Gender characteristics of urinary excretion of oxalates, calcium and phosphates in children and teenagers

Relevance. The risk factors for urolithiasis include an increase in the daily excretion of lithogenic metabolites. These factors have not been sufficiently studied in childhood. Methods. We conducted a study of the 24-hour urinary excretion of calcium, oxalate and phosphorus in 196 patients (median age was 9.0 [6.0; 14.0] years, boys 23.5% (46/196)) with the urinary syndrome. Results. We found a statistically significantly higher daily urinary excretion of oxalates in boys compared to girls, 18.1 [11.2; 25.6] mg/day and 14.1 [9.6; 21.3] mg/day, respectively, p = = 0.012. However, these differences manifest themselves only at the age of 10 years and older, amounting to 23.85 [11.2; 25.5] mg/day in boys and 13.91 [8.02; 18.9] mg/day in girls, p = 0.005. We did not establish gender differences in daily calcium excretion, p = 0.45. At the same time, we revealed gender differences in daily phosphorus excretion in boys compared with girls 23.25 [15.0; 38.0] mmol/day and 18.9 [10.6; 29.2] mmol/day, respectively, p = 0.013. These patterns were also typical only for the age older than 10 years – in boys 31.7 [21.1; 43.0] mmol/day, in girls 17.9 [11.6; 30.9] mmol/day, p = 0.003. Conclusions. Boys aged 10 years and older have a statistically significantly higher 24-hour urinary excretion of oxalate and phosphorus than girls. This may indicate the gender dependence of some lithogenic factors and the need for increased attention to the prevention of nephrolithiasis during early puberty

Results Of Orthotopic Bladder Creation After Radical Cystectomy In Patients With Bladder Cancer

This article presents the results of 116 radical cystectomies of patients with bladder cancer. In all the cases various generated modifications of orthotopic bladder including the authors' methodology have been carried out. The structure of complications during the post-operative period has been analyzed. Various complications occurred in 16,4 % of patients. In 3,4 % of cases they caused death. In 74% of cases direct dependence of postoperative complications on advanced tumorous process and severity of accomponied pathology has been identified. Direct dependence on the selection of method of urine derivation has not been found. Five-year cancer survival rate accounted 70 %. The study of patients' quality of life has been performed using EORTC-QLQ-C-30. High indices have been worked out. Dependence on the method of orthotopic bladder creation has been negligibl

Relationship of nutritional status and spirometric parameters in children with bronchial asthma

© 2020, Privolzhsky Research Medical University. All rights reserved. The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma. Materials and Methods. The study involved 54 patients with BA at the age of 8 to 17 years, 33 boys and 21 girls with different nutritional status. Assessment of nutritional status was carried out with the calculation of body mass index (BMI), relative body mass index (RBMI), and determination of body fat (% BF). Spirogram parameters were evaluated, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, maximum expiratory flow at the point of 25% loop flow-volume (MEF 25). Results. Among the children examined, taking into account the BMI Z-score, 9.3% (5/54) had low body weight (group 1), 33% (18/54) had normal body weight (group 2), 31.5% (17/54) overweight (group 3), 25.9% (14/54) obesity (group 4). As the body weight increased, a statistically significant decrease in the FEV1/FVC ratio was observed, amounting to 84.6 [79.3; 90.0], 79.4 [76.6; 82.2], 74.6 [71.7; 77.5], 70.2 [67.0; 73.4]%, respectively, p=0.003; as well as a decrease in MEF 25 (% pred.), which amounted, respectively, to 95.6 [76.1; 115.2], 81.7 [71.4; 92.0], 56.3 [45.7; 66.9], and 48.4 [36.7; 60.1]%, p=0.003. A statistically significant negative relationship was found between indicators of nutritional status, including BMI, RBMI, % BF, and spirometry parameters reflecting bronchial patency, including FEV1/FVC ratio and MEF 25 (% pred.); all p<0.01. Conclusions. Overweight and obesity in children with BA, estimated both by calculated methods with determination of BMI and RBMI and direct determination of body fat content, are accompanied by a statistically significant decrease in bronchial patency

Connection between body mass index, relative body mass index and bronchial patency indicators in children with bronchial asthma

Objective of the study: To study the relationship between nutritional status parameters and spirometric parameters reflecting bronchial patency in children with bronchial asthma (BA). Materials and methods of research: A retrospective non-randomized single-center comparative study of 417 children, 297 boys (71,2%) and 120 girls (28,8%), age 10,5 [10,2; 10,9] years with atopic BA. All children underwent spirometry and anthropometry. Results: An increase in body weight from underweight to obesity was accompanied by a decrease in the FEV1/FVC ratio from 80,4 [48,8; 97,9]% to 73,7 [47,4; 88,1]%, p=0,003, MEF 25% (% pred) from 70,9 [19,4; 171,5]% to 55,1 [20,2; 110,0]%, p=0,003 and FEF 25-75 (% pred) from 79,2 [28,6; 173,6]% to 65,9 [24,8; 103,5]%, p=0,02; at the same time, there is an increase in FVC% pred from 104,88±17,26 to 112,13±16,22%, р=0,01, which may be associated with the phenomenon of dysanapsis. The body mass index (BMI) and relative BMI values negatively correlate with the FEV1/FVC index (r=-0,20 and r=-0,19, respectively, p=0,0001). Similar data for the general cohort was collected in the cohort of boys. Conclusion: Indicators of nutritional status, as well as spirometric indicators, can be important components of an objective assessment of the condition of children with asthma for individual effective therapy of the disease. © 2021, Pediatria Ltd.. All rights reserved

Relationship of nutritional status and spirometric parameters in children with bronchial asthma

The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma. Materials and Methods. The study involved 54 patients with BA at the age of 8 to 17 years, 33 boys and 21 girls with different nutritional status. Assessment of nutritional status was carried out with the calculation of body mass index (BMI), relative body mass index (RBMI), and determination of body fat (% BF). Spirogram parameters were evaluated, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, maximum expiratory flow at the point of 25% loop flow-volume (MEF 25). Results. Among the children examined, taking into account the BMI Z-score, 9.3% (5/54) had low body weight (group 1), 33% (18/54) had normal body weight (group 2), 31.5% (17/54) overweight (group 3), 25.9% (14/54) obesity (group 4). As the body weight increased, a statistically significant decrease in the FEV1/FVC ratio was observed, amounting to 84.6 [79.3; 90.0], 79.4 [76.6; 82.2], 74.6 [71.7; 77.5], 70.2 [67.0; 73.4]%, respectively, p=0.003; as well as a decrease in MEF 25 (% pred.), which amounted, respectively, to 95.6 [76.1; 115.2], 81.7 [71.4; 92.0], 56.3 [45.7; 66.9], and 48.4 [36.7; 60.1]%, p=0.003. A statistically significant negative relationship was found between indicators of nutritional status, including BMI, RBMI, % BF, and spirometry parameters reflecting bronchial patency, including FEV1/FVC ratio and MEF 25 (% pred.); all p<0.01. Conclusions. Overweight and obesity in children with BA, estimated both by calculated methods with determination of BMI and RBMI and direct determination of body fat content, are accompanied by a statistically significant decrease in bronchial patency. © 2020, Privolzhsky Research Medical University. All rights reserved

THE EFFECT OF ABDOMINAL OBESITY AND EXTERNAL RESPIRATION FUNCTION IN CHILDREN AND ADOLESCENTS WITH BRONCHIAL ASTHMA

Objective of the study: to study the relationship of the ratio «abdominal circumference/height» as a marker of abdominal obesity with spirometric parameters reflecting bronchial patency in children and adolescents with bronchial asthma (BA). Materials and methods of research: a pilot prospective non-randomized single-center comparative study of 167 children aged 12.0 [9.0; 14.0] years with atopic BA. All children underwent spirometry and anthropometry, which included measuring abdomen circumference (AC) and calculating the ratio of AC/height. If this ratio is exceeding above the 90th percentile, it is assumed that the patient has abdominal type of obesity. Results: the AC index/height above the 90th percentile was statistically significantly more common in patients with reduced/normal body weight (8.3%) compared with patients with increased body weight and/or obesity (77.6%, p&lt;0.0001). Statistically significant positive correlations of the ratio AC/height with the forced vital capacity of the lungs (FVC, R=0.29, p=0.002) and negative with spirometric parameters reflecting bronchial patency, including the ratio of forced expiratory volume in the first second/FVC (R=–0.24 at p=0.002), the average volumetric rate of expiratory flow in the 25–75% section of the flow-volume loop (R=–0.21 at p=0.007) were established, the maximum volumetric velocity of the expiratory flow at the point of 25% of the flow-volume loop (R=–0.29 at p=0.0002). Conclusion: abdominal obesity in children with BA is accompanied by an increase in lung volume and a decrease in bronchial patency with the formation of an obstructive breathing pattern. © 2022, Pediatria Ltd.. All rights reserved

THE RELATIONSHIP BETWEEN PHOSPHATE METABOLISM AND EXTERNAL RESPIRATION FUNCTION IN CHILDREN AND ADOLESCENTS WITH BRONCHIAL ASTHMA

Objective of the study: to study some indicators of renal function, phosphate homeostasis and their relationship with external respiration function parameters in children and adolescents with bronchial asthma (BA). Materials and methods of research: a pilot prospective non-randomized single-center comparative study of 31 children aged 12.0 [9.0; 14.0] years with atopic BA. All children underwent anthropometry, spirometry, blood biochemical parameters test and 24-hour urine collection. Results: glomerular filtration rate calculated by the classic Schwartz formula was below the median in 18 (58%) of 31 patients. Serum phosphate concentration was excessive (more than +1Z above the mean) in 71% (22/31) of patients. Positive relationships were found between the maximum expiratory flow rate at the 25% point of the flow–volume loop (MOC25), the average expiratory flow rate at the 25–75% portion of the flow–volume loop (COC25–75), and blood creatinine concentration (r=0.36, p=0.04 and r=0.34, p=0.05, respectively); a negative relationship between the ratio of forced expiratory volume in 1 s to forced vital capacity and urinary phosphate concentration (r=–0.38, p=0.03). A negative relationship was noted between MOC25, SOC25–75 and urinary phosphate concentration (r=–0.37, p=0.03 and r=–0.36, p=0.04, respectively) and phosphorus/creatinine ratio (r=–0.4, p=0.02 and r=–0.39, p=0.02, respectively). Age-dependent sex differences normalized phosphate excretion was positively correlated with MOC25 (r=0.36, p=0.04). Conclusion: we have found a negative relationship between the concentration of phosphates in urine and blood with indicators of bronchial patency, as well as a positive relationship between patency in the small bronchi and the concentration of blood creatinine. The development of phosphate metabolism disorders in patients with BA may be associated with prolonged spasm of bronchial smooth muscles with the development of hyperphosphatemia and compensatory hyperphosphaturia. Further study of glomerular and tubular function in children with BA is required for the purpose of early prevention of the development of chronic kidney disease in this cohort. © 2022, Pediatria Ltd. All rights reserved