The effect of piezoelectric shockwave lithotripsy with 2- and 8-mm focus sizes on stone disintegration and renal injury

OBJECTIVES

To compare the efficacy and safety of shockwave lithotripsy (SWL) using a narrow focus or wide focus for renal stones.

PATIENTS AND METHODS

A double-blind randomised trial included adult patients with a solitary radio-opaque renal pelvic stone of 1-2 cm. Patients were randomised into two groups: narrow-focus (2 mm) SWL and wide-focus (8 mm) SWL. The stone-free rate (SFR) and presence of complications such as haematuria, fever, pain, and peri-renal haematoma were evaluated. Pre- and postoperative urinary markers (neutrophil gelatinase-associated lipocalin [NGAL] and kidney injury molecule 1 [KIM-1]) concentrations were compared to assess renal injury.

RESULTS

A total of 135 patients were recruited for this study. The SFR after the first SWL session was 79.2% and 69.1% in narrow- and wide-focus groups, respectively. There was a comparable rise in the median 2-h NGAL concentration in both groups (P = 0.62). However, the rise in the median (interquartile range [IQR]) 2-h KIM-1 concentration was significantly higher in the narrow-focus group at 4.9 (4.6, 5.8) ng/mL compared with the wide-focus group at 4.4 (3.2, 5.7) ng/mL (P = 0.02). Nevertheless, the 3-day NGAL and KIM-1 urinary marker concentrations were significantly improved (P = 0.263 and P = 0.963, respectively). The overall SFR after three sessions was 86.6% and 86.8% in the narrow- and wide-focus groups, respectively (P = 0.77). Both groups were comparable for complications, apart from the median pain score and the percentage of high-grade haematuria, which were significantly higher in the narrow-focus group (P < 0.001 and P = 0.03, respectively).

CONCLUSION

Narrow- and wide-focus SWL were associated with comparable outcomes and re-treatment rates. However, narrow-focus SWL was associated with significantly higher morbidity in terms of pain and haematuria.

Serum level of serum amyloid A1 protein in patients with acne vulgaris

INTRODUCTION

The serum amyloid A1 (SAA1) protein is involved in many pathological diseases. The increased secretion of SAA1 can maintain inflammatory conditions. Acne vulgaris (AV) is a chronic inflammatory disease of pilosebaceous glands and may be associated with systemic manifestations.

AIM OF THE WORK

This study aimed to evaluate the serum level of SAA1 in patients with AV.

SUBJECTS AND METHODS

120 participants were included in this study: 60 patients with AV and 60 apparently healthy volunteers as a control group. These participants were subjected to dermatological examination and assessments of lipid profile, fasting blood glucose (FBG), and serum SAA1.

RESULTS

Both serum SAA1 and FBG are significantly elevated in patients with AV than control (p < 0.0001 and p < 0.001, respectively). Furthermore, there are positive correlations between AV severity and SAA1 and FBG (p < 0.001 and p < 0.0001, respectively).

CONCLUSIONS

Serum amyloid A1 is increased in AV, and this elevation may play a role in the inflammatory milieu of AV.