47 research outputs found

    Practice patterns of kidney stone management across European and non-European centers: an in-depth investigation from the European Renal Stone Network (ERSN).

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    Kidney stones are a common condition in the general population, however, high-quality evidence for its management is scarce. We propose the creation of an international network with the aim of sharing practice patterns and patient data towards an improvement of our knowledge of the disease. Cross-sectional survey. An online survey was circulated through several scientific societies. Items were grouped into six domains. Each center's overall score (OS) was also calculated. Chi square and Mann-Whitney tests were performed for differences across centers. The countries that contributed most were Italy (8.6%), Turkey (6.6%), France and Spain (6.1%). Some type of nutritional work-up was implemented in 62% of centers. A DEXA scan was performed by 46% of centers, whereas some kind of acidification test was performed by 25% of centers. Most centers (80%) implemented blood investigations at least at baseline. With regard to 24-h urine exams, 7 out of 16 were performed by at least 50% of centers. Information on stone composition was collected by 58% of centers. The OS was significantly higher among higher-volume centers compared with lower-volume centers (p = 0.002). Significant differences between EU and non-EU centers were found. Cross-sectional design; no validation on information. Our survey highlights the potential for the creation of a network of centers that could share information in a common database for observational research and for enrollment of patients in interventional trials

    Increased Beta Cell Workload Modulates Proinsulin/Insulin Ratio in Humans

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    Increased proinsulin secretion, which characterizes type 2 diabetes and insulin resistance, may be due to an intrinsic, primitive defect in proinsulin processing, or be secondary to increased demand on \u3b2-cells (hyperinsulinemia secondary to insulin resistance). An alternative way to investigate the relation between relative hyperproinsulinemia and increased secretory demand is to study the dynamic changes in proinsulin to insulin ratio after partial pancreatectomy, a model of acute increased beta cell workload on the remaining pancreas. To pursue this aim, non-diabetic patients, scheduled for partial pancreatectomy, underwent 4-hour mixed meal tests and hyperinsulinemic euglycemic clamps before and after surgery. Following acute beta cell mass reduction, no changes were observed in fasting proinsulin to insulin ratio, while fold change in proinsulin to insulin ratio significantly increased over time after the meal. Further, our data demonstrate that whole-body insulin resistance is associated with underlying defects in proinsulin secretion, which become detectable only in the presence of increased insulin secretion demand

    Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement

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    Background: Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research. Design: A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and allied fields. A systematic review of the literature was conducted and 5216 potentially relevant articles were selected; from these, 407 articles were deemed to provide useful scientific information. The Faculty, divided into working groups, analysed the relevant literature. Preliminary statements developed by each group were exhaustively discussed in plenary sessions and approved. Results: Statements were developed to inform clinicians on the identification of secondary forms of calcium nephrolithiasis and systemic complications; on the definition of idiopathic calcium nephrolithiasis; on the use of urinary tests of crystallization and of surgical observations during stone treatment in the management of these patients; on the identification of patients warranting preventive measures; on the role of fluid and nutritional measures and of drugs to prevent recurrent episodes of stones; and finally, on the cooperation between the urologist and nephrologist in the renal stone patients. Conclusions: This document has addressed idiopathic calcium nephrolithiasis from the perspective of a disease that can associate with systemic disorders, emphasizing the interplay needed between urologists and nephrologists. It is complementary to the American Urological Association and European Association of Urology guidelines. Future areas for research are identified

    Horizontal Branch Stars: The Interplay between Observations and Theory, and Insights into the Formation of the Galaxy

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    We review HB stars in a broad astrophysical context, including both variable and non-variable stars. A reassessment of the Oosterhoff dichotomy is presented, which provides unprecedented detail regarding its origin and systematics. We show that the Oosterhoff dichotomy and the distribution of globular clusters (GCs) in the HB morphology-metallicity plane both exclude, with high statistical significance, the possibility that the Galactic halo may have formed from the accretion of dwarf galaxies resembling present-day Milky Way satellites such as Fornax, Sagittarius, and the LMC. A rediscussion of the second-parameter problem is presented. A technique is proposed to estimate the HB types of extragalactic GCs on the basis of integrated far-UV photometry. The relationship between the absolute V magnitude of the HB at the RR Lyrae level and metallicity, as obtained on the basis of trigonometric parallax measurements for the star RR Lyrae, is also revisited, giving a distance modulus to the LMC of (m-M)_0 = 18.44+/-0.11. RR Lyrae period change rates are studied. Finally, the conductive opacities used in evolutionary calculations of low-mass stars are investigated. [ABRIDGED]Comment: 56 pages, 22 figures. Invited review, to appear in Astrophysics and Space Scienc

    Frequency spectrum of toroidal Alfv\'en mode in a neutron star with Ferraro's form of nonhomogeneous poloidal magnetic field

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    Using the energy variational method of magneto-solid-mechanical theory of a perfectly conducting elastic medium threaded by magnetic field, the frequency spectrum of Lorentz-force-driven global torsional nodeless vibrations of a neutron star with Ferraro's form of axisymmetric poloidal nonhomogeneous internal and dipole-like external magnetic field is obtained and compared with that for this toroidal Alfv\'en mode in a neutron star with homogeneous internal and dipolar external magnetic field. The relevance of considered asteroseismic models to quasi-periodic oscillations of the X-ray flux during the ultra powerful outbursts of SGR 1806-20 and SGR 1900+14 is discussed.Comment: Accepted for publication in Astrophysics & Space Scienc

    75th Anniversary of ‘Existence of Electromagnetic-Hydrodynamic Waves’

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    We have recently passed the 75th anniversary of one of the most important results in solar and space physics: Hannes Alfv\'en's discovery of Alfv\'en waves and the Alfv\'en speed. To celebrate the anniversary, this article recounts some major episodes in the history of MHD waves. Following an initially cool reception, Alfv\'en's ideas were propelled into the spotlight by Fermi's work on cosmic rays, the new mystery of coronal heating and, as scientific perception of interplanetary space shifted dramatically and the space race started, detection of Alfv\'en waves in the solar wind. From then on, interest in MHD waves boomed, laying the foundations for modern remote observations of MHD waves in the Sun, coronal seismology and some of today's leading theories of coronal heating and solar wind acceleration. In 1970, Alfv\'en received the Nobel Prize for his work in MHD, including these discoveries. The article concludes with some reflection about what the history implies about the way we do science, especially the advantages and pitfalls of idealised mathematical models.Comment: 10 pages, accepted by Solar Physic

    A multi‐omics approach identifies key regulatory pathways induced by long‐term zinc supplementation in human primary retinal pigment epithelium

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    In age-related macular degeneration (AMD), both systemic and local zinc levels decline. Elevation of zinc in clinical studies delayed the progression to end-stage AMD. However, the molecular pathways underpinning this beneficial effect are not yet identified. In this study, we used differentiated primary human fetal retinal pigment epithelium (RPE) cultures and long-term zinc supplementation to carry out a combined transcriptome, proteome and secretome analysis from three genetically different human donors. After combining significant differences, we identified the complex molecular networks using Database for Annotation, Visualization and Integrated Discovery (DAVID) and Ingenuity Pathway Analysis (IPA). The cell cultures from the three donors showed extensive pigmentation, development of microvilli and basal infoldings and responded to zinc supplementation with an increase in transepithelial electrical resistance (TEER) (apical supplementation: 443.2 ± 79.3%, basal supplementation: 424.9 ± 116.8%, compared to control: 317.5 ± 98.2%). Significant changes were observed in the expression of 1044 genes, 151 cellular proteins and 124 secreted proteins. Gene set enrichment analysis revealed changes in specific molecular pathways related to cell adhesion/polarity, extracellular matrix organization, protein processing/transport, and oxidative stress response by zinc and identified a key upstream regulator effect similar to that of TGFB1

    Magnetohydrodynamic Oscillations in the Solar Corona and Earth’s Magnetosphere: Towards Consolidated Understanding

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