A large 15 - year database analysis on the influence of age, gender, race, obesity and income on hospitalization rates due to stone disease

ABSTRACT Purpose: To assess the public hospitalization rate due to stone disease in a large developing nation for a 15-year period and its association with socio-demographic data. Materials and Methods: A retrospective database analysis of hospitalization rates in the Brazilian public health system was performed, searching for records with a diagnosis code of renal/ureteral calculi at admission between 1998­2012. Patients managed in an outpatient basis or private care were excluded. Socio-demographic data was attained and a temporal trend analysis was performed. Results: The number of stone-related hospitalizations increased from 15.7%, although the population-adjusted hospitalization rate remained constant in 0.04%. Male:female proportion among hospitalized patients was stable (49.3%:50.7% in 1998; 49.2%:50.8% in 2012), though there was a significant reduction in the prevalence of male hospitalizations (−3.8%;p=0.041). In 2012, 38% of hospitalized patients due to stone disease had 40­59 years-old. The ≥80 years-old strata showed the most significant decrease (−43.44%;p=0.022), followed by the 20­39 (−23.17%;p<0.001) and 0­19 years-old cohorts (−16.73%;p=0.012). Overall, the lowest relative hospitalization rates were found for yellow and indigenous individuals. The number of overweight/obese individuals increased significantly (+20.6%), accompanied by a +43.6% augment in the per capita income. A significant correlation was found only between income and obesity (R=0.64;p=0.017). Conclusions:The prevalence of stone disease requiring hospitalization in Brazil remains stable, with a balanced proportion between males and females. There is trend for decreased hospitalization rates of male, <40 and ≥80 years-old individuals. Obesity and income have a more pronounced correlation with each other than with stone disease.

Xanthogranulomatous Pyelonephritis (XGPN) in a Child with Multiple Ureteric Calculi.

Xanthogranulomatous pyelonephritis (XGPN) is an unusual suppurative granulomatous reaction to chronic renal infection, often in the presence of chronic obstruction, characterised histologically by granulomatous reaction with giant cells and foamy histiocytes1. XGPN is rare in children2. We report a case of XGPN, in a child with multiple lower ureteric calculi. An 11 year old male child presented to us, with features suggestive of acute pyelonephritis of two months duration.complete evaluation including contrast CT of the abdomen a diagnosis of XGPN was made. As the renal unit in question was non functional, he was treated successfully by subcapsular nephrectomy. This case is presented to emphasise the fact that, it is very important to diagnose XGPN early and differentiate it from chronic pyelonephritis. Prolonged antibiotic therapy and surgery is invariably required to relieve the obstruction and to eradicate the infection in patients with XGPN.

Rigid ureteroscopy for removal of stones: astudy of 2500 patients

Until recently, the only treatment available for ureteric calculi was open ureterolithotomy. However, with the introduction of ureteroscopy, stones can now be removed with Dormia under vision or broken into small pieces with ultrasound, electrohydraulic probe or lithoclast. In this study, we present a review of 2500 cases with ureteric stones of different sizes and at different levels treated with rigid ureteroscopy. The success rate was 92.05% in the lower one-third, 84% in the middle one-third and 26.55% in the upper one-third of the ureter. This method is safe and also results in shorter hospital stay

Contribución al estudio de la urolitiasis en nuestro medio pediátrico / Urolithiasis in chilhood

Se presentan las observaciones realizadas en un grupo de 193 pacientes estudiados en el Hospital del Niño de Lima en los años de 1952 a 1970, haciendo notar la alta incidencia como problema endémico entre las clases mas pobres del país. Se analiza la causa alimenticia como factor etiopatogenio de fondo a través de un estudio bibliográfico y comparativo. Se presenta una hipótesis de trabajo con relación a los cereales como factor predisponente, sugiriendo unos cuestionarios epidemiológicos y dietéticos como futuro estudio. Se presenta una breve revisión de los recientes trabajos experimentales en la que se indican la posibilidad teórica de un inbalance por falta de aminoácidos individuales, asociados con una deficiencia ya sea primaria o secundaria en el grupo constituyente de Vit. B1 y posiblemente B6 en el metalismo intermedio de ésta última; problema que sumado a la carencia de proteinas animales, calcio y vitamina A, comunes en nuestra menesterosa población infantil; coincide con lo demostrado con las publicaciones hasta ahora realizadas