Insights about urinary hippuric and citric acid as biomarkers of fruit and vegetable intake in patients with kidney stones: The role of age and sex.

Objectives: Urinary hippuric acid (HA) and citrate can represent useful biomarkers of fruit and vegetable (FAV) intake in nephrolithiasis. However, their clinical significance across the life span has been poorly investigated. The aim of this study was to investigate the association between the two biomarkers with FAV intake across different age groups and sexes in a large group of stone formers (SFs).

Short-Term Changes in Urinary Relative Supersaturation Predict Recurrence of Kidney Stones: A Tool to Guide Preventive Measures in Urolithiasis.

Purpose: Kidney stone disease is characterized by a relatively high rate of recurrence. In our study we analyzed the association between relative supersaturation and the risk of stone recurrence. Additionally, we examined the association between the risk of recurrence and changes in relative supersaturation and urinary composition after 1 week of medical treatment.

Determinants of calcium and oxalate excretion in subjects with calcium nephrolithiasis: the role of metabolic syndrome traits.

Background: The association of metabolic syndrome (MetS) traits with urinary calcium (UCE) or oxalate excretion (UOE) is uncertain in calcium stone formers (CSFs). Our aim was to investigate this association in a large group of Caucasian CSFs.

Methods: We retrospectively reviewed data of CSFs evaluated at our Kidney Stone Clinic from 1984 to 2015.

Calcium urolithiasis course in young stone formers is influenced by the strength of family history: results from a retrospective study.

The role of the strength of family history of stones (FHS), i.e., degree of relatives with the disease, on the course of calcium urolithiasis (CU) is not fully understood, particularly in young patients where genetic background has the greatest influence on disease expression.

The influence of maternal and paternal history on stone composition and clinical course of calcium nephrolithiasis in subjects aged between 15 and 25.

Our aim was to compare the influence of maternal history of stones (MHS) and paternal history of stones (PHS) on composition of calculi and disease course in a group of patients with calcium nephrolithiasis (CN) aged between 15 and 25, the age range with the maximal influence of family history on disease expression. One-hundred thirty-five patients (68 F) with CN and one stone-forming parent were retrospectively selected from the database of our outpatient stone clinic, and categorized according to MHS or PHS. Data about stone disease course and composition of passed calculi, determined by chemical analysis or Fourier-transformed infrared spectrophotometry, were collected together with information on blood chemistry and 24-h urinary profile of lithogenic risk.

A novel organizational model to face the challenge of multimorbid elderly patients in an internal medicine setting: a case study from Parma Hospital, Italy.

Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients.

Spring season birth is associated with higher emergency department admission for acute allergic reactions.

Background: Acute allergic reactions are important causes of emergency department (ED) admission, imposing a significant clinical and organizational burden. Since the season of birth is linked with early exposure to allergens, this study was aimed to establish whether an association exists between season of birth and incidence and severity of acute allergic reactions in the ED.

Methods: The electronic hospital database was searched to identify all consecutive adult patients who were admitted to the ED for acute allergic reactions (acute urticaria, acute angioedema, urticaria-angioedema and anaphylaxis) during a 1-year period.

Idiopathic Calcium Nephrolithiasis and Hypovitaminosis D: A Case-control Study.

Objective: To investigate the association between vitamin D deficiency (25-hydroxyvitamin D <20 ng/mL) and idiopathic calcium nephrolithiasis (ICN).

Methods: A total of 884 patients with ICN (363 males, mean age of 51 ± 14) and 967 controls (162 males, mean age of 59 ± 15) from an area with no food fortification policy were considered following a case-control study design. Patients were enrolled at a third-level outpatient stone clinic.

Mean platelet volume is significantly associated with serum levels of thyroid-stimulating hormone in a cohort of older euthyroid subjects.

Purpose: This retrospective and observational study aimed to establish whether any relationship exists between the values of serum thyroid-stimulating hormone (TSH) and those of the mean platelet volume (MPV) in a large cohort of older euthyroid Italian subjects.

Materials And Method: The study population was represented by a cohort of 1,050 ostensibly healthy and euthyroid patients aged 50 years and older, who were referred for screening of thyroid disorders over a 1-year period.

Results: A significant association was found between MPV and TSH values in both simple (r = 0.

Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group.

Objective: Diet interventions may reduce the risk of urinary stone formation and its recurrence, but there is no conclusive consensus in the literature regarding the effectiveness of dietary interventions and recommendations about specific diets for patients with urinary calculi. The aim of this study was to review the studies reporting the effects of different dietary interventions for the modification of urinary risk factors in patients with urinary stone disease.

Materials And Methods: A systematic search of the Pubmed database literature up to July 1, 2014 for studies on dietary treatment of urinary risk factors for urinary stone formation was conducted according to a methodology developed a priori.

Water and other fluids in nephrolithiasis: State of the art and future challenges.

Adequate hydration, as to maintain urinary volume over 2 L/day, has long been considered as the cornerstone medical prescription for preventing nephrolithiasis. However, scientific evidence about what kind of water stone formers should drink and about the effects of other beverages on urinary stone risk factors is sometimes unclear. Moreover, the recommendation that water therapy prevents kidney stone recurrence relies on only one randomized controlled trial, even if more epidemiologic and basic science studies seem to support this assumption.

B-type natriuretic peptide may be unsuitable for diagnosing central acute pulmonary embolism.

We describe a case of a 90-year-old male admitted to the emergency department with deep vein thrombosis and central acute pulmonary embolism. Despite a remarkably increased value of D-dimer and a modestly elevated concentration of cardiac troponin I, the value of B-type natriuretic peptide was found to be non-diagnostic. Limited to this single case report, our evidence suggests that the measurement of natriuretic peptides is questionable for diagnosing central acute pulmonary embolism in the emergency department.

Neutrophil gelatinase-associated lipocalin (NGAL): a promising biomarker for the early diagnosis of acute kidney injury (AKI).

Acute kidney injury (AKI) is a common complication that occurs in a broad spectrum of clinical settings. Cardiac surgery-associated AKI continues to be a well-recognized complication of cardiac surgery with high morbidity and mortality. The lack of early biomarkers has for long prevented timely interventions to mitigate the effects of AKI.

Transient global amnesia.

Transient Global Amnesia (TGA) is a clinical syndrome characterized by temporary inability to form new memories described as anterograde amnesia. It is associated with retrograde amnesia and repetitive questioning. During the attack patients remain conscious and communicative and personal identity is preserved.

Exacerbations of severe asthma: a focus on steroid therapy.

Bronchial asthma remains one of the most common chronic diseases in the world; approximately 10% of patients shows exacerbations severe enough to be judged life-threatening, whereas around 2-20% of patients are admitted to the Intensive Care Unit (ICU). Acute severe asthma is a dangerous condition where the deterioration of the asthmatic exacerbation usually progresses over days or weeks, although in a few patients over hours or even minutes. Morbidity and mortality are mainly related to the underestimation of the severity of the exacerbation, delay in referring to hospital and inadequate emergency treatment.

Comorbidities and disease severity as risk factors for carbapenem-resistant Klebsiella pneumoniae colonization: report of an experience in an internal medicine unit.

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging multidrug-resistant nosocomial pathogen, spreading to hospitalized elderly patients. Risk factors in this setting are unclear. Our aims were to explore the contribution of multi-morbidity and disease severity in the onset of CRKP colonization/infection, and to describe changes in epidemiology after the institution of quarantine-ward managed by staff-cohorting.

The mean platelet volume is significantly associated with higher glycated hemoglobin in a large population of unselected outpatients.

Aims: To examine the association between mean platelet volume (MPV) and glycated hemoglobin (HbA1c) in a large cohort of unselected outpatients.

Methods: We retrospectively reviewed combined results of complete blood count (CBC) and hemoglobin A1c (HbA1c) performed in all outpatients aged 18 years or older, who were referred to the outpatient clinic of our hospital for routine health check-up during the year 2013.

Results: Cumulative results of both CBC and HbA1c could be retrieved for 4072 male and female outpatients aged 18 years or older.

Hippuric acid in 24 h urine collections as a biomarker of fruits and vegetables intake in kidney stone formers.

This work aimed to underline the prospects of hippuric acid, a product of the metabolism of polyphenols, as a new biomarker of fruits and vegetables intake associated with lithogenic risk. Biochemical parameters of lithogenic risk and hippuric acid were measured in the 24 h urine collections of a cohort of 696 Italian kidney stone formers divided into two subgroups according to their different dietary habits. The link between lithogenic risk parameters and hippuric acid was assessed and this compound was revealed as a valuable biomarker of fruits and vegetables intake in kidney stone formers.

Fad diets and their effect on urinary stone formation.

The influence of unhealthy dietary habits on urinary stone formation has been widely recognized in literature. Dietary advice is indeed the cornerstone prescription for prevention of nephrolithiasis as well. However, only a small amount of medical literature has addressed the influence of popular or fad diets, often self-prescribed for the management of obesity and overweight or for cultural beliefs, on the risk of kidney stones.

Salt and nephrolithiasis.

Dietary sodium chloride intake is nowadays globally known as one of the major threats for cardiovascular health. However, there is also important evidence that it may influence idiopathic calcium nephrolithiasis onset and recurrence. Higher salt intake has been associated with hypercalciuria and hypocitraturia, which are major risk factors for calcium stone formation.

Neutrophil gelatinase-associated lipocalin in cancer.

Neutrophil gelatinase-associated lipocalin (NGAL), also known as lipocalin-2, is a 178-amino acid protein which exists in three molecular forms, including a 25-kDa monomer, a 45-kDa homodimer, and a 135-kDa heterodimer complexed with matrix metalloproteinase 9 (MMP-9). Polymorphonuclear neutrophils and tubular cells of the kidney are the most representative cellular sources. As such, NGAL is now considered the biochemical gold standard for early diagnosis of acute kidney injury.

Dizziness and syncope in young people: keep your mind open! Case report of the challenging differentiation between arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) and catecholaminergic polymorphic ventricular tachycardia (CPVT).

A paradigmatic case of aborted sudden cardiac death (SCD) in a young man is discussed, mirroring the challenge of diagnosing the various conditions potentially underlying this dramatic condition. Based on the clinical characteristics of our case, presenting some overlapping clinical features common to both the diseases, the discussion will be focused on Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) and Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVC/D). Epidemiological, genetic, diagnostic and therapeutic aspect will be discussed.

Adiponectin and migraine: systematic review of clinical evidence.

Although the pathogenesis of migraine is very complex and has not been thoughtfully elucidated, general consensus exists to date that this condition should be considered a primary neurovascular disorder with an important inflammatory component. Owing to epidemiological evidence of increased risk of migraine in overweight and obese subjects and to the inverse relationship that exists between serum adiponectin concentration and obesity, we performed an electronic search on Medline, Scopus and Web of Science, using the keywords "migraine" and "adiponectin" with no language or date restriction to explore the existence of an association between serum adiponectin and migraine. According to our search criteria, five studies were finally included in this systematic review, four cross-sectional (totaling 300 patients with migraine and 177 controls) and one interventional.