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Biomedical subjects

A Costa-Bauzá

Publications and source records attributed to A Costa-Bauzá.

At least 19 recordsLinked to original sources
PubMed2006

Factors affecting calcium oxalate dihydrate fragmented calculi regrowth.

BACKGROUND: The use of extracorporeal shock wave lithotripsy (ESWL) to treat calcium oxalate dihydrate (COD) renal calculi gives excellent fragmentation results. However, the retention of post-ESWL fragments within the kidney remains an important health problem. This study examined the effect of various urinary conditions and crystallization inhibitors on the regrowth of spontaneously-passed post-ESWL COD calculi fragments. METHODS: Post-ESWL COD calculi fragments were incubated in chambers containing synthetic urine varying in pH and calcium concentration: pH = 5.5 normocalciuria (3.75 mM), pH = 5.5 hypercalciuria (6.25 mM), pH = 6.5 normocalciuria (3.75 mM) or pH = 6.5 hypercalciuria (6.25 mM). Fragment growth was evaluated by measuring increases in weight. Fragment growth was standardized by calculating the relative mass increase. RESULTS: Calcium oxalate monohydrate (COM) crystals formed on COD renal calculi fragments under all conditions. Under pH = 5.5 normocalciuria conditions, only COM crystals formed (growth rate = 0.22 +/- 0.04 microg/mg x h). Under pH = 5.5 hypercalciuria and under pH = 6.5 normocalciuria conditions, COM crystals and a small number of new COD crystals formed (growth rate = 0.32 +/- 0.03 microg/mg x h and 0.35 +/- 0.05 microg/mg x h, respectively). Under pH = 6.5 hypercalciuria conditions, large amounts of COD, COM, hydroxyapatite and brushite crystals formed (growth rate = 3.87 +/- 0. 34 microg/mg x h). A study of three crystallization inhibitors demonstrated that phytate completely inhibited fragment growth (2.27 microM at pH = 5.5 and 4.55 microM at pH = 6.5, both under hypercalciuria conditions), while 69.0 microM pyrophosphate caused an 87% reduction in mass under pH = 6.5 hypercalciuria conditions. In contrast, 5.29 mM citrate did not inhibit fragment mass increase under pH = 6.5 hypercalciuria conditions. CONCLUSION: The growth rate of COD calculi fragments under pH = 6.5 hypercalciuria conditions was approximately ten times that observed under the other three conditions. This observation suggests COD calculi residual fragments in the kidneys together with hypercalciuria and high urinary pH values may be a risk factor for stone growth. The study also showed the effectiveness of specific crystallization inhibitors in slowing calculi fragment growth.

Calcium↗
PubMed2005

An experimental study on residual lithiasis after shock wave lithotripsy.

The main objective of this paper was to study residual lithiasis after extracorporeal shock wave lithotripsy (post-ESWL), with the aim of contributing to the development of effective prophylactic measures. In vivo regrown calcium oxalate monohydrate (COM) post-ESWL residual fragments were studied by stereoscopic microscopy, infrared spectroscopy and scanning electron microscopy with an energy dispersive X-ray analyzer. An in vitro system was also used to study the regrowth of post-ESWL fragments of COM calculi. The regrowth was evaluated as the relative increase in the weight of the fragments. The effects of a calcium oxalate crystallization inhibitor (phytate) were also evaluated. All of the in vivo regrown COM real residual post-ESWL fragments exhibited practically the same internal structural features. The in vitro studies demonstrated that the regrowth of post-ESWL residual fragments, in the absence of crystallization inhibitors, occurred even using normocalciuric/normooxaluric urine and could be detected at 24 h. At 144-240 h, the formation of new COM columnar zones was observed. The presence of 1.5 mg/l of phytate totally blocked the growth process. When hypercalciuric/normooxaluric urine was used, significant amounts of disorganized calcium oxalate dihydrate (COD) crystals were formed. The in vitro regrowth of post-ESWL COM fragments was clearly influenced by the presence of crystallization inhibitors. These data also demonstrate the importance that effective prophylactic therapies could exert on preventing recurrence.

Calcium Oxalate↗
PubMed2004

Determination of myo-inositol in biological samples by liquid chromatography-mass spectrometry.

Due to the absence of HPLC methods to determine myo-inositol using mass detection and considering its sensitivity and selectivity, a high performance liquid chromatography-mass spectrometry method for the analysis of myo-inositol is described and applied to its direct determination in urine and saliva samples. Successful resolution of myo-inositol and its related substances was achieved with a stationary phase Aminex HPX-87C Column with milli-Q water as mobile phase and 5 mM ammonium acetate added post-column. The detector counted positive ions by monitoring m/z = 198, which corresponds to the myo-inositol adduct with ammonium cation. Urine and saliva samples were previously purified by passing through an anion-exchange resin. Concentrations as low as 138 and 461 microg/l in saliva and urine could be respectively quantified. Intra-day R.S.D. ranged from 0.83 to 1.02%, whereas inter-day R.S.D. was between 1.54 and 3.58%.

Chromatography, High Pressure Liquid↗
PubMed2004

Effect of phytate on element bioavailability in the second generation of rats.

In this paper the relation between long term consumption of a high dose of sodium phytate and the mineral status of the organism is evaluated in rats. For this purpose, element concentrations (Ca, Mg, Fe, Zn, Mn) were determined in liver, heart, testicle, bone and urine of a second generation of Wistar rats, treated with a phytate free diet (AIN-76A) and with the same diet plus 1% phytate as sodium salt. The most significant differences were observed between bone zinc contents of male and female rats. The zinc content of rats fed a 1% phytate as sodium salt diet resulted clearly lower than that found in no-phytate treated rats. Hence, it is concluded that when up to 1% of phytate as sodium salt is consumed together with an equilibrated purified diet (free of phytate), no decrease in mineral bioavailability is observed in second generation rats, except for an indication of lower zinc availability by lower zinc concentrations in some organs, mainly bone. However, using this purified diet, the zinc concentration in bone resulted around 10 times higher than found in rats fed with a common non purified rat chow.

Animals↗
PubMed2001

Absorption and excretion of orally administered inositol hexaphosphate (IP(6) or phytate) in humans.

A study of the pharmacokinetic profile (oral absorption and renal excretion) of inositol hexaphosphate or phytate (IP(6)) is presented. Seven healthy volunteers were following a IP(6) poor diet (IP(6)PD) in a first period, and on IP(6) normal diet (IP(6)ND) in a second one. When following the IP(6)PD they become deficient in IP(6), the basal levels found in plasma (0.07+/- 0.01 mg/L) being clearly lower than those found when IP(6)ND was consumed (0.26+/- 0.03 mg/L). During the restriction period the maximum concentration in plasma were obtained 4 h after the ingestion of a single dose of IP(6), observing almost the same renal excretion profiles for the three different commercial sources and doses. After the IP(6) restriction period, volunteers were on IP(6)ND, reaching normal plasma and urinary IP(6) values in 16 days. Thus, the normal plasma and urinary concentrations, can be obtained either by consumption of a IP(6)ND taking a long time or in a short period by IP(6) supplements.

Absorption↗
PubMed2001

Study on concretions developed around urinary catheters and mechanisms of renal calculi development.

AIMS: To study the structure and composition of encrustation and concretions developed on urinary catheters to better understand their formation mechanism to be able to prevent them. METHODS: The surface of catheters was studied by direct and scanning electron microscopy observation. In vitro formation of encrustations was performed in synthetic urine. RESULTS: The surface of catheters was covered by a continuous layer of organic matter, on which a thin scale consisting of crystals of calcium oxalate monohydrate (COM), uric acid anhydrous or calcium phosphate developed. Encrustations observed on catheters generally exhibited the same composition as the previously developed renal calculi. In catheters collected from patients without previous episodes of renal calculi or with previous episodes of infected renal calculi in which infection was afterwards eradicated, on the first organic layer, in that case plate-like COM crystals forming a columnar layer were observed. In vitro experiments demonstrated that COM columnar structures were only formed when normocalciuric urine containing organic matter was used, and the presence of crystallization inhibitors, as phytate, notably delayed their formation. CONCLUSION: Calcium oxalate was the main crystalline phase developed on catheters inserted in patients, specially in the absence of urinary infection or urinary pH values <5.5 and high urinary uric acid levels. Thus, prophylaxis of encrustations may consist of preventive measures usually applied in cases of recurrent idiopathic calcium oxalate urolithiasis.

Adult↗
PubMed2001

[Microinfections and kidney lithiasis].

OBJECTIVE: The existence of microinfections produced by bacteria of a very small size (nanobacteria) could be a risk factor for stone formation. The results of a study to detect the presence of nanobacteria in calculi are presented. METHODS: 1,000 calculi (excluding struvite calculi) were analyzed by macroscopic and microscopic techniques. RESULTS: Microorganisms were detected in only 5 calculi (0.5%). All these calculi had developed in cavities with low urodynamic efficacy. The microorganisms were located in the center of the calculus and the main component was calcium oxalate monohydrate or uric acid. Ammonium urate/sodium urate were frequently found to be a minor component in the center of the calculus. The only common biochemical urinary alteration observed in these patients was a urinary pH below 5.5; conventional urine cultures were always negative. CONCLUSIONS: Our findings demonstrate that these bacteria can play an important role in the development of calculus by inducing the formation of heterogeneous nucleants of calcium oxalate and uric acid. According to our results, however, this mechanisms is not common and would also be associated to other lithogenic risk factors. It is important to underscore that the majority of patients suffered from stomach ulcers and/or gingivitis which are conditions that could be induced by the same type of microorganisms. Therefore, it can be deduced that similar bacterial factors might be involved in pathologies that have as yet not been related. Further studies are warranted to clearly identify these bacteria.

Bacterial Infections↗
PubMed2001

[Types of kidney calculi. Relationship with urinary biochemistry].

OBJECTIVE: To present a simple classification of the most frequent renal calculi that relates each type of calculus with the main possible etiologic factors linked to its formation (mainly urinary biochemical parameters). METHODS: The macro, microstructure and composition of 2,500 renal calculi were studied by appropriate combination of stereoscopic microscopy, IR spectroscopy and scanning electron microscopy + X-ray microanalysis. The information obtained were related with the main urinary biochemical parameters, determined by conventional analytical procedures. RESULTS: Ten main categories of renal stones, covering over 95% of all conceivable calculi, are distinguished based on their composition and structure. Etiologic factors, mainly urinary biochemical parameters, leading to the formation of stone of every category are specified. CONCLUSIONS: From the detailed study of the renal calculus important etiologic factors can be deduced. Such information complements and confirms the urinary biochemical studies. As a consequence, the corresponding treatment can be better established.

Humans↗
PubMed2000

Effects of phytate and pyrophosphate on brushite and hydroxyapatite crystallization. Comparison with the action of other polyphosphates.

This is a comparative study of the effects of phytate and pyrophosphate and other polyphosphates on the crystallization of hydroxyapatite and brushite, the most frequent calcium phosphates involved in calcium oxalate urolithiasis. Brushite and hydroxyapatite crystal formation was studied in synthetic urine, through kinetic-turbidimetric measurements that allowed evaluation of the inhibitory effects on crystallization of insoluble salts. The effectiveness in preventing brushite crystallization decreases in the sequence phytate > polyphosphate > EDTPO > etidronate > pyrophosphate > triphosphate > medronate; whereas the order of effectiveness in preventing hydroxyapatite crystallization was EDTPO > etidronate = pyrophosphate > triphosphate > medronate > polyphosphate > phytate. Phytate, a natural inhibitor in urine, most effectively blocked brushite precipitation (1.21x10(-5) M prevented crystallization during time periods of at least 1 h), and pyrophosphate was the natural inhibitor that most effectively blocked hydroxyapatite precipitation (2.87x10(-6) M prevented crystallization during time periods of at least 1 h). This demonstrates that low excretion of these substances would pose a risk of renal lithiasis.

Calcium Phosphates↗
PubMed2000

Uric acid calculi: types, etiology and mechanisms of formation.

The study of the composition and structure of 41 stones composed of uric acid was complemented by in vitro investigation of the crystallization of uric acid. Uric acid dihydrate (UAD) precipitates from synthetic urine under physiological conditions when the medium is supersaturated with respect to this compound, though uric acid anhydrous (UAA) represents the thermodynamically stable form. Solid UAD in contact with liquid transforms into UAA within 2 days. This transition is accompanied by development of hexagonal bulky crystals of UAA and appearance of cracks in the UAD crystals. Uric acid calculi can be classified into two groups, differing in outer appearance and inner structure. Type I includes stones with a little central core and a compact columnar UAA shell and stones with interior structured in alternating densely non-columnar layers developed around a central core; both of them are formed mainly by crystalline growth at low uric acid supersaturation. Type II includes porous stones without inner structure and stones formed by a well developed outermost layer with an inner central cavity; this type of stones is formed mainly by sedimentation of uric acid crystals generated at higher uric acid supersaturation.

Chemical Phenomena↗
PubMed2000

Kinetic versus thermodynamic factors in calcium renal lithiasis.

Calcium renal lithiasis formation depends on the balance between thermodynamic (supersaturation) and kinetic (inhibitors, nucleants) factors. In this paper, the importance of both groups was evaluated using (a) the complete urine analysis data obtained from 32 healthy volunteers and 141 active stone-formers, and (b) a comprehensive computer model to calculate the supersaturation values of calcium oxalate monohydrate, hydroxyapatite and brushite in each urine sample. The results of this evaluation were used to assess the possible effectiveness of a given pharmacological treatment.

Calcium↗
PubMed2000

Urinary phytate in calcium oxalate stone formers and healthy people--dietary effects on phytate excretion.

The phytate urinary levels in a group of active calcium oxalate stone formers were studied and compared with those found in healthy people. Urinary phytate was significantly lower for stone formers. If deficit of the capacity to inhibit crystallization of calcium salts is considered an important factor related to calcium stone formation, the excretion of low phytate amounts could be an important risk factor in the development of this type of renal calculi. The influence of dietary phytate on urinary excretion was also studied. Clearly maintenance of a phytate-free diet significantly decreased the urinary excretion of phytate (about 50% after 36 h). This demonstrated the importance of dietary phytate in maintaining adequate urinary levels to permit effective crystallization inhibition of calcium salts and consequently preventing renal stone development.

Adult↗
PubMed1999

Ammonium and sodium urates precipitating from synthetic urine and fine structure of urate renal calculi.

A study of ammonium and sodium urate precipitation in vitro and the fine structure of several urate renal calculi was carried out to contribute to an understanding of the participation of ammonium and sodium urates in urolithiasis. Ammonium urate precipitated in vitro in two different morphologies: a typical spherulite morphology formed at high supersaturation and disorganized needle-like crystals formed at low supersaturation. In all cases sodium urate precipitated in vitro as bundles of curved fibrils, its crystallization being inhibited by calcium in concentrations between 20 and 60 mg/l depending on the sodium urate supersaturation. From a collection of 1300 renal calculi, only three had ammonium urate as their main component (0.2%), three were mixed calculi (0.2%) consisting of ammonium urate and calcium oxalate (two) or uric acid (one), and in one calculus ammonium urate was present as a minor component. Only in a mixed calculus of uric acid and calcium oxalate was sodium urate detected in a very low quantity. The study of the fine structure of the renal calculi constituted mainly by ammonium urate demonstrated similar patterns in which spherulites, needle-like individual crystals and an amorphous mass of ammonium urate with abundant organic matter in non-organized structures coexist. As minor components, struvite or calcium oxalate crystals were found. A general mechanism of the formation of such calculi is proposed.

Chemical Precipitation↗
PubMed1999

Indinavir crystallization and urolithiasis.

The crystallization of indinavir in synthetic urine at different pH values and indinavir concentrations was kinetically studied. It was found that precipitation time notably decreases at urinary pH values above 6.0. The effects of some products as potential crystallization inhibitors were studied. Some natural saponins such as escin and glycyrrhizic acid provoked a notable increase in the precipitation time of indinavir, this pointing out their possible use to prevent renal tubular solid deposition.

Chemical Precipitation↗
PubMed1999

Renal stone formation and development.

A concise account of formation mechanisms of attached (papillary) and unattached renal stones is presented. Urinary conditions prevailing at least during the stone forming period are indicated. Ten main categories of renal stones, covering over 95% of all conceivable calculi, are distinguished based on their composition and structure. Aetiologic factors leading to stone formation of every category are specified and general outlines of recommended treatment procedures indicated.

Humans↗
PubMed1999

Uric acid urolithiasis and crystallization inhibitors.

An in vitro study of the inhibitory effects that some substances occasionally present in urine can provoke on the crystallization of uric acid has been performed. The most remarkable crystallization inhibitory effects were produced by mucine at concentrations of >0.5 mg/l. Pentosan polysulfate and chondroitin sulfate also clearly increased the uric acid crystallization times at concentrations of >100 mg/l. Saponins, such as escin and glycyrrhizic acid, also produced a notable delay in uric acid crystallization times at concentrations of >10 mg/l. Similar effects were observed in the presence of a surfactant substance, lauryl sulfate. N-Acetyl-L-cysteine caused crystallization perturbations only when it was present at concentrations of >50 mg/l. Citric acid and phytic acid caused no effects on uric acid crystallization even at the highest concentrations assayed (1,000 and 5 mg/l, respectively). From the results obtained it can be deduced that mainly glycoproteins, glycosaminoglycans and surfactant substances can exert protective effects against uric acid crystallization.

Acetylcysteine↗
PubMed1999

Urinary lithogen risk test: usefulness in the evaluation of renal lithiasis treatment using crystallization inhibitors (citrate and phytate).

OBJECTIVES: This paper presents the results of a test to globally determine the urinary risk factor of calcium stone formation in the evaluation of treatments using crystallization inhibitors, such as citrate and phytate. METHODS: Three groups of active calcium oxalate stone-formers have been selected. The lithogen urinary risk was determined using a specially designed disposable test before any medical treatment. After evaluation group I did not receive any treatment, group II was treated with potassium citrate and group III with a phytate-rich dietary complement. When 15 days had elapsed, the test to evaluate the risk of urinary calcium stone formation was applied again to the three groups. The main lithogenic biochemical parameters of each tested urine were also determined before and after treatment. RESULTS: An important number of calcium oxalate stone-formers with high urinary risk factor (positive test) became negative after medical treatment (52% of the citrate-treated patients and 50% of the phytate-treated patients), but only 7% of the untreated patients (1 patient) showed a decrease in their urinary risk factor for calcium stones (negative test) after 15 days had elapsed. When the treatment was not effective, in an important number of cases, the urine contained high levels of calcium or showed pH values greater than 6.5. CONCLUSION: From the obtained results it can be concluded that the test is useful to evaluate the efficacy of a given renal lithiasis medical treatment, and also the efficacy of the treatment of calcium oxalate renal lithiasis using crystallization inhibitors, such as citrate and phytate, in an important number of cases.

Citrates↗