Variations in the mineral content of bottled 'carbonated or sparkling' water across Europe : a comparison of 126 brands across 10 countries

Kidney stone disease is a common disease with high recurrence rates. Sufficient intake of water is the cornerstone in primary prevention of stone disease. However, the mineral composition of water can affect urinary minerals and influence stone formation. The aim of this study is to assess the variation in the mineral composition of bottled sparkling or carbonated drinking water across Europe. The two largest supermarket chains in each participating country were visited to obtain data on mineral composition regarding bicarbonate, calcium, magnesium, potassium, sodium and sulphates of sparkling or carbonated waters by reading the ingredient labels on the bottles supplied by the manufacturers. Alternatively, the web-shops of these supermarkets were consulted. In total, 126 sparkling water brands across ten European countries were analysed regarding mineral composition. The median concentrations per mineral varied greatly. The greatest variation in median mineral content was found for sodium and sulphates with levels ranging from 3.1 mg/l to 63.0 mg/l and 6.0 mg/l to 263.0 mg/l respectively. A wide distribution of calcium content was found in Switzerland, with calcium levels reaching up to 581.6 mg/l. This study confirms that the mineral composition of sparkling or carbonated water varies greatly across Europe. Patients with kidney stone disease should be aware that the mineral content of water may influence stone formation and be mindful of the great variation that exists between different water brands. Mineral water can be a source of potential promotors or inhibitors of stone formation and patients and urologists need to be mindful of this

Rules and regulations for a pregnant endourologist: the European perspective

Introduction Working in surgery while pregnant is challenging. Navigating this period safely is of paramount importance. Anecdotal observation suggests that there exists great variation among European nations in regard to maternity leave and radiation safety. The aim of this article was to gain insight into policy patterns and variations across Europe regarding these issues. Methods A series of core question items was distributed to representatives across 12 nations Austria, Belgium, Germany, Greece, Iceland, Italy, Netherlands, Norway, Poland, Republic of Ireland, Spain and the United Kingdom). Results The total number of weeks with full pay ranged from as little as 4 weeks in Belgium to 32 and Iceland. All countries included in this study give the option of additional weeks beyond the initial period, however at reduced pay. Some offer unpaid leave beyond this. Only 5/12 countries had a specific policy on when the pregnant surgeon should come off the on-call rota. Only Austria, Italy and Poland stipulate a requirement for the pregnant clinician to be replaced or be completely exempt in cases involving radiation. Only Germany, Iceland, Norway and Poland highlight the need to limit radiation dose in the first trimester. Beyond this, Germany alone provides written guidance for reduction in gown weight and along with Poland, display arguably the most forward-thinking approach to resting. Conclusion There is a marked range in maternal leave policies across Europe. There also exists a lack of universal guidance on radiation safety for the pregnant urologist. There is urgent need for this void to be addressed.publishedVersio

Global Variations in the Mineral Content of Bottled Still and Sparkling Water and a Description of the Possible Impact on Nephrological and Urological Diseases

Kidney stone disease (KSD) is a complex disease. Besides the high risk of recurrence, its association with systemic disorders contributes to the burden of disease. Sufficient water intake is crucial for prevention of KSD, however, the mineral content of water might influence stone formation, bone health and cardiovascular (CVD) risk. This study aims to analyse the variations in mineral content of bottled drinking water worldwide to evaluate the differences and describes the possible impact on nephrological and urological diseases. The information regarding mineral composition (mg/L) on calcium, bicarbonate, magnesium, sodium and sulphates was read from the ingredients label on water bottles by visiting the supermarket or consulting the online shop. The bottled waters in two main supermarkets in 21 countries were included. The evaluation shows that on a global level the mineral composition of bottled drinkable water varies enormously. Median bicarbonate levels varied by factors of 12.6 and 57.3 for still and sparkling water, respectively. Median calcium levels varied by factors of 18.7 and 7.4 for still and sparkling water, respectively. As the mineral content of bottled drinking water varies enormously worldwide and mineral intake through water might influence stone formation, bone health and CVD risk, urologists and nephrologists should counsel their patients on an individual level regarding water intake

Global Variations in the Mineral Content of Bottled Still and Sparkling Water and a Description of the Possible Impact on Nephrological and Urological Diseases

Kidney stone disease (KSD) is a complex disease. Besides the high risk of recurrence, its association with systemic disorders contributes to the burden of disease. Sufficient water intake is crucial for prevention of KSD, however, the mineral content of water might influence stone formation, bone health and cardiovascular (CVD) risk. This study aims to analyse the variations in mineral content of bottled drinking water worldwide to evaluate the differences and describes the possible impact on nephrological and urological diseases. The information regarding mineral composition (mg/L) on calcium, bicarbonate, magnesium, sodium and sulphates was read from the ingredients label on water bottles by visiting the supermarket or consulting the online shop. The bottled waters in two main supermarkets in 21 countries were included. The evaluation shows that on a global level the mineral composition of bottled drinkable water varies enormously. Median bicarbonate levels varied by factors of 12.6 and 57.3 for still and sparkling water, respectively. Median calcium levels varied by factors of 18.7 and 7.4 for still and sparkling water, respectively. As the mineral content of bottled drinking water varies enormously worldwide and mineral intake through water might influence stone formation, bone health and CVD risk, urologists and nephrologists should counsel their patients on an individual level regarding water intake

Ureteroscopy for stone disease: expanding roles in the modern era

INTRODUCTION: The prevalence of urolithiasis is increasing worldwide and is causing significant morbidity and cost to the healthcare systems. While ureteroscopy (URS) has been established as a treatment option, our review highlights the expanding role of URS for the management of more complex stones and patients in the modern era.MATERIAL AND METHODS: Ureteroscopy has shown to have good outcomes with stone free rates (SFR) comparable to other treatment modalities. Relevant publications have been identified. Their findings were critically appraised and used to formulate clinically oriented conclusions.RESULTS: The use of URS has increased and now includes URS management for large stones, bilateral stone disease, obesity, pregnancy, pediatrics, solitary kidney, horseshoe kidney and patients with a bleeding diathesis.CONCLUSIONS: With advances in URS technique and technology, its role has expanded to offer treatment in difficult clinical scenarios with good outcomes.</p

Ureteroscopy for stone disease: expanding roles in the modern era

INTRODUCTION: The prevalence of urolithiasis is increasing worldwide and is causing significant morbidity and cost to the healthcare systems. While ureteroscopy (URS) has been established as a treatment option, our review highlights the expanding role of URS for the management of more complex stones and patients in the modern era.MATERIAL AND METHODS: Ureteroscopy has shown to have good outcomes with stone free rates (SFR) comparable to other treatment modalities. Relevant publications have been identified. Their findings were critically appraised and used to formulate clinically oriented conclusions.RESULTS: The use of URS has increased and now includes URS management for large stones, bilateral stone disease, obesity, pregnancy, pediatrics, solitary kidney, horseshoe kidney and patients with a bleeding diathesis.CONCLUSIONS: With advances in URS technique and technology, its role has expanded to offer treatment in difficult clinical scenarios with good outcomes.</p

Postrzeganie problemu nietrzymania moczu przez kobiety w Polsce

Objectives: Assessment of perception of urinary incontinence (UI) among women in Poland.Materials and methods: The Centre for Public Opinion Research TNS OBOP conducted a multisubjectthematic, face-to-face interview, in the homes of respondents. Questioning about the quality of life was carriedon in two successive editions of the survey from 4 to 7 and from 11 to 14 February 2010. The study was performedon a nationwide random sample of 855 women aged 35 and older.Results: The most troublesome consequences of UI are odour (44%), leaking of urine (43%), lack of controlover own body (31%), unexpected search for toilets (24%), feeling of moisture (22%) and fear of the reaction ofothers (15%). Most frequently indicated ways to improve the quality of life for women with UI are a visitto the doctor (57%), the use of anatomical inserts (33%) and pelvic floor muscle exercise (21%). Sense ofattractiveness is retained for 53% of Polish women with UI, 25% do not feel attractive as a woman and 22%have no opinion on this subject.Conclusion: The problem of UI is common and is associated with reduction in quality of life. However, thosewho benefit from medical consultations, hygiene products (anatomical pads) or pelvic floor muscle exercisesoften retain a sense of attractiveness

Optimal management of lower pole stones: the direction of future travel

INTRODUCTION: Kidney stone disease is increasing worldwide with its most common location being in the lower pole. A clear strategy for effective management of these stones is essential in the light of ever increasing choice, effectiveness, and complications of different treatment options.MATERIAL AND METHODS: This review identifies the latest and clinically relevant publications focused on optimal management of lower pole stones.RESULTS: We present an up-to-date European Association of Urology and American Urological Association algorithm for lower pole stones, risks and benefits of different treatments, and changing landscape with the miniaturization of percutaneous stone treatments.CONCLUSIONS: Available literature seems to be deficient on quality of life, patient centered decision making, and cost analysis of optimal management with no defined standard of 'stone free rate', all of which are critical in any surgical consultation and outcome analysis.</p

Objawy ze strony dolnych dróg moczowych — związek z ryzykiem sercowo-naczyniowym

Lower urinary tract symptoms (LUTS) are etiologically heterogeneous group of clinical symptoms, which are related to disorders of the lower urinary tract (bladder, prostate and urethra). LUTS are common break down into two symptoms groups: voiding (obstructive) symptoms or storage (irritative) symptoms. Patients may have mainly voiding symptoms, storage symptoms or a combination of both. The occurrence of LUTS is not limited to specific disease despite the frequent association of these symptoms with the bladder outlet obstruction. Furthermore, they can be an indicator of structural and functional abnormalities of the urinary tract, as well as the indicator of many other non-urological diseases (e.g. chronic kidney disease, cardiovascular disease, disorders of the central nervous system and endocrine system). In many cases, LUTS are consequence of systemic changes that are caused by cardiovascular risk factors such as diabetes, hyperlipidemia or hypertension. This paper discusses the relationship between the occurrence of LUTS and the cardiovascular disease and the potential clinical implications regarding the management of the patients.Objawy ze strony dolnych dróg moczowych (LUTS) to etiologicznie niejednorodna grupa zaburzeń dotycząca przechowywania moczu, oddawania moczu i dolegliwości pomikcyjnych. Występowanie LUTS nie ogranicza się do konkretnych jednostek chorobowych mimo częstego związku tych objawów z występowaniem przeszkody podpęcherzowej; mogą być wskaźnikiem dysfunkcji pęcherza moczowego i innych strukturalnych oraz funkcjonalnych nieprawidłowości dróg moczowych, jak również zwiastunami wielu innych chorób nieurologicznych, na przykład niewydolności nerek, zaburzeń krążenia, zaburzeń ze strony ośrodkowego układu nerwowego i układu dokrewnego. W wielu przypadkach niekorzystne zmiany zachodzące w układzie moczowym są konsekwencją ogólnoustrojowych zmian spowodowanych przez czynniki ryzyka sercowo-naczyniowego, takie jak cukrzyca, hiperlipidemia czy nadciśnienie tętnicze. W artykule omówiono związek między występowaniem LUTS a chorobami układu sercowo-naczyniowego oraz wynikające z tego potencjalne implikacje kliniczne dotyczące postępowania z pacjentem

Variations in the Mineral Content of Bottled "Still" Water Across Europe: Comparison of 182 Brands Across 10 Countries

Introduction: Kidney stone disease (KSD) is a highly prevalent disease worldwide. As water intake and its mineral content influence stone formation and recurrence, patients and physicians must be aware of the mineral content of drinkable water. We analyzed commercial bottled still water within Europe to assess the variation in its mineral composition across different manufacturers and countries. Materials and Methods: Data on the mineral composition of bottled still water regarding bicarbonate, calcium, magnesium, potassium, sodium, and sulfate concentration (mg/L) were collected from ten European countries. To collect the data, the two main supermarket chains in each participating country were either visited to check for the ingredient label on bottles or the online shop was consulted through the website of the supermarket in question. Descriptive statistics such as simple boxplots were used to illustrate the variation in mineral content. Results: One hundred eighty-two different commercial water brands were analyzed. Up to a fivefold variation in average concentrations per mineral between countries was observed. For calcium, a wide distribution was found in France and Switzerland compared with other countries with calcium levels ranging from 10.5 to 565 mg/L and 8.4 to 579 mg/L, respectively. By consuming 2 L of water with such high calcium levels, the daily reference intake for calcium is already achieved. Conclusions: The mineral content of bottled still water across Europe varies greatly. For patients with KSD it is important to be aware of the mineral content of the water they drink, as it might influence stone recurrence rates and necessitate alterations of their diet