two diagnostic groups: malignant neoplasm (33.1%) and cerebral ictus (17.5%). Some data evidenced remarkable clinical complexity: 93.9% of the patients had one or more secondary diagnoses; when initially admitted 89.4% already presented with complications or serious outcomes; while in the Long-Stay Unit 83.3% required medical treatment and extensive nursing care; 87.1% had further major complications; 56.3% was totally dependent; 42.6% was totally bedridden and 35.4% died. In conclusion, the majority of long-stay patients in a medium-to-large polyclinic hospital present with several concomitant diseases, with extremely invalidating complaints, characterized over the short-to-mid term by serious clinical complications. They require a great deal of competent medical/nursing care as well as highly qualified internal medicine specialists.
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422
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Borghi L, Meschi T, Schianchi T, Briganti A, Guerra A, Allegri F, Novarini A. Urine volume: stone risk factor and preventive measure. Nephron Clin Pract 2000; 81 Suppl 1:31-7. [PMID: 9873212 DOI: 10.1159/000046296] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A high fluid intake is the oldest existing treatment for kidney stones, and, up until a few decades ago, it was the only preventive measure at the physician's disposal for stone recurrences. METHODS Using the data available in literature and partly unpublished personal research, we examine the role of urine volume as a stone risk factor, its impact on calcium crystallization mechanisms and its real importance as a means of prevention. RESULTS To sum up, the most important findings are: (1) a low urine volume must be considered as a real risk factor, both as regards the onset of renal calculi and stone relapses; (2) an increase in urine volume induced by a high water intake produces favourable effects on the crystallization of calcium oxalate and does not reduce the activity of natural inhibitors; (3) a sufficiently high intake of water and probably other fluids such as coffee, tea, beer and wine has a preventive effect on nephrolithiasis and its recurrence, and (4) the role of fruit juice is still to be defined. CONCLUSIONS A high intake of fluids, especially water, is still the most powerful and certainly the most economical means of prevention of nephrolithiasis, and it is often not used to advantage by stone formers.
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423
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Borghi L, Meschi T, Guerra A, Briganti A, Schianchi T, Allegri F, Novarini A. Essential arterial hypertension and stone disease. Kidney Int 1999; 55:2397-406. [PMID: 10354288 DOI: 10.1046/j.1523-1755.1999.00483.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cross-sectional studies have shown that nephrolithiasis is more frequently found in hypertensive patients than in normotensive subjects, but the pathogenic link between hypertension and stone disease is still not clear. METHODS Between 1984 and 1991, we studied the baseline stone risk profile, including supersaturation of lithogenic salts, in 132 patients with stable essential hypertension (diastolic blood pressure of more than 95 mm Hg) without stone disease and 135 normotensive subjects (diastolic blood pressure less than 85 mm Hg) without stone disease who were matched for age and sex (controls). Subsequently, both controls and hypertensives were followed up for at least five years to check on the eventual formation of kidney stones. RESULTS Baseline urine levels in hypertensive males were different from that of normotensive males with regards to calcium (263 vs. 199 mg/day), magnesium (100 vs. 85 mg/day), uric acid (707 vs. 586 mg/day), and oxalate (34.8 vs. 26.5 mg/day). Moreover, the urine of hypertensive males was more supersaturated for calcium oxalate (8.9 vs. 6.1) and calcium phosphate (1.39 vs. 0.74). Baseline urine levels in hypertensive females were different from that of normotensive females with regards to calcium (212 vs. 154 mg/day), phosphorus (696 vs. 614 mg/day), and oxalate (26.2 vs. 21.7 mg/day), and the urine of hypertensive females was more supersaturated for calcium oxalate (7.1 vs. 4.8). These urinary alterations were only partially dependent on the greater body mass index in hypertensive patients. During the follow-up, 19 out of 132 hypertensive patients and 4 out of 135 normotensive patients had stone episodes (14.3 vs. 2.9%, chi-square 11.07, P = 0.001; odds ratio 5.5, 95% CI, 1.82 to 16.66). Of the 19 stone-former hypertensive patients, 12 formed calcium calculi, 5 formed uric acid calculi, and 2 formed nondetermined calculi. Of the urinary factors for lithogenous risk, those with the greatest predictive value were supersaturation of calcium oxalate for calcium calculi and uric acid supersaturation for uric acid calculi. CONCLUSIONS A significant percentage of hypertensive subjects has a greater risk of renal stone formation, especially when hypertension is associated with excessive body weight. Higher oxaluria and calciuria as well as supersaturation of calcium oxalate and uric acid appear to be the most important factors. Excessive weight and consumption of salt and animal proteins may also play an important role.
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424
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Borghi L, Guerra A, Meschi T, Briganti A, Schianchi T, Allegri F, Novarini A. Relationship between supersaturation and calcium oxalate crystallization in normals and idiopathic calcium oxalate stone formers. Kidney Int 1999; 55:1041-50. [PMID: 10027942 DOI: 10.1046/j.1523-1755.1999.0550031041.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In an earlier study on recurrent CaOx stone formers with no detectable abnormalities, we found that the urine of these subjects had a lower tolerance to oxalate load than controls and that the removal of urinary macromolecules with a molecular weight greater than 10,000 D improved their tolerance to oxalate. METHODS The effects on CaOx crystallization of reduced urinary supersaturation of calcium oxalate (CaOx), induced by night water load, were studied in 12 normal males and in 15 male OxCa stone formers who were free from urinary metabolic abnormalities. The effect of the macromolecules, purified and retrieved from the natural and diluted urine, were analyzed in a metastable solution of CaOx. RESULTS The water load caused an increase in urine volume (from 307 +/- 111 to 572 +/- 322 ml/8 hr, P = 0.014 in normal subjects, and from 266 +/- 92 to 518 +/- 208 ml/8 hr, P = 0.001 in the stone formers) and a concomitant reduction of the relative CaOx supersaturation (from 8.7 +/- 2.5 to 5.1 +/- 2.5 ml/8 hr, P = 0.001 in normal subjects, and from 10.4 +/- 3.5 to 5.0 +/- 2.7 ml/8 hr, P = 0.001 in the stone formers). The decrease in CaOx supersaturation was accompanied by an increase of the permissible increment in oxalate, both in normal subjects (from 43.8 +/- 10.1 to 67.2 +/- 30. 3 mg/liter, P = 0.018) and in the stone formers (from 25.7 +/- 9.4 to 43.7 +/- 17.1 mg/liter, P = 0.0001), without any significant variations of the upper limit of metastability for CaOx (from 21.6 +/- 5.3 to 20.5 +/- 4.2 mg/liter in normal subjects, and from 18.7 +/- 4.5 to 17.1 +/- 3.7 mg/liter in the stone formers). The inhibitory effect of urinary macromolecules with molecular weight greater than 10,000 Daltons did not undergo any change when the latter were recovered from concentrated or diluted urine, either in normal subjects or in the stone formers. CONCLUSIONS Reduced CaOx supersaturation by means of water load has a protective effect with regards to CaOx crystallization in subjects who do not present any of the common urinary stone risk factors.
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425
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Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 1996. [PMID: 8583588 DOI: 10.1016/s0022-5347(01)66321-3] [Citation(s) in RCA: 461] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE We define the role of urine volume as a stone risk factor in idiopathic calcium stone disease and test the actual preventive effectiveness of a high water intake. MATERIALS AND METHODS We studied 101 controls and 199 patients from the first idiopathic calcium stone episode. After a baseline study period the stone formers were divided by randomization into 2 groups (1 and 2) and they were followed prospectively for 5 years. Followup in group 1 only involved a high intake of water without any dietetic change, while followup in group 2 did not involve any treatment. Each year clinical, laboratory and radiological evaluation was obtained to determine urinary stone risk profile (including relative supersaturations of calcium oxalate, brushite and uric acid by Equil 2), recurrence rate and mean time to relapse. RESULTS The original urine volume was lower in male and female stone formers compared to controls (men with calcium oxalate stones 1,057 +/- 238 ml./24 hours versus normal men 1,401 +/- 562 ml./24 hours, p < 0.0001 and women calcium oxalate stones 990 +/- 230 ml./24 hours versus normal women 1,239 +/- 440 ml./24 hours, p < 0.001). During followup recurrences were noted within 5 years in 12 of 99 group 1 patients and in 27 of 100 group 2 patients (p = 0.008). The average interval for recurrences was 38.7 +/- 13.2 months in group 1 and 25.1 +/- 16.4 months in group 2 (p = 0.016). The relative supersaturations for calcium oxalate, brushite and uric acid were much greater in baseline urine of the stone patients in both groups compared to controls. During followup, baseline values decreased sharply only in group 1. Finally the baseline urine in patients with recurrences was characterized by a higher calcium excretion compared to urine of the patients without recurrences in both groups. CONCLUSIONS We conclude that urine volume is a real stone risk factor in nephrolithiasis and that a large intake of water is the initial therapy for prevention of stone recurrences. In cases of hypercalciuria it is suitable to prescribe adjuvant specific diets or drug therapy.
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