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Wildfires are considered a major disturbance to forest ecosystems in the Mediterranean countries of Southern Europe. Although ground-dwelling macroinvertebrates are crucial to many soil functions, there is a fundamental lack of understanding of how wildfires impact this community in the immediate term and of the role of stones in their survival. Hence, in the present study we assessed the immediate effects of wildfires in the ground-dwelling macroinvertebrate community found under stones by comparing communities in burnt and non-burnt Mediterranean oak forests. Our results revealed that stones allowed the survival of many taxa in the burnt area. However, abundance, richness, diversity, and equitability per stone were significantly lower at the burnt than unburnt sites. Furthermore, the results also showed that richness and abundance increased significantly with increasing stone depth and area, both at the burnt and unburnt sites. Significant changes at the trophic level were observed in the burnt area comparing to the unburnt, particularly a decline in predators. No significant differences were identified concerning habitat associations among taxa. Overall, this study stressed the role of stones as microhabitats and refuge for the ground-dwelling macroinvertebrate community during wildfires. [ABSTRACT FROM AUTHOR]

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AbstractRecent research in the field of education studies has raised concerns about anthropocentric discourses and methods regarding materiality. Creating new pedagogical approaches and practices to advance cultural and material understanding is the key objective for scholars and educators. This article demonstrates how the collection of self-taken digital photographs of stones activated a researcher for educational thinking process, and it does this methodologically by using situated writing and digital photographs as co-thinkers. The main task is to explore the meaning of blurred relationships of material worlds by asking especially what stones, and especially children’s interest towards stones, can teach us, what they can remind us of, and how they may help us reflect on education and growth as a celebration of open approaches and critical reconsiderations in order to deflect the focus away from anthropocentric subjectivity. The aim is to produce a novel contribution and a situated writing sample of not representing world and education but encountering them anew and being part of its process, connecting things that are not typically connected. [ABSTRACT FROM AUTHOR]

Background In acute settings around the globe, renal/ureteric colic remains one of the most common diagnoses for patients presenting with loin-to-groin pain. Even though management spans from medical expulsive therapies to surgical options, pain as a significant component of a patient’s presentation must be dealt with quickly, decisively, and safely, as it can be excruciating and its effects on overall health are dire. This study aimed to explore compliance with the National Institute for Health and Care Excellence (NICE) guidelines for pain management in patients with suspected renal/ureteric colic. It includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs), intravenous paracetamol, and opioids as first-, second-, and third-line analgesics, respectively, and does not offer antispasmodics. In the event of deviations from the standard, the aim was to put in corrective measures, followed by re-exploration of compliance with patient care. Methods This study involved a single healthcare facility with the study type being retrospective before interventions and prospective after interventions. In the first cycle, we retrieved and analysed 78 patients records whom had been suspected to have renal/ureteric colic between July and September 2022. The inclusion criteria were documented complaints of “flank/loin-to-groin pain” and diagnosis prior to performing diagnostic tests. We surveyed the first-, second-, and third-line painkillers issued, and whether an antispasmodic was given. We collected and entered data into a Microsoft Excel file and correlated it with NICE standards. Having found deviations from the standard, we conducted interventions, allowed time for clinicians to adapt, and re-explored compliance using patient case records [n=58] between February and May 2023. Results In the 1 st cycle, 78 patients were suspected of having renal/ureteric colic. M: F = 1.2:1. Non-contrast computerized tomography of the kidney ureters and bladder (NC-CTKUB) confirmed 87% of patients with stones and 3% had no stones. NC-CTKUB was not performed in 9% of patients because they were young, and urinalysis showed no microscopic hematuria. One patient had discharged against medical advise before the NC-CTKUB was performed. Compliance with the NICE pain management guidelines for suspected renal/ureteric colic was full in 23% of cases but unsatisfactory in 78% of cases. In the 2 nd cycle, M: F = 1.5:1, NC-CTKUB was not re-audited, as the first cycle study yielded excellent results, and our action plan resulted in an NICE pain management compliance rate of 56%. Although our interventions resulted in improvements of more than twice the initial results, work still needs to be performed. Conclusion Clinicians’ ability to correctly diagnose renal/ureteric colic is remarkable. However, the pain management compliance rate indicates room for improvement. This may be due to the limited awareness of the NICE guideline or the fact that the clinical team has an affinity for certain analgesics compared to others. We propose the need to consider select variables to existing standard guidelines to enhance compliance for improved patient care.

To determine predictors for missing trifecta in patients who underwent flexible ureteroscopy (FURS) for treatment of renal and upper ureteric calculi. The data of adult patients with renal or upper ureteral stones who underwent FURS from June 2021 through December 2022 were retrospectively reviewed. Stone-free status (no residual stones > 3 mm) was evaluated after 3 months with non-contrast CT. Modified Clavien classification was used to grade complications. A stone-free status after a single intervention of FURS without complications was defined as trifecta. Patients were divided into two groups (trifecta and non-trifecta). Risk factors for missing trifecta were compared between both groups using univariate and multivariate analyses. Three hundred twenty-three patients with mean age 48.9 ± 13 years and mean stone length 16 ± 5.9 mm were included. The trifecta criteria were applicable for 250 patients (71%). On multivariate analysis, risk factors for missing trifecta were stone multiplicity (OR: 3.326, 95%CI: 1.933–5.725) and non-experienced surgeons (OR: 1.819, 95%CI: 1.027–3.220). Multiple stones and performance of FURS by non-experienced surgeons are the independent risk factors for missing trifecta of FURS. [ABSTRACT FROM AUTHOR]

Through the biography of a guardian-stone, Misa Qala, this text explores lithic encounters in the Bolivian region of Northern Potosí. The biographical perspective makes it possible to show that the region's inhabitants view Misa Qala as part of an ecosystem of relations that is not exclusively human. This text will consider the stone's various displacements, the manifestations of its subjectivity, and finally its social relations. It will show that the action of stones can be independent of human manipulations and that humans and stones do not share the same pace of life. This text will also propose new understandings of territory as created through interpenetration of space, time, and human and nonhuman agencies. [ABSTRACT FROM AUTHOR]

Even though kidney stones seem to be one of the oldest disorders recognized by medicine, the exact processes by which they form and grow remain unknown. Significant progress has been achieved in our understanding of the pathophysiology of ten different types of stones, including the most common type, the idiopathic calcium oxalate stone former, thanks to the new digital endoscope and extensive renal physiological studies conducted on well-phenotyped stone formers. Based on our findings and those of others studying model systems, four distinct mechanisms for kidney stone formation have been proposed. It appears that the main way stones are formed in patients with hypercalciuria is by calcium oxalate crystals growing over Randall's plaque sites. In most stone phenotypes, overgrowths of the extremities of Bellini duct plugs have been observed; do these overgrowths lead to clinical stones? The cystinuric stone formers' microlith production appears to be limited to the lumens of their dilated inner medullary collecting ducts. Finally, it is suggested that cystinuric stone formers create their stones in free solution in the presence of several small, oval, smooth-looking calyceal stones that appear yellow. This article reviews the scientific evidence for these four different types of stone production and uses it to propose new areas of study. Moreover, it provided information on the pathology of kidneys, especially the different types of stone formation, mechanisms, complications, and management. [ABSTRACT FROM AUTHOR]

What does literature tell us about the concept of chance? And how is chance relevant to literary theory and comparison? Relating chance to theory is counter-intuitive, because the very attempt to theorise seems to aim at reducing the coincidental and advancing systematic interpretations of literature. But writings about stones tell us otherwise. By highlighting stones' aesthetic qualities and quasi-artistic status, these writings raise questions about the role of chance in the natural processes that form stones, and in the human perception that frame them as aesthetic objects. I read Roger Caillois's lithic writings alongside the poetics of Chinese scholars' rocks and poet Lu Ji's 陸機 (c. 261-303) Rhapsody on Literature (文賦 Wenfu). Their writings raise questions about the intersections between chance, writing, and literary theory: What can stones tell us about our understanding of chance and creativity? Can creativity and criticism flourish by promoting instead of calculating or eliminating chance? If yes, how? I discuss how lapidary writings and practices posit stones as poetic and discursive objects that engage with chance reveries, aesthetic sensations, and effects of human-mineral symbiosis. [ABSTRACT FROM AUTHOR]

Les avancées technologiques en endo-urologie font désormais de l'urétéroscopie souple (URSS) une technique de choix pour traiter les calculs urinaires mais aussi un casse-tête lorsqu'il s'agit de choisir son équipement. La mise en place d'un guide de sécurité au sein des cavités rénales (nitinol, 0,035″, « stiff ») par cystoscopie rigide est non obligatoire mais constitue un critère de sécurité. Il en est de même concernant les gaines d'accès urétéral, celles avec aspiration étant en cours d'évaluation. Si leur utilisation réduit la pression et la température au sein des cavités rénales facilitant la vision, leur insertion peut occasionner des lésions urétérales. Les systèmes d'irrigation utilisant la gravité avec pompe manuelle sont à privilégier pour minimiser le risque de barotraumatisme. Le choix de l'urétéroscope est complexe : diamètre, capacité de déflexion, position du canal opérateur et qualité de vision sont à considérer. Aussi, il est difficilement envisageable de n'utiliser qu'un modèle endoscope pour l'intégralité des URSS. Les lasers Holmium:Yttrium-Aluminium-Grenat (Ho:YAG) et Thulium Fibré (TFL) sont aujourd'hui recommandés pour le traitement des calculs urinaires en URSS, avec un avantage potentiel du TFL pour la pulvérisation fine. Les paniers sont nombreux et divers, leur taille et forme devant également être considérées avant acquisition. En fin d'intervention, un drainage urétéral n'est pas systématique, mais les sondes JJ en silicone ont montré des risques d'incrustation et de gêne fonctionnelle plus faibles que les sondes faites de polyuréthane. Flexible ureteroscopy is now widely used as the preferred option to surgically treat a urinary stone, due to several technological advancements. Thus, choosing the adequate equipment is challenging, but respects safety concepts. Indeed, placing the safety wire (nitinol, 0,035″, "stiff") under rigid cystoscopy is not mandatory but improve safety. Regarding ureteral access sheath (UAS), considerations are similar: UAS facilitates vision, pressure and temperature control but can also be responsible of ureteral injuries at insertion. Suction devices are now under evaluation and could not be discussed. To limit the barotrauma risk, irrigation devices with manual pumps should be used (40 cmH 2 0). Choosing a flexible ureteroscope (fURS) is challenging; a special attention has to be given to size, deflexion, working channel position and vision. Thus, using a single fURS is hardly imaginable. Both Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) and Thulium Fiber (TFL) lasers are recommended to treat urinary stones during fURS, with a potential advantage of TFL on thin pulverization. A wide variety of baskets exists and size and shape have to be considered before acquisition. Finally, if ureteral stenting is not mandatory in uncomplicated cases, silicone stents present a lower risk of encrustation and stent-related symptoms compared to polyurethane ones. [ABSTRACT FROM AUTHOR]

Introduction and Objective: Prior literature had demonstrated increased stone burden and higher rates of staged surgery in individuals of lower socioeconomic status (SES). Low SES individuals are more likely to experience delays in definitive stone surgery after initial presentation to the emergency department (ED) for kidney stones. This study aims to investigate the relationship between delays in definitive kidney stone surgery and the subsequent need for percutaneous nephrolithotomy (PNL) and/or staged surgical procedures using a statewide data set. Methods: This retrospective cohort study gathered longitudinal data from 2009 to 2018 using the California Department of Health Care Access and Information data set. Patient demographic characteristics, comorbidities, diagnosis/procedure codes, and distance were analyzed. Complex stone surgery was defined as initial PNL and/or undergoing more than one procedure within 365 days of initial intervention. Results: A total of 1,816,093 billing encounters from 947,798 patients were screened, resulting in 44,835 patients with ED visits for kidney stones followed by a urologic stone procedure. Multivariable analysis revealed that relative to patients who underwent surgery within 1 month of initial ED visit for stone disease, patients were at increased odds of undergoing complex surgery if waiting ≥6 months (odds ratio [OR] 1.18, p = 0.022), ≥1 year (OR 1.29, p

Abstract Background Tamsulosin, an alpha-blocker in medical expulsive therapy, selectively relaxes ureteral smooth muscle, while Tadalafil, a PDE5-Is, is recommended for treating lower urinary tract symptoms. Methods This study compares the effectiveness of Tadalafil and Tamsulosin as medical expulsive therapy for distal ureteric stones at the Urology Department, Beni-Suef University Hospital, Egypt, using baseline demographics, preoperative data, intraoperative data, and outcome analysis. Results A randomized comparative study that is prospective and was from March 2019 to March 2021. Although 280 instances were eligible, 30 were eliminated & 250 were randomized, and only 164 patients completed the study. 83 patients were in the study Tadalafil group (Group A), 54 males (65.1%) & 29 (34.9%) and 81 patients were assigned to the Tamsulosin group (Group B), 47 males (58%) &34 females made up the Tadalafil group (Group A). The study was completed by 34 females (42%). Additionally, there was a significant difference in the meantime for stone expulsion between groups A (8.8 ± 3.1 days) and B (10.8 ± 3.4 days, (p = 0.001). With fewer episodes of colic, Group A needed less analgesia than Group B. Conclusions Tadalafil is a safer and more effective treatment for 5–9 mm lower ureteric end stones, offering a higher stone expulsion rate, earlier passage, lower analgesic requirements, and fewer colic episodes.

Décrire la technologie du laser Thulium:Yttrium-Aluminium-Garnet pulsé (p-Tm:YAG) et ses résultats actuels pour lithotritie laser endocorporelle. Une revue de la littérature, interrogeant les bases Pubmed, Scopus, et Cochrane a été conduite en janvier 2024 utilisant les mots clés « laser », « pulsed Thulium:YAG », « stones » et « lithotripsy ». De par les faibles niveaux de preuve et nombre de publications, une revue narrative de la littérature a été réalisée. Le laser p-Tm:YAG est un laser à cavité avec un cristal YAG dopé aux ions thulium, pompé par des diodes laser. Avec une longueur d'onde du faisceau laser de 2013 nm, il présente un coefficient d'absorption dans l'eau intermédiaire entre le laser Ho:YAG et TFL. Le diamètre minimal utilisable des fibres laser est de 200 μm. Différentes modulations impulsionnelles sont proposées visant à minimiser la rétropulsion des calculs avec notamment une puissance crête (Peak Power) réglable (≥ 800 W). De multiples études comparatives in vitro suggèrent que la capacité du p-Tm:YAG à fragmenter les calculs serait similaire à celle de l'Ho:YAG ; au contraire, sa capacité à pulvériser (dusting) tous types de calculs serait similaire à celle du TFL, avec une faible rétropulsion. Une seule étude in vivo a confirmé la faisabilité de la lithotritie du p-Tm:YAG au cours d'une urétéroscopie souple avec des taux de sans fragment résiduel (< 3 mm) et zéro fragment résiduel de 95 % et 55 %, respectivement. Aucune étude comparative n'est disponible à ce jour. Le nouveau laser p-Tm:YAG pulsé pourrait représenter un compromis sûr et efficace entre le laser Ho:YAG et le TFL pour la lithotritie laser endocoporelle mais des études comparatives, notamment avec le TFL sont nécessaires pour définir sa place dans l'arsenal thérapeutique. To describe the pulsed-Thulium:Yttrium-Aluminum Garnet (p-Tm:YAG) laser technology and its current evidence for endoscopic laser lithotripsy. A literature review, querying PubMed, Scopus, and Cochrane databases, was conducted in January 2023 using keywords "laser", "pulsed Thulium:YAG", "stones" and "lithotripsy". Due to the limited level of evidence and the number of publications, a narrative literature review was undertaken. The p-Tm:YAG laser is a cavity laser with a thulium-doped YAG crystal, pumped by laser diodes. With a laser beam wavelength of 2013 nm, p-Tm:YAG presents an intermediate absorption coefficient in water between Ho:YAG and TFL lasers. The minimal usable diameter of laser fibers for this technology is 200 μm. Various pulse modulations are proposed to minimize stone retropulsion, including adjustable peak power (≥ 800 W). Multiple in vitro comparative studies suggest that p-Tm:YAG's ability to fragment stones is similar to that of Ho:YAG, while its ability to dust various types of stones is similar to TFL, with low retropulsion. A single in vivo study confirmed the feasibility of p-Tm:YAG lithotripsy during flexible ureteroscopy, with stone-free (< 3 mm) and zero-fragment rates of 95% and 55%, respectively. No comparative studies are available to date. The new pulsed p-Tm:YAG laser could represent a safe and effective compromise between Ho:YAG and TFL for endoscopic laser lithotripsy, but comparative studies, especially with TFL, are necessary to define its role in the therapeutic arsenal. [ABSTRACT FROM AUTHOR]

In the Andes, mountains, rocks, and stones (all conceptually related) are powerful entities that engage with human beings in different ways. Among other qualities, they take human shape, accomplish great deeds, heal, protect fields, or increase fertility. One aspect that has not been explored much is how stones can also work to reestablish a positive relationship between humans and superior forces. This article examines this capacity in the context of the largest Peruvian pilgrimage (also the highest in the world), the pilgrimage to the sanctuary of the Taytacha Qoyllurit'i (dear father of the shiny snow) located in Cuzco, Peru. This analysis takes place in relation to the central concept underlying the pilgrimage, that of pampachay, which literally means "flattening the ground." While the whole pilgrimage is a way to maintain a reciprocal relationship with the Taytacha Qoyllur Rit'i (an image of Christ crucified on a rock at the bottom of a glacier), the traditional on-foot travel has specific key rituals that must take place along the way to reestablish this reciprocity. Pilgrims need to carry stones uphill and put them in designated places where they will leave them for good. By doing so pilgrims leave behind the part of themselves that might have disturbed the reciprocal relationship with the Taytacha. Resumen: En los Andes, montañas, rocas y piedras (todas conceptualmente relacionadas) son entidades poderosas que interactúan con los seres humanos de diversas maneras. Entre otras cualidades toman forma humana, logran grandes hazañas, curan, protegen los campos o aumentan la fertilidad. Un aspecto que no ha sido muy explorado es cómo las piedras son también un medio para restablecer una relación positiva entre los seres humanos y las fuerzas superiores. Este artículo examina dicha capacidad en el contexto de la peregrinación más grande del Perú (y la más alta del mundo), la peregrinación al santuario del Taytacha Qoyllurit'i (querido padre de la nieve resplandeciente) en Cuzco, Perú. Este análisis se realizará en relación con el concepto central que está detrás de esta peregrinación que es el de pampachay, que literalmente significa "aplanar o nivelar el terreno." Mientras que toda la peregrinación se puede ver como una forma de mantener una relación recíproca con el Taytacha Qoyllurit'i (una imagen de Cristo crucificado en una roca), en la caminata tradicional a pie hay rituales específicos que los peregrinos deben realizar a lo largo del camino para restablecer esa reciprocidad. Los peregrinos necesitan cargar piedras a la espalda en subidas empinadas y colocarlas en lugares designados para dejarlas allí permanentemente. Al hacer esto los peregrinos dejan la parte de ellos que puede haber dañado la relación recíproca con el Taytacha. [ABSTRACT FROM AUTHOR]

Jayanta Mahapatra's Relationship: A Long Poem is considered as his magnum opus. In 1981 Mahapatra was honoured with Sahitya Akademi Award for this book Relationship. He was the first Indian English writer to gain this prestigious award. This long poem in twelve sections was composed when he was working as a physics professor. Though the poem covers only some thirty pages it needs several hours and several readings to go deep into the lines and seek the hidden meanings and images. The chief imagery and locale of Relationship is Konark. The poem delves deep into Oriya land, cartography, history, art, culture, society, tradition, belief and heritage and living. [ABSTRACT FROM AUTHOR]

This review is based investigations on the Western Isles, Scotland, by Martin Martin, a notable Scottish Highlander, academic and medical doctor, of the 17th–18th century. His extensive observations of the geography and peoples of these Isles were recorded in his books, "On the Description of the Western Islands of Scotland Circa 1695" and "A Late Voyage to St Kilda". In these books and subsequent papers there were some noteworthy observations on the occurrence (and as he says non-occurrence) of "epidemical" diseases and conditions afflicting the peoples of The Isle of Skye and the Western Isles of Scotland in this period, and these are discussed in this review. Martin also gives details of a wide variety of remedies that were observed or reported by inhabitants around that time. Some of these remedies are interesting for their relevance to the period but others are of doubtful merit. These are reviewed here more for their significance in the understanding of the diseases and conditions of humans and even in some cases animals at that time. Introductions by Charles Withers and R.W. Munro, 11 and re-assessments of the contributions of Martin and colleagues of that time have given insight into the health and condition of peoples of the Western Isles of Scotland(the Occidental) (Martin 1695; Martin 1716). [ABSTRACT FROM AUTHOR]

Les lasers sont aujourd'hui des outils incontournables en endourologie, aussi bien pour le traitement des calculs urinaires, que des tumeurs urothéliales (vésicales ou du haut appareil) ou de l'hypertrophie bénigne de prostate. Si pendant une trentaine d'années, le laser Holmium : Yttrium-Aluminium-Grenat (Ho:YAG) a été l'acteur prépondérant pour ces applications, les lasers thulium fibré (TFL) et Thulium : YAG (Tm:YAG) sont aujourd'hui des alternatives grandissantes. Les TFL et Ho:YAG sont désormais recommandés pour le traitement des calculs urinaires, un manque de données cliniques limite les recommandations concernant le Tm:YAG. Pour le traitement des lésions urothéliales (énucléation « en-bloc » vésicales ou vaporisation des lésions du haut appareil urinaire), Ho:YAG, TFL et Tm:YAG sont utilisables mais il n'est pas possible à ce jour de recommander une source laser en particulier. De la même manière, ces trois sources lasers semblent utilisables pour réaliser une énucléation endoscopique de prostate, bien que le recul soit plus important pour l'Ho:YAG. Les techniques chirurgicales et les courbes d'apprentissage vont dépendre de la source laser, responsables d'effets bien différents, qu'il faut donc prendre en considération avant d'acquérir un générateur laser. Nowadays, laser technology has become the gold standard for many endourological applications, encompassing the treatment of urinary calculi, urothelial tumors (bladder or upper tract), and benign prostatic hyperplasia. While the Holmium: Yttrium-Aluminum-Garnet (Ho:YAG) laser dominated these applications for about thirty years, thulium fiber laser (TFL) and Thulium: YAG (Tm:YAG) lasers are emerging as growing alternatives. TFL and Ho:YAG are now recommended for urinary calculi treatment, but a lack of clinical data limits recommendations for Tm:YAG. For urothelial lesion treatment ("en-bloc" enucleation of a bladder tumor or vaporization of upper urinary tract lesions), Ho:YAG, TFL, and Tm:YAG are usable, but it is not currently possible to recommend a specific laser source. Similarly, these three laser sources appear usable for endoscopic prostate enucleation, although there is more extensive experience with Ho:YAG. Surgical techniques and learning curves will depend on the laser source, which can produce different effects, requiring careful consideration before acquiring a laser generator. [ABSTRACT FROM AUTHOR]

Wongel Tena Shale,1 Tolasa Dibisa Jirata,2 Mekbeb Chere Enawgaw,1,3 Ararso Gonfa Metekia,2 Yosef Lemma Kelecha1 1Jimma University College of Public Health and Medical Sciences, Department of Surgery, Jimma University, Jimma, Oromia, Ethiopia; 2Jimma University College of Public Health and Medical Sciences, Department of Orthopedic Surgery, Jimma University, Jimma, Oromia, Ethiopia; 3Jimma University College of Public Health and Medical Sciences, Department of Surgery, Urology Unit, Jimma University, Jimma, Oromia, EthiopiaCorrespondence: Wongel Tena Shale, Jimma, Oromia, Ethiopia, Tel +251911636127 ; +251913862475, Email tenawongel@gmail.comBackground: The endocrine disorder known as hyperparathyroidism (HPT) is characterized by excessive parathyroid hormone (PTH) secretion, and when it is accompanied with hypercalcemia it is called primary HPT (PHPT). PHPT is characterized by the hyper-functioning of one or more parathyroids. The most common form of PHPT is sporadic parathyroid adenoma.Case Presentation: A 33-year-old male presented to our emergency room with the classic presentation of PHPT affecting the skeletal, gastrointestinal, genitourinary, and neurologic systems including, multiple long bone fractures and bilateral nephrolithiasis with preserved renal function. Diagnosis was made by elevated serum PTH and calcium levels, as well as, bone imaging. Neck ultrasound and fine needle aspiration cytology (FNAC) of the neck mass were done to localize the lesion. After pre-operative optimization, bilateral neck exploration and en-bloc resection of the left inferior parathyroid with the left lobe of the thyroid was done. In the post-operative period, he developed persistent hypotension and severe hypocalcemia.Conclusion: Although it is uncommon in the industrialized countries, the traditional PHPT presentation with “Bones, Stones, abdominal groans, and psychic moans” is nevertheless common in impoverished nations like Ethiopia. Surgery is the mainstay of treatment but complications such as hungry bone syndrome can increase the post-operative morbidity following parathyroidectomy.Keywords: primary hyperparathyroidism, PHPT, bones, stones, abdominal groans, psychic overtones, brown tumor, hungry bone syndrome, case report

The essay poses a question about the cultural representation of mountains and minerals in the Islamic tradition. Drawing on the most basic resource of the Qur’anic text, it observes that stones, mountains and other elements of the subterranean world acquire a positive value in the Islamic cosmological outlook, being a part of the well-ordered and beneficial natural phenomena and even playing a role of ethical companionship to man. In parallel, mountaintops and the stone structure of the Ka‘ba are shown to play a central ordering role in the structure of the religious time-space. The positive and significant representation of stones and mountains, which stands partly in contrast to the European culture, is tentatively ascribed both to the specific natural conditions of the Arabian milieu of Muhammad’ s prophethood and the religious legacies of the pre-Islamic era.

Purpose: To assess the safety and efficacy of super-mini PCNL (SMP, 14 Fr) when compared to standard PCNL (sPCNL, 24–30 Fr) in the management of renal calculi of size ranging from 1.5 to 3 cm. Methods: From February 2021 to January 2022, a total of 100 patients were randomized to either SMP group or sPCNL group in a 1:1 ratio (50 in each group) using computer-generated simple randomization. Demographic data, stone characteristics, operative times, perioperative complications, blood transfusions, postoperative drop in haemoglobin, postoperative pain, duration of hospital stay and stone-free rates were compared between the two groups. Results: Mean stone volume (2.41 cm2 vs 2.61 cm2) and stone-free rates (98% vs 94%, p = 0.14) were similar in both the SMP and sPCNL groups, respectively. The SMP group had significantly longer mean operative times (51.62 ± 10.17 min vs 35.6 ± 6.8 min, p = 0.03). Intraoperative calyceal injury (1/50 vs 7/50, p = 0.42) and mean postoperative drop in haemoglobin (0.8 ± 0.7 g/dl vs 1.2 ± 0.81, p = 0.21) were lower in the SMP group, but not statistically significant. SMP group showed significantly lower mean postoperative pain VAS scores (5.4 ± 0.7 vs 5.9 ± 0.9, p = 0.03) and mean duration of hospital stay (28.38 ± 3.6 h vs 39.84 ± 3.7 h, p = 0.0001). Complications up to Clavien grade 2 were comparable, with grade ≥ 3 complications higher in the standard group, but not statistically significant. Conclusion: Super-mini PCNL is equally effective as standard PCNL in treating renal calculi up to 3 cm, with significantly reduced postoperative pain and duration of hospital stay and lower risk of Clavien grade ≥ 3 complications, although with higher operative times. [ABSTRACT FROM AUTHOR]

Purpose: The present paper takes a different and more critical look at the role of alpha-blockers, sometimes nicknamed as “magical pills”, in particular for stone disease and medical expulsive therapy (MET). Methods: A non-systematic narrative review was performed, synthesizing pertinent information from selected articles, and critically evaluating their conclusions. Sometimes different views on alpha-blockers were laid bare, including curiosities or other entertaining nuances suitable to the present topic, but always maintaining sharp objectivity and the foremost scientific rigor. Results and Conclusions: Alpha-blockers seem to be a panacea, being used to treat a wide variety of non-urological diseases and conditions. Urological applications include erectile dysfunction to benign prostatic hyperplasia, from incontinence to urinary retention, or even to facilitate urinary stone passage along the urinary tract. Due to its versatility, alpha-blockers appear to be the Swiss army knife of urological medications. However, the efficacy of alpha-blockers for MET, pain management, or facilitating upper tract access is very disappointing, bringing no, or in some instances, only marginal benefits. Their treatment results are far from being significant or impressive let alone magical. Regular sexual intercourse is an effective alternative to alpha-blockers, providing faster ureteral stone expulsion rates and reducing the need for pain medication. Most of the research supporting alpha-blockers has been based on single-center, underpowered, low-quality studies. These low-quality studies biased several subsequent meta-analyses, contaminating them with their low-quality data, enhancing and prolonging this delusion. These results emphasize the need for large, multi-centric, unbiased, randomized, double-blinded, placebo-controlled trials to prevent future year-long delusions that may afflict any medical field. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Arabian Sciences Heritage is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Athar alrafedain is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background The introduction of sialendoscopy has been a major step forward in providing an accurate means of diagnosing and locating submandibular sialolithiasis, also in permitting minimally invasive surgical treatment that can successfully manage those stones aiming for gland preservation. Methods We conducted a systemic review to assess the efficacy and safety of combined sialendoscopic assisted surgery in the management of submandibular sialolithiasis. This study included published medical articles from 2000 till 2022 concerning the efficacy and safety of combined sialendoscopic-assisted surgery in management of submandibular sialolithiasis searching Medline database (PubMed), Web of Science, Springer, Cochrane library, EMBASE. Fifteen articles met the inclusion criteria and were reviewed and analyzed. Results The success rate of combined sialendoscopic assisted surgery in management of submandibular sialolithiasis is 0.955% with 95% CI: (91.4% to 98.5). The overall percentage of sialadenectomy cases in the included studies is 2%. The overall percentage of complications in the included studies is 8%. Conclusion Combined sialendoscopic-assisted surgery is efficient and safe in management of submandibular sialolithiasis.

The central dogma of pain in patients with chronic pancreatitis revolves around the pathophysiology of ductal hypertension owing to stones that obstruct the pancreatic duct. Conventional modalities available to decompress the pancreatic duct are occasionally limited by failed selective pancreatic duct cannulation during endoscopic retrograde cholangiopancreatography. We describe a novel endoscopic approach of EUS-guided laser lithotripsy to assist in pancreatic duct (PD) stone fragmentation in two symptomatic patients with underlying chronic pancreatitis who had failed PD cannulation and extracorporeal shock wave lithotripsy (ESWL). In both cases, a 365-micrometer LightTrail TracTip Holmium laser fiber was advanced within a 19G endoscopic ultrasound aspiration needle (Expect Slimline (SL), Boston Scientific, Marlborough, Massachusetts, United States) under endoscopic ultrasound (EUS) guidance to fragment the PD stones. There were no procedure-related complications encountered and follow-up after 1 month of the procedure revealed significant reduction in abdominal pain scores. To the best of our knowledge, these are the first reported cases of EUS-guided laser lithotripsy performed for PD stones. Our approach of performing laser lithotripsy under EUS guidance obviates the need for an ESWL procedure; however, it is technically more challenging and requires precision to avoid injury to the pancreas. Further prospective studies are required to evaluate the safety and efficacy of this novel approach and its applicability as either a rescue procedure or in tandem with conventional pancreatic endotherapy modalities.

Background: Usually, the daily self-grooming by rabbits leads to fur accumulation in the animal's stomach. Since rabbit hair is looser than other animals and constantly licks their body, the fur can be pulled out easily. On the other hand, rabbits are susceptible to urinary stone formation. Objectives: This study was designed to investigate the presence of hairballs and urinary stones in Razi Institute Laboratory rabbits. Methods: During the 1 year, the albino Dutch laboratory rabbit colony, in research, breeding, and production of the Laboratory Animals Department of Razi Institute, including 106 males, 287 females, and 166 kittens, were monitored. After the necropsy of the selected animals, the gastrointestinal tract (stomach and intestines) were examined for the presence of hair and hairballs. Then the urinary system (kidneys, ureter, urinary bladder, and urethra) was examined for any urinary stones. Results: No symptoms of anorexia, lethargy, abdominal pain, weight loss, decrease and abnormal stools were observed in them, and also no mortality occurred in the whole colony. All samples' stomach was full, indicating enough eating. No gas or congested spots, or hemorrhage were observed in the intestines. The amount and consistency of stool in the intestines were normal. In none of the samples, hairballs were observed, but in most rabbits' stomachs (both sexes), a small amount of hair was observed in the stomach contents. Also, no symptoms of urinary stones were observed in the colony of the studied rabbits. Conclusion: Balanced diet, supply of nutritional requirements, and the absence of any stressors in breeding environments have played a key role and prevented many diseases, such as hairballs and urinary stones. No observation of urinary stones in this study could lead to the hypothesis that infection with the bacteria that cause urinary stones in the studied rabbits was eliminated or non-pathogenic, indicating specific pathogen-free animals. However, bacterial and other infectious agent monitoring should be specialized. [ABSTRACT FROM AUTHOR]

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose of Review: We aimed to examine the role of low-dose CT (LDCT) in the diagnostic work-up for suspected urolithiasis in pregnancy. We reviewed contemporary urologic recommendations for CT in pregnancy, its utilization for suspected urolithiasis, and explored barriers to its use. Recent Findings: National urologic guidelines and the American College of Obstetricians and Gynecologists recommend the judicious use of LDCT imaging in pregnancy when necessary. We noted inconsistencies in review article management pathways and recommendations for CT imaging for suspected urolithiasis in pregnancy. Overall CT utilization in pregnancy for suspected urolithiasis is low. Proposed barriers to LDCT use in pregnancy include fears of litigation and misperceptions of the harm of diagnostic radiation. Summary: Recent advancements in imaging technologies for urolithiasis in pregnancy are limited. More specific diagnostic pathway recommendations from national urologic guideline bodies for when to use LDCT to investigate renal colic in pregnancy may reduce diagnostic and intervention delays. [ABSTRACT FROM AUTHOR]

Xanthinuria is a clinically significant form of urolithiasis in cats with poor clinical outcomes and limited treatment options. In humans, xanthinuria has an autosomal recessive mode of inheritance, with variants in xanthine dehydrogenase (XDH) and molybdenum cofactor sulfurase (MOCOS) responsible for cases. While causative genetic variants have not been identified in the domestic cat, a recessive mode of inheritance has been suggested. DNA was extracted from EDTA‐stabilised blood obtained from a Domestic Shorthair cat with clinically confirmed xanthinuria. Whole‐genome sequencing and variant assessment in XDH and MOCOS identified XDH:c.2042C>T (XDH:p.(A681V)) as a candidate causative variant for xanthinuria in this cat. The variant is located in a highly conserved part of the molybdenum–pterin co‐factor domain, responsible for catalysing the hydroxylation of hypoxanthine to xanthine and uric acid. Variants in this domain of XDH have been shown to disrupt enzyme function and to cause xanthinuria in other species. When assessed in the wider cat population, the variant had an allele frequency of 15.8%, with 0.9% of the animals assessed homozygous for the alternative allele. Cats diagnosed with xanthinuria should be tested for this variant to validate its clinical relevance in the wider population. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study evaluated and compared the surgical outcomes of retrograde intrarenal surgery (RIRS) lithotripsy versus robot-assisted laparoscopic pyelolithotomy (RAPL) in community patients with renal pelvic stones larger than 2 cm. Materials and Methods: A total of 77 patients who underwent RIRS (RIRS group, n = 50) or RAPL (RAPL group, n = 27) at our institution between December 2016 and July 2022 were recruited. A single surgeon performed all surgical operations. Preoperative, operative, and postoperative data were recorded. The study evaluated various clinical outcomes, namely, urinary tract infections, analgesic use, emergency room readmissions, stone clearance rates, surgical complications, and medical expenditures associated with the treatment courses, and compared them between the groups. Results: The RAPL group had a larger mean stone diameter and higher degree of hydronephrosis than the RIRS group did. The RIRS group had superior outcomes regarding operative time, length of postoperative hospital stay, surgical wound pain, and medical expenditures. Regarding postoperative outcomes, comparable rates of postoperative urinary tract infection, prolonged analgesic use, and emergency room readmissions were observed between the groups. However, the RAPL group had a higher stone clearance rate than the RIRS group did (81.5% vs. 52.0%, p = 0.014). Conclusions: For the surgical treatment of renal pelvis stones larger than 2 cm, RAPL has a superior stone clearance rate than RIRS; however, RIRS achieves superior outcomes in terms of medical expenditures, length of hospital stay, and surgical wound pain. Both procedures were equally safe. [ABSTRACT FROM AUTHOR]

The principles of this work are the study of masonry materials with a view to the conservation and rehabilitation of buildings. It is important to preserve and care for the historical heritage. Development and associated innovation require knowledge of the physical and mechanical characteristics of materials. Situational causes of pathologies found in stone masonry can be identified by the photographs presented, showing a horizontal cracking due to physical natural actions, temperature variations and the presence of water. The main causes of pathological changes are air pollution, but the water and the temperature also play a very important role in the development of the deterioration. The test results are essential to obtain the quality and durability of the materials of the limestone and mortar to prevent damage the water in the environment with the incorporation of paint with good quality.

Introduction. Urolithiasis is not a simple disease, but it is a group of metabolic and endocrine disorders in the organism, coupled with changes in the urinary tract. Objectives. Research on the etiopathogenesis of urolithiasis; to analyze parathyroid hormones, to determine citrates in urine; their influence on the occurrence of urolithiasis. Research and the role of infection in the occurrence of urolithiasis, clinical symptoms, diagnostic methods, prevention methods and as well as preventive measures. Materials and methods. The research was conducted on our patients at the Urology Clinic, University Clinical Center of Kosovo, in Pristina. The work was prospective; in our research, we included 102 patients. Results. Our research has increased Parathormone in 5, 88% of cases. We had hypocitraturia in 57, 84% of cases. Hypocyturia then affects the creation of conditions for the crystallization and aggregation of stoneforming substances. Urolithiasis includes both sexes, primarily men 66, 7%, and women 33.3%. With X2- test we obtained a significant difference with statistical significance in the number of cases by gender (X2 = 11.3, P = 0.001). The most attacked age group was 40-49 years old. Symptoms are dominated by colic, nephralgia, dysuria, and hematuria. In this research, we have 22.5% of positive results of urine cultures. Conclusion. Therefore, there is still no explanation about the pathogenesis of urolithiasis, and with the knowledge of the etiopathogenesis of urolithiasis, symptoms, clinic, metabolic disorders and pathomorphology of urolithiasis, prophylactic measures can be taken, and urolith recurrence can be prevented.

Damage to the rocks of historic built heritage needs to be addressed to facilitate their conservation and restoration; the most serious damage is caused by environmental conditions and human activities. Buildings constructed with ignimbrite blocks bonded with lime mortar in Morelia, México, a UNESCO World Heritage site, were studied. The damage mainly occurs in the facades, on the surfaces of the rocks and in the mortar of the union exposed to climatic factors such as sun, rain, wind, and temperature changes, due to the actions of humans and vehicles emitting polluting gases; and due to pigeon excrement. This has caused the formation of patinas and flora, reduced the mechanical strength and exfoliation, decreased the density and cohesion in the mortar with rocks, and led to friction damage caused by people. In the facades of five buildings, the mechanical resistance and microstructural characteristics were indirectly determined by XRD, XRF, and SEM. The results were related to the climate, humans, and vehicular pollutant emissions. The damage was due to the environment, the influencing geographic orientation, and prevailing winds, rising capillary water on the facades, pigeon droppings, vehicular pollutant gases, and humans. Potential banks of healthy quarries were analyzed for use in the conservation and restoration of damaged monuments.