An epidemiological study of renal lithiasis in gypsies and others in Spain.

A comparative epidemiological study was done on renal lithiasis in gypsies and nongypsies in Eastern Andalucía, Spain. A family history of lithiasis in gypsies was obtained 2 to 3 times less often compared to nongypsies (1.14 versus 4.34 per cent). The male-to-female ratio of gypsies with lithiasis was 0.59 per cent compared to 1.54 per cent in others. The inverse ratio in gypsies contrasted with those obtained by various authors in western countries of white and black populations. There was a predominance of immediate family history of lithiasis in gypsies with stones (p less than 0.001, 11.81 per cent), which was not observed among nongypsies (p equals 0.80). The incidence of consanguineous marriage among gypsies was high (26.95 per cent) compared to others (4.07 per cent). There was a dependent relationship in gypsies between family history of lithiasis and consumption of meat products (p equals 0.001), dairy products and food rich in oxalic acid (p equals 0.05). In nongypsies these differences were less significant statistically and were nonexistent in the incidence of consumption of food containing oxalic acid. We ascribe the difference in the incidence of lithiasis between gypsies and other subjects principally to hereditary and dietary factors.

[Clinical behavior of mixed nucleus reno-ureteral calculi]. / Comportamiento clínico de los cálculos renoureterales de núcleo mixto.

We made a statistical study, by means of a computer, of 87 crystallographically-analysed stones, corresponding to 85 patients, assessing different clinical data with the mixed composition of the nucleus of these stones. We deduce that in general, the behaviour of these stones is determined by the interaction of their components, with the main substance predominating. The most significant correlations were obtained when we assessed the sex, age, urinary infection, simple or coralliform morphology of the stone, the number of stones formed, permanent, homolateral, kidney damage, overall kidney failure and procedure for removing the stone. We did not find any valid links when we compared the family record of lithiasis, affectation of the counterlateral kidney and the fact whether the stone was from the right or the left.

[Ultrastructure of primary or endogenous prostatic calculi. Scanning electron microscopic study]. / Ultraestructura de los cálculos prostáticos primarios o endógenos. Estudio al microscopio electrónico de barrido o "scanning".

We make an analysis by means of a Scanning Electromicroscope, of the ultrastructure of 15 Primary Prostate stones. The components identified were: Carboapatite in 14 stones, Hydorxyapatite in 3, Whitlockite in 4 and Wedellite in 2 stones. The ultrastructural findings have enabled us to classify them as follows: 1. Hydroxyapatite stones, which we call "Crystalline", the rarest, due to the predominance of the inorganic component. 2. Carboapatite stones, which possess a great deal of organic material and which we subdivide into "Amylaceous" for those which possess some ovoid formations which appear to us to correspond to amylaceous bodies and "non-amylaceous" for those without them.

A crystallographic study of prostatic calculi.

We analyzed 70 prostatic calculi using crystallographic methods and determined the individual composition of the layers, structures and ultrastructures, thus, obtaining a more precise classification of these calculi.

[Mixed-nucleus renal calculi]. / Cálculos renales de nucleo mixto.

We made a crystallographic analysis of 87 mixed-nucleus stones and found 4 groups of stones of this kind, which are as follow: urico-oxalic, oxalico-uric, phosphato-oxalic and oxalic-phosphatic. We did not find any mixed-nucleus, urico-phosphatic or phosphatico-uric stones and we explain this fact according to the known lithogenic, metabolic mechanisms, in which urinary pH has an important function.

[Evaluation of 7 methods of analysis of urinary calculi]. / Valoración de siete métodos de análisis de calculos urinarios.

We assess seven methods of analysing urinary stones which we have used to study a total of 893 cases of lithiasis. For the purpose of a routine identification of the components, we consider the Immersion Method to be the best technique, followed by X-Ray Diffraction or Infrared Spectroscopy. We reject Scanning, qualitative, chemical analysis and quantitative, chemical analysis because of their drawbacks. For research purposes, we favour the "fine plate" supported by X-Ray Diffraction and Infrared Spectroscopy.

[Crystallography of 804 renal calculi]. / Estudio cristalográfico de 804 calculos renales de la provincia de Granada.

We analyse a total of 804 kidney stones in 225 patients aged between 10 and 71 years, with an average age of around 45, by means of the following techniques: optico-differential analysis (immersion method, PRIEN and FRONDEL, 1947), fine plate, X-ray diffraction, infrared-ray spectroscopy and qualitative chemical analysis. In all the stones, we identify the composition of the nucleus and periphery separately. Our results give 51.32% of patients forming essentially oxalic stones, 28.31% uric ones, 19.46% phosphatic and 0.44% cystine stones. These statistics coincide quite closely with those obtained by Cifuentes (quot. in Dalet, F.; Pinto, B., 1976) in Madrid and differ a little more from those obtained by the Puigvert Foundation (quot. in Dalet, F.; Pinto, B., 1976) in Barcelona. They are also similar to those obtained by Sutor (1974) for non Anglo-Saxon, industrialized countries, such as Czechoslovakia and Kuwait. We identify the following components in this collection of stones: anhydrous uric acid, dihydrate uric acid, amorphous urates (sodic, ammonic), whewellite, wedellite, hydroxyapatite, carbo-apatite, struvite, newberyte, whitlockite, brushite and cystine. We found no xanthine stone.

[Crystallography in the analysis of urinary calculi in Spain. Historical review of the Spanish contribution to the subject]. / La cristalografía aplicada al análisis de los cálculos urinarios en España. Revisión histórica de la aportacion española al tema.

We make a review of the Spanish contribution to the field of crystallography applied to the study of Urinary Lithiasis and assess the current state of the same. We emphasize, by virtue of the number and quality of their works, CIFUENTES, DELATTE and COLLS, SOMACARRERA and ALONSO as pioneers of ultramicroscopic studies. GUILEN CAVERO because of his impressive explanation of Lithogenesis and B. PINTO for his contribution to the generalization of the knowledge of analysed calculation by means of crystallographic methods.

[Structure of primary prostatic endogenous calculi]. / Estructura de los calculos prostáticos primarios o endógenos.

A crystallographic analysis ("fine plate") is carried out on a total of 62 primary or endogenous prostate stones and the particular features of their structures are described. We observed that they present a compact nucleus consisting of just apatite or whitlockite or of mixtures of the first with other minority components, with apatite (basically carbo-apatite) being the essential component in 98.38% of the stones studied. The periphery present concentric layers, some of which are lobe-shaped, intercalated in cases of mixed periphery and in which there is a qualitative and quantitative predominance of apatite, which may be the only component of the same. The most frequent observation is the association of layers of apatite intercalated with whitlockite to which fine, oxalic or uric layers may sometimes be added. There is sometimes no apatite in the periphery in which case this is made up of layers of whitlockite either interspersed or not with other oxalic or uric ones.

[Structure of secondary or exogenous prostatic calculi]. / Estructura de los cálculos prostáticos secundarios o exógenos.

Out of a series of 70 prostatic stones, we found 8 considered to be "secondary" or "exogenous" (i.e. originated inside the acinis, following the initial crystallization of the components of the orine introduced into the acini) which underwent crystallographic analysis, using basically the "fine plate" to determine their structure. There were found to be two types of stones: one kin essentially uric (5 in all) and others essentially oxalic (3). We observed that these may be formed by pure substances as in the case of two uric stones but generally the nucleus is made up of uric or oxalic components with a tendency in the periphery to form concentric layers of apatite or whitlockite, similar to those observed in primary or endogenous prostatic stones, accompanied by other oxalic or uric components or not. We found that both the uric acid (anhydrous) as well as the oxalates may adopt the same strucutre presented by the urinary stones (renal, vesical) but the anhydrous, uric acid may also present in the nucleus of a stone, an association of 3 structures (granuloporous + fibrosoradiated + palisaded) which does not occur in urinary stones and it may also form a structure which we call "concretioning" which has not previously been described.