Stone Analysis Research Articles

Tracing the Past: Microwear Analysis of Stone and Shell Beads Unearthed in Early Neolithic Burials at Samborzec, Poland

This paper presents a thorough analysis of ornaments discovered in two Neolithic burials at Samborzec Site 1, providing valuable insights into their origins and significance. The artefacts, retrieved over six decades ago in the burials of a woman and child, have undergone extensive examination, including raw material identification, microwear studies, and the analysis of red residues found on their surfaces. While most of the ornaments concerned were crafted from marble, two beads were identified as Spondylus shells. Chemical analysis of residues, primarily found on the marble ornaments, revealed the presence of cinnabar, a red pigment of foreign origin. The remarkable similarities in ornaments between the investigated burials strongly suggest the association of both with LBK communities. The presented studies offer valuable insights into their object biographies, from the acquisition of raw materials from distant regions through their manufacture, assembly, and prolonged use as personal items. In this context, our research emphasizes their belonging to a shared Neolithic tradition in Europe.

Challenges in diagnosis and treatment of cystinuria patients with Urolithiasis: multicenter patient centered study.

Cystinuria represents a rare cause of urolithiasis, accounting for 1% of all cases. However, it poses unique challenges in diagnosis and management. This study aimed to examine the challenges of managing cystine stones from the perspective of cystinuria patients. Following ethical approval, we reviewed the medical records of cystine stone patients treated at four tertiary centers from 2016 to 2021 and surveyed them on their perceptions of cystinuria. It included questions about demographic characteristics, herbal treatments, pain management, online engagement, disease outcomes, and cystinuria-related fears. The study included 28 adults with cystinuria nephrolithiasis, with a mean age of 30.5 years. Of these, 78.6% had consanguineous parents, and the first stone episode occurred at a mean of 14.82 years age. Family history of Cystinuria was encountered in 82.1%. Cystinuria was diagnosed after a mean of 6.43 years from the first stone episode, and stone analysis was performed in 22/28 after a mean of 3.86 years from the first stone episode. Only 17 patients (60.8%) underwent metabolic evaluation for kidney stones. Regarding non-surgical treatments, 13 (46.5%) patients received alkalinization medication, and only 10 (35.7%) were prescribed chelating agent therapy. Additionally, 50% of patients took herbal remedies. The diagnosis of cystinuria is often delayed, leading to a delay in receiving medical treatment (alkalinization and chelating agents) and poor health education and counseling. Thus, referring cystinuria patients to tertiary hospitals and providing a multidisciplinary approach might decrease the morbidity of the disease and enhance their well-being.

From Patents to Progress: Unraveling Gout's Journey Through Clinical Trials and Advancements.

Gout, an inflammatory arthritis form, is renowned for its historical association with affluence. This review delves into its pathophysiology, exploring hyperuricemia, urate crystal formation, and the ensuing inflammatory response. The epidemiology of gout is examined, focusing on its rising prevalence and impact on public health. In this study, progress in gout management is discussed, involving pharmacological interventions, dietary changes, and emerging therapies. Genetic predisposition and triggers like alcohol, temperature, and diet are highlighted in this study. Prevention strategies, including serum urate-lowering therapy and lifestyle modifications, aim to reduce recurrent flares and complications. The inflammatory response in acute gout attacks is elucidated, involving immune cells, cytokines, and the NLRP3 inflammasome. Chronic gout manifestations, such as gouty tophus formation, are explored for their destructive impact on surrounding tissues. Recent advancements in gout treatment, including nanotherapies and novel compounds, are discussed, along with promising urate-lowering drugs. Cutting-edge research on zinc ferrite nanoparticles, dimethyl fumarate, and myricetin/nobiletin hybrids addresses oxidative stress and inflammation in gout. Additionally, the potential therapeutic role of methanolic leaf extract of Euphorbia milii and tip-loaded CLC-Soluplus® MAPs is explored as natural and transdermal alternatives for gout management. The review also covers the development status of new urate-lowering drugs, providing insights into promising candidates and their mechanisms. Patents on gout and recent diagnostic advancements using techniques like laser confocal micro Raman spectrometer, FTIR, and THz-TDS offer a more accurate approach for gout stone analysis, enabling early detection and targeted treatment.

Cystine and urate cystoliths in dogs are frequently visible on radiographs prior to surgical or nonsurgical removal.

To investigate the frequency at which cystine and urate cystoliths (stones) are visible on radiographs prior to surgical or nonsurgical retrieval. Records of client-owned dogs (n = 331) were analyzed between January 2019 and December 2023 for cystoliths submitted for stone analysis after surgical removal or nonsurgical retrieval. Records were analyzed for cystolith type; when cystine or urate stones were identified, records were analyzed for signalment, procedure, presence of mineral opaque cystoliths on pre-procedural radiographs, urine pH and crystalluria, history of previous cystoliths, prior prescription diet attempt, recurrence, and genetic, congenital and acquired comorbidities. Descriptive statistics were generated after data collection. 31 of 331 (9%) were cystine stones, 49 of 331 (15%) were urate, and 1 of 331 (0.3%) was a mix of urate and cystine. When radiographs were taken prior to stone removal, 24 of 28 (85%) of urate, 24 of 26 (92%) of cystine, and 1 of 1 (100%) of urate/cystine were visible on radiographs. Cystine and urate stones are visible on survey radiography at a high frequency in dogs. While cystine and urate stones have been historically designated as radiolucent, they are frequently radiopaque on radiographs. Radiopacity is commonly used as one of the criterion to determine whether a dissolution or prevention diet is an appropriate management technique, particularly when determination of the stone type has yet to be performed. As a result, these findings may prompt clinicians to investigate other patient-specific factors before a specific dietary recommendation is made.

CISTOTOMIA EM CADELA COM HIDRONEFROSE ASSOCIADA A OBSTRUÇÃO POR URÓLITOS VESICAIS: RELATO DE CASO

Urolithiasis is one of the most common diseases of the canine urinary system, which can be caused by diet, reduced water consumption by the animal, in addition to racial, age and sex predisposition. Furthermore, urolithiasis can culminate in hydronephrosis, in which the renal pelvis dilates as a result of the obstruction of urinary flow. The clinical signs of this condition vary according to the severity of the animal’s condition, but may include dysuria, polyuria and urinary incontinence. The definitive diagnosis is based on history, clinical evaluation, complementary imaging exams such as abdominal ultrasound and abdominal radiography. Treatment can be clinical or surgical and dietary management may be necessary, depending on the urinary stone analysis made. The objective of this report was to describe the clinical signs, diagnosis, treatment and prognosis of a five-year-old Shitzu female dog, with bladder uroliths and hydronephrosis as a result of this condition. After care and clinical management with laboratory and complementary exams, the treatment through cystotomy was the one of choice. The urolith was sent for analysis and allowed the establishment of an appropriate therapeutic protocol, through dietary management. Besides that, the female dog was monitored to observe the reversal of hydronephrosis. After surgical and clinical treatment, the animal presented a stable condition and the dilation of the renal pelvises were reversed, making the animal’s prognosis favorable.

Decoding Urinary Stones: Compositional Insights and Recurrence Patterns from a Tertiary Care Hospital in Eastern India.

Background and objective Urinary stones are a prevalent medical condition entailing significant health burdens and substantial financial ramifications. Its global prevalence is expected to rise notably, particularly in low-middle-income nations. Understanding the spectrum of diverse urinary stone types is crucial for effective management and prevention. This study aims to elucidate the demographic profiles, clinical types, and recurrence of urinary stone cases at a tertiary care hospital in Eastern India. Methods and materials The clinical data from the electronic medical record of 1,231 patients with urolithiasis who underwent surgery in a tertiary care center in eastern India from January 2015 to November 2022 were retrospectively analyzed. Patient data, including demographic information, clinical records, dietary habits, water intake, and stone recurrence history, were collected. A thorough statistical analysis was conducted to elucidate the associations between patient characteristics, urinary stone composition, and recurrence. Results Among the 1,231 participants, the majority of cases (343 (27.9%)) were in the 31-40 age group, with a higher prevalence in males (876 (71.2%)) than in females (355 (28.8%)). Flank pain or abdominal pain (593 (48.1%)) was the primary complaint, followed by nausea/vomiting (227 (18.5%)). Most stones (922 (74.9%)) were located in the kidney, and calcium oxalate was the predominant stone component (773 (62.8%)). The highest stone recurrence rates were in patients aged between 21-30 years (21 (36.8%)) and 31-40 years (16 (28.0%)). A low non-vegetarian diet and adequate hydration may reduce the likelihood of stone recurrences. Conclusion This study provides insights into the compositional analysis of urinary stones in the eastern Indian population, addressing the causes of their recurrence and management strategies, which are crucial for prevention and effective management. The findings indicate that the early middle-aged group exhibited the highest incidence of urinary stones. We also observed that strict adherence to a low animal protein, along with proper hydration and lifestyle changes, significantly reduced urinary stone recurrence.

Epidemiology of urolithiasis in south of Tunisia

Determine the epidemiological characteristics of urolithiasis in the South region of Tunisia and the impact of age and sex on stone composition. We conducted a retrospective study including patient records whose urinary lithiasis was analyzed within the biochemistry department of CHU Habib Bourguiba of Sfax (2011-2020). Stone analysis was performed using a stereomicroscope and infrared spectroscopy. A total of 1127 stones were analyzed. The sex ratio was 2,6. Renal Colic pain was the most common symptom (48,3%). The most frequent localization of the stones (84.6%) was the upper urinary tract. Whewellite was the most common component (64.1%). The study of stone component according to age showed a decrease in the frequency of weddellite (p =0,024) and an increase in the frequency of uric acid stones with age (p <0,001). Whewellite was more frequent in men (p =0.022) and, notably in our series, uric acid was significantly more frequent in women (p <0.001). The epidemiological profile of urolithiasis in south of Tunisia is similar to that observed in industrialized countries.

Multimodal analysis of renal stones to explore new biomarkers of urolithiasis

Despite advances in minimally invasive surgery, urolithiasis still recurs within the first five years after the first episode in more than 50% of patients. Researchers continue to search for new crystallisation inhibitors, metaphylaxis strategies and laser sources for stone destruction. Therefore, to achieve these goals, it is necessary to study kidney stones not only as the result of an isolated process of pathological biomineralisation in the human body, but also as a biogenic mineral or rock that obeys universal patterns and has certain properties. Consequently, kidney stones need to be studied using methods that are widely used in the geological sciences for the study of minerals, such as computed microtomography and petrological analysis. In this review, the properties of kidney stones studied using various research methods used in geosciences are discussed. These properties are also considered as new biomarkers of urolithiasis. This review discusses how new data from multimodal stone analysis can be used to develop personalised metaphylaxis and treatment strategies for all types of urolithiasis, including the most common idiopathic calcium-oxalate urolithiasis.

Do We Really Need Stone Analysis and 24-Hour Urine Testing? No.

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Investigation and quantification of composition variability in urinary stone analysis.

To investigate the variability in urinary stone composition analysis due to sampling and suggest potential solutions. We collected 1,135 stone fragments from 149 instances that had undergone a stone removal at Hanoi Medical University Hospital from January 2022 to August 2022. Each fragment was ground into fine powder and divided into separate specimens if the amount was abundant. For composition analyzing every specimen, Fourier transform infrared spectroscopy was performed. The composition of a given fragment was the average of its belonging specimens. The variability in composition was assessed on the fragment level (i.e., between fragments of an instance). We defined an instance as "significantly variable" if the maximum difference in any composition across its belonging fragments was equal to or greater than a given threshold. On average, there were 7.6±3.3 stone fragments per instance and 2.3±0.5 specimens per fragment. We found that the variability could be substantial on the fragment level. Eighty-nine (69.5%) and 70 (54.7%) out of 128 multiple-component instances were significantly variable if the threshold was set at 20% and 30%, respectively. The variability of an instance on the fragment level was correlated with the size of fragment and the number of components. Our study demonstrated the significant variability in urinary stone composition and showed that it correlated with the size and the impurity of samples. Mapping denotation while sampling and analyzing as well as reporting the composition of individual fragments could be valuable to reduce potential variability.

A review: evaluating methods for analyzing kidney stones and investigating the influence of major and trace elements on their formation

Abstract Kidney stone disease is a global concern, and its prevalence is increasing. The objective of this review is to provide a thorough analysis of the many analytical techniques used in the study of kidney stones and to investigate the significance of major and trace components in the development of kidney stone formation. The samples included organic (uric acid) and inorganic (calcium oxalate and carbonate apatite). To study kidney stone analysis methods like XRD, FTIR, SEM, and ICP-MS, a systematic literature review was conducted. The quantities and effects of main (calcium, oxalate, phosphate) and trace (magnesium, zinc, copper) elements in kidney stone development were also examined. The review shows that XRD and FTIR are best for evaluating kidney stone crystalline structure and content, whereas SEM gives rich morphological insights. Its trace element detection sensitivity makes ICP-MS unique. Calcium oxalate and calcium phosphate, the most common components, affect kidney stone development. Trace elements like magnesium prevent stone formation, whereas zinc and copper may encourage crystallisation. Results revealed significantly higher calcium levels in inorganic components compared to organic ones. Uric acid stones exhibited lower element content except for copper and selenium, likely originating from the liver. Carbonate apatite stones showed higher element concentrations, particularly magnesium, compared to calcium oxalate stones. Principal component analysis (PCA) identified three principal components, explaining 91.91 % of the variance. These components reflected specific co-precipitation processes of elements, with distinct distributions among different stone types. This variability in element content among stone types could serve as valuable guidance for patient dietary considerations.

Analysis of Kidney Stones Using Single Pulse Laser-Induced Breakdown Spectroscopy (SP-LIBS) to Determine the Concentrations of Elements

Analysis of Kidney Stones Using Single Pulse Laser-Induced Breakdown Spectroscopy (SP-LIBS) to Determine the Concentrations of Elements

Long-Term Follow-up Results of Children with Urolithiasis Followed in Our Clinic

Title and Objective: Urolithiasis is a prevalent condition frequently observed in childhood within the Turkish population. The aim of this study was to evaluate the metabolic, radiological, and clinical features of pediatric patients with urolithiasis. Materials and Methods: Records of 158 children referred to the Pediatric Nephrology Department of Celal Bayar University between 2010 and 2020 with suspected urolithiasis and microlithiasis were retrospectively reviewed. The complaints and ages of the cases during hospital admission, their medical histories, and the location of the stones were determined. All patients underwent complete urine analysis, spot urine electrolytes, urine culture, serum electrolytes, kidney function tests, uric acid, albumin measurements, and urinary ultrasonography. 24-hour urine electrolytes were studied in patients capable of urine collection. Stone analysis using X-ray diffraction was performed on patients from whom stones were obtained. Results: Out of the individuals, 88 (55.7%) were male, and 70 (44.3%) were female, resulting in a male-to-female ratio of 1.25:1. The average age at the time of diagnosis was determined to be 89.82 ± 57.35 months. A family history of urolithiasis was reported in 108 (68.3%) patients, and 46 individuals (29%) were born from consanguineous marriages. At the time of diagnosis, 32 patients (20%) had a urinary tract infection. Stones were predominantly situated in the upper urinary system in 129 patients (81.6%), with 123 (77.8%) having unilateral stones and 35 (22.2%) having bilateral stones. Calcium oxalate stones were the most commonly observed (80%) in patients who underwent stone analysis. Hypercalciuria emerged as the most frequently identified urinary metabolic risk factor. At the end of the follow-up period, 14 patients experienced a recurrence, while 67 patients remained free of stones. Conclusion: Urolithiasis continues to be a significant concern among children in our nation. Due to the higher recurrence rate and more frequent underlying metabolic disorders in children with stone diseases compared to adults, metabolic assessment and stone analysis are recommended procedures, emphasizing the need for lifelong monitoring in these cases.

The Role of the Nephrologist in the Treatment and Prevention of Nephrolithiasis

Abstract Nephrolithiasis is a disease with a high risk of recurrence: 50% within five years and up to 80–90 % within 10 years after the first episode. Often, with this diagnosis, there is only symptomatic treatment with the aim of expelling the kidney stone and removing the pain. In such patients, however, initial stratification of the risk of recurrence based on the risk factors present is essential. Every patient with nephrolithiasis, whether it is a single episode or recurrent, should follow general measures to prevent kidney stones. Depending on the results of the kidney stone analysis and the risk of recurrence, it is necessary to carry out a specialised nephrological metabolic examination which is performed by a nephrologist in Slovakia, with subsequent personalised recommendations depending on the cause of recurrent nephrolithiasis. These include dietary and regimen measures, as well as pharmacological treatment. In the following article we summarize specific measures for individual types of nephrolithiasis, as well as basic preventive measures for the recurrence of kidney stones, with a focus on dietary risk and protective factors.

Preoperative parameters (signalment, digital radiography, urinalysis, urine microbiological culture) and novel algorithm improve prediction of canine urocystolith composition.

To determine the accuracy of 4 preoperative parameters (signalment, urinalysis, urine microbiological culture, and digital radiography) in predicting urocystolith composition, compare accuracy between evaluators of varying clinical experience and a mobile application, and propose a novel algorithm to improve accuracy. 175 client-owned dogs with quantitative analyses of urocystoliths between January 1, 2012, and July 31, 2020. Prospective experimental study. Canine urocystolith cases were randomly presented to 6 blinded "stone evaluators" (rotating interns, radiologists, internists) in 3 rounds, each separated by 2 weeks: case data alone, case data with a urolith teaching lecture, and case data with a novel algorithm. Case data were also entered into the Minnesota Urolith Center mobile application. Prediction accuracy was determined by comparison to quantitative laboratory stone analysis results. Prediction accuracy of evaluators varied with experience when shown case data alone (accuracy, 57% to 82%) but improved with a teaching lecture (accuracy, 76% to 89%) and further improved with a novel algorithm (accuracy, 93% to 96%). Mixed stone compositions were the most incorrectly predicted type. Mobile application accuracy was 74%. Use of the 4 preoperative parameters resulted in variable accuracy of urocystolith composition predictions among evaluators. The proposed novel algorithm improves accuracy for all clinicians, surpassing accuracy of the mobile application, and may help guide patient management.

Protein Intake and High Uric Acid Stone Risk

Rationale & ObjectiveWe evaluated the metabolic differences between pure and impure uric acid stone formers in this retrospective study of uric acid kidney stone formers diagnosed between 1996 and 2021. Study DesignDemographics and medical history were compared by chi-squared tests. 24-hour urine chemistries were compared using logistic regressions while controlling for demographics and comorbidities. Setting & ParticipantsPatients from Yale Urology and Nephrology Clinics with a documented kidney stone analysis containing uric acid were included. 4294 kidney stone formers had a stone analysis and 722 (16.8%) contained uric acid. Patients with all stone analyses ≥50% uric acid were allocated to the pure group, while patients with at least one stone analysis <50% uric acid were allocated to the impure group. ResultsAmong kidney stone formers, the prevalence of uric acid nephrolithiasis was 16.8%. Pure uric acid stone formers were more likely to be older, heavier, and were 1.5 times more likely to have chronic kidney disease. When controlling for age, sex, race, ethnicity, and body mass index, pure uric acid stone formers had lower urine pH and lower urine citrate normalized for creatinine. Additionally, they had a higher protein catabolic rate, urine urea nitrogen, and urine sulfur normalized for creatinine, all markers of dietary protein intake. These findings persisted after controlling for chronic kidney disease. LimitationsThis is a retrospective study from a single center. ConclusionsPure uric acid stone formation is more common with diminished kidney function; however, after controlling for kidney function, pure uric acid stone formation is associated with protein intake, suggesting that modifying protein intake may reduce risk.

Hybrid kidney stones physicochemical and morphological characterization: A spectroscopic study analysis

This study was designed to scrutinize the practical health index of uroliths for investigating composition, structural characterization, phase quantification and shape of kidney stone patients with respect to socioeconomically status in territory of Bahawalpur, southern Punjab, Pakistan. Morphology of the kidney stones were determined using SEM. The Ultra violet spectra of kidney stones in narrow range of 220–280 nm. Quantitative phase analysis of stones indicates as oxalate, calcium oxalate monohydrate, calcium oxalate dehydrates, calcium phosphate, cysteine and uric acid with 40.51 %, 26.24 %, 14.24 %, 36.45 %,13.18 % and 9.86 % respectively. A survey analysis also supports the vitro data showing patient age with 30–40 years with more predominance in males than females. Metabolic abnormalities were detected in 75 % patients with stone recurrence 15 % complained of having digestive disease. The overall concludes from qualitative and quantitative results suggested the community for preventive measures in reducing the risk of pervasiveness and relapse of urolithiasis.

Stepping Stones In Prevention of Kidney Stone Disease In Pakistan

The prevalence and incidence of kidney stone disease (KSD) has increased in Pakistan since last 5 decades, it is not only the cause of pain, hematuria and fever but is also an important cause of chronic kidney disease, Morbidity and mortality as well if left untreated. It is recurrent disease and can be manifestation of systemic diseases, (D.M, obesity, HTN) genetic and environmental factors play a role in etiology of disease. In spite of modern methods of surgical removal available in Pakistan there is constant increase in number of patients. Economic burden of disease is quite significant, so established metaphylaxsis program is essential part of management of this surgical and medical disease. Main therapies based on history, stone analysis, 24 hour urine metabolic study constitutes the basis of prevention. Increasing fluid intake dietary modification, Pharmacotherapy is the main stay of metaphylaxsis. Compliance of the patient and establishment of specialized stone clinics should be managed jointly by urologist, nephrologist, dietitians, metabolic laboratory expert and Medical Social officers. Prevention is possible in many cases if these patients are managed jointly by multidisciplinary team.

Досвід лікування конкрементів сечовидільних шляхів у дітей

Aim - to analyze the treatment of children with urolithiasis (urolithiasis), taking into account the location of stones in the urinary tract, their size and density, to select further individual patient management tactics. Materials and methods. The study included 48 patients with single urinary tract stones aged 6 months to 18 years. X-ray structural analysis and determination of the chemical composition was carried out with 39 stone fragments. Results. In 5 (10.4%) patients with calculi in the distal part of the ureter up to 5 mm in size, medical expulsive therapy was started. 17 (35.4%) patients with kidney and ureter calculi measuring 6-14 mm and density up to 900 HU underwent extracorporeal shock wave lithotripsy. In 3 (6.3%) patients with kidney and ureter calculi 6-14 mm in size and with a density of more than 900 HU, ureterorenoscopy (URS) and extraction using a Dormia basket or forceps to capture fragments were performed. 20 (41.7%) children with kidney stones larger than 15 mm or density greater than 1200 HU underwent contact lithotripsy. Contact endovesical lithotripsy was performed in 2 (4.2%) patients with massive calculi in the urinary bladder who underwent cystoplasty for an exstrophy-epispadias malformation. Results of X-ray structural stones analysis: calcium oxalate (wevelite, wedelite) - 31 (79.5%), calcium phosphate (hydroxyapatite) - 5 (12.8%), brushite - 2 (5.1%), cystine - 1 (2.6%). Conclusions. Modern minimally invasive technologies make it possible to remove calculi of any density and localization from the urinary system in a minimally traumatic, effective and sufficiently safe manner, regardless of the age of the child. In the treatment of urolithiasis in children, it is advisable to follow a personalized approach with the step-by-step use of the optimal arsenal of means to remove the stone. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the local ethics committee of the listed institution. Informed consent of children and their parents was obtained for the research. No conflict of interest was declared by the authors.

Do We Really Need a Stone and Metabolic Urine Analysis? Yes.

N/A.