Idiopathic urolithiasis in Tunisian children: a report of 134 cases.

We evaluated the metabolic and the nutritional aspects of 134 urolithiasis children in order to outline the characteristics of idiopathic urolithiasis in children. This prospective study group of 134 children (56 females, 78 males) with renal calculi was evaluated. The age range of the patients was six months to 16 years. A dietary survey was performed on every child. All patients were investigated with respect to stone localization and serum and urine risk factors. Statistical analysis of data was carried out using software SPSS 11.0 for Windows. Hypercalciuria was the most common risk factor detected in this group (28.3%). A decrease of water intake was noted in all age groups, especially in the rural area (549.6 mL/day vs. 1150.6 mL/day), and there was an increase in animal protein intake in 17 cases (mean: 1.9 g/kg). In addition, increased intake of starchy foods and food with high oxalate content (sorgum) were detected in the ten to 16 years age group (51%) of our study. Calcium oxalate monohydrate represents the principal component of idiopathic stone (58.2%), which is more frequent in children (68%) than in infants (51.7%) (P <0.02). The major etiology of idiopathic urolithiasis highlights the influence of dietary habit in stone formers in our country. The increased occurrence of calcium oxalate stones in school age children confirms the change in the etiology of urolithiasis according to age.

[Stone composition in the central coast Tunisian population]. / Étude de la composition des calculs urinaires en fonction de l'âge dans la population du centre tunisien.

BACKGROUND: Studies that evaluated the effect of age and gender on the stone composition were scarce. The aim of this study was to identify the stone composition in Tunisian patients and to highlight their modification according to patients' sex and age. PATIENTS AND METHODS: We studied 1200 urolithiasic patients, from the urologic and the pediatric surgery departments, ranging from six months to 92years old and known as having urinary stones (729 males and 471 females). Stone analysis was performed respectively using a stereomicroscope and infrared spectroscopy to determine, respectively, the morphological type and the molecular composition of each. RESULTS: Kidney stones were encountered in 48.6% of calculi. Children and old men were more affected by bladder stone. Whewellite was the main component in 51.8% of the stones and 39.6% of the stone core, its frequency fell according to age from 61.4% in young adults to 47.7% in elderly in favor of the increase of uric acid stones, from 16.4% in young adults to 35.6% in elderly (P<0,02). Struvite stones were rare (3.2%) and more frequent in boys. CONCLUSION: The analysis of these data shows that urinary stones in Tunisia were tending to evolve in the same direction as in industrialized countries.

Cambios en el tipo de cálculos renales según sexo y edad en pacientes tunecinos / Changes in Kidney Stones Type According to Sex and Age in Tunisian Patients

Objetivos: Los estudios que evalúan el efecto de la edad y el género sobre la composición de las piedras renales son escasos. El objetivo de este estudio es subrayar la modificación de las características epidemiológicas de esta patología de acuerdo con el sexo y la edad de los pacientes. Material y métodos: Estudiamos a 1.269 pacientes con urolitiasis de edades comprendidas entre 6 meses y 92 años y que se conocía que tenían cálculos urinarios (752 varones y 517 mujeres). Se realizó un análisis de las piedras usando un microscopio estereoscópico y espectroscopía infrarroja para determinar respectivamente el tipo morfológico y la composición molecular de cada una. Resultados: La incidencia anual promedio de formación de nuevas piedras fue de 30,25 por cada 100.000 personas. En 1.041 pacientes (el 81%) los cálculos estuvieron localizados en el tracto urinario superior. Los niños y ancianos fueron más afectados por piedras en la vejiga. El monohidrato de oxalato de calcio sigue siendo el componente más frecuente de los cálculos, a pesar de que su frecuencia caía en relación con la edad (63,2% en adolescentes y 40,6% en ancianos [p<0,05]). Las piedras de estruvita fueron raras (3,5%) y más frecuentes en niños. Conclusión: El análisis de estos datos muestra que los cálculos urinarios en Túnez tienden a evolucionar en la misma dirección que en países indrustrializados (AU)

Background: Studies that evaluate the effect of age and gender on the stone composition are scarce. The aim of this study is to highlight the modification of epidemiological characteristics of this pathology according to patients’ sex and age. Patients and methods: We studied 1269 urolithiasic patients ranging from 6 months to 92 years old and known as having urinary stones (752 males and 517 females). Stone analysis was performed respectively using a stereomicroscope and infrared spectroscopy to determine, respectively, the morphological type and molecular composition of each. Results: The annual average incidence of new stone formation was 30.25 per 100000 inhabitants. In 1041 patients (81%), calculi were located in the upper urinary tract. Children and old man were more affected by bladder stone. Calcium oxalate monohydrate remains the most frequent stone component even if its frequency fell according to age (63.2% in teenagers and 40.6% in elderly [p<0.05]) in favour of the increase of uric acid stones (3,5% in teenagers and 41.5% in elderly [p<0.05]). Struvite stones were rare (3.5%) and more frequent in children. Conclusion: The analysis of these data shows that urinary stones in Tunisia are tending to evolve in the same direction as in industrialized countries (AU)

[Changes in kidney stones type according to sex and age in Tunisian patients]. / Cambios en el tipo de cálculos renales según sexo y edad en pacientes tunecinos.

BACKGROUND: Studies that evaluate the effect of age and gender on the stone composition are scarce. The aim of this study is to highlight the modification of epidemiological characteristics of this pathology according to patients' sex and age. PATIENTS AND METHODS: We studied 1269 urolithiasic patients ranging from 6 months to 92 years old and known as having urinary stones (752 males and 517 females). Stone analysis was performed respectively using a stereomicroscope and infrared spectroscopy to determine, respectively, the morphological type and molecular composition of each. RESULTS: The annual average incidence of new stone formation was 30.25 per 100,000 inhabitants. In 1041 patients (81%), calculi were located in the upper urinary tract. Children and old man were more affected by bladder stone. Calcium oxalate monohydrate remains the most frequent stone component even if its frequency fell according to age (63.2% in teenagers and 40.6% in elderly [p<0.05]) in favour of the increase of uric acid stones (3,5% in teenagers and 41.5% in elderly [p<0.05]). Struvite stones were rare (3.5%) and more frequent in children. CONCLUSION: The analysis of these data shows that urinary stones in Tunisia are tending to evolve in the same direction as in industrialized countries.

Pediatric urolithiasis in the central coast of Tunisia: Epidemiologic changes over the past twenty-five years.

The incidence of pediatric urolithiasis has been constantly decreasing during the past twenty-four years (1982-2007) in Tunisia as well as in other Mediterranean countries. This study was undertaken to observe the incidence of stone disease and its composition in children. Our study shows a downward trend of incidence of urolithiasis in pediatric patients over the last 25 years. The prevalence of calcium oxalate stones has constantly increased with decrease in the stones related to infections Whewellite (calcium oxalate) was more frequent in children of school age. In conclusion, the decrease in struvite frequency in children patients during the past twenty-five years and the stabilization of calcium phosphate stones are the result of a significant improvement of diagnostics and the treatment of urinary tract infections in the young children in our country.

Changes in stone composition according to age and gender in Tunisian children.

OBJECTIVE: Studies evaluating the influence of age and gender on the distribution of the various types of pediatric urinary calculi are scarce. The aim of this study was to highlight the modification of epidemiological characteristics of this pathology according to patients' sex and age. PATIENTS AND METHODS: A total of 205 calculi (from 122 boys and 83 girls) were analyzed by infrared spectroscopy between 1993 and 2007; 54.6% of the patients were under 5 years. RESULTS: Calcium oxalate was the predominant constituent in 54.7% of stones, followed by calcium phosphate and purines (14.6% each). We found a predominance of calcium oxalate in females (59.1% vs 50.8%), and a male preponderance for struvite stones (12.3% vs 1.2%). There was an increasing prevalence of calcium oxalate stones with age in both genders (42.9% in infants vs 59.3% in older children). Purine stones were predominant in 20% of cases, but prevalence decreased with age (28.6% in infants vs 18.5% in older children). CONCLUSION: The increase in calcium oxalate stones in school-age children and the decrease in stones containing purines confirm a change in the etiology of urolithiasis according to age.

[Prevalence and composition of urolithiasis in a pediatric Tunisian population]. / Prévalence et composition de la lithiase urinaire dans une population pédiatrique tunisienne.

OBJECTIVES: The epidemiologic characteristics are significant to take into account in order to determine the etiology of the paediatric urinary calculi. In this study we studied the composition of stones according to the sex and the age. PATIENTS AND METHODS: Our study focuses on 205 tunisian children aged between three months and 16 years, admitted in our service between 1993-2007. A first urinary metabolic balance was conducted among 126 patients. The physical and chemical stones analysis was performed respectively by a stereomicroscope and infrared spectroscopy. Statistical analysis of the results was made using the software SPSS11.0. RESULTS: Bladder stone was present in 30.7%. It was more frequent in infants than children over 10 years (p<0.02). The Whewellite was present in 72.7% and predominant in older children stones (59.3% vs 42.9% in infants) (p<0.05). Purines stones were more common among infants. Struvite has been the major compound in only 7.8% of cases where it was more common in infants (p<0.05) male (p<0001). CONCLUSION: The higher prevalence of calcium oxalate stones and weaker purin ones in old children suggested the presence of different lithogenous factors of risk according to the age. A modification of the food practices is probably in question.

[Rhinitis and asthma related to cotton dust exposure in apprentices in the clothing industry]. / Rhinite et asthme liés à l'exposition aux poussières de coton chez des apprentis en habillement.

OBJECTIVE: Respiratory allergies are the most common occupational diseases in the world. The aim of this study was to determine the prevalence of rhinitis and asthma among apprentices exposed to cotton dust in the clothing industry and to describe their epidemiologic and clinical profiles. SUBJECTS AND METHODS: We carried out a descriptive study of 600 apprentices in a textile and clothing vocational training centre in the Monastir area. The investigation comprised a questionnaire exploring risk factors and symptoms appearing during their training. Subjects who developed allergic respiratory symptoms at the work-place underwent a clinical examination, rhinomanometry and investigation of their allergic status and respiratory function. RESULTS: One hundred twenty apprentices (20%) developed allergic respiratory reactions due to exposure to textile dust (exclusively cotton) during their training, with a positive withdrawal-re-exposure test. Conjunctivitis (14.3%) and rhinitis (8.5%) were the most frequent allergic symptoms. Twenty eight apprentices (4.6%) presented symptoms of asthma. Rhinitis was associated with asthma in 45% of cases. Two cases of asthma were diagnosed clinically at the work-place following their exposure to textile dust. The prick test performed in 120 symptomatic apprentices was positive in 41.6% of cases. There was sensitization to pollens in 29 cases and to dermatophagoides in 13 cases. Cotton and wool allergy was noted in two cases. Allergic symptoms developing during the training were significantly more frequent in the atopic group, and they varied according to the intensity of textile dust exposure. CONCLUSION: In the textile and clothing industry the frequency of respiratory disorders caused by allergens remains high, especially in atopic apprentices who constitute a population at high risk.