J Urol. 1999 Mar;161(3):869-73.
Ammonium acid urate calculi: a reevaluation of risk factors.
Soble JJ, Hamilton BD, Streem SB.
Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
PURPOSE: We reevaluate the demographic and metabolic risk factors for ammonium acid urate stones. MATERIALS AND METHODS: Since 1986, 23 women and 21 men ranging in age from 20 to 81 years (mean 48.7) were treated for stones partly composed of ammonium acid urate. Stone composition ranged from 2 to 60% ammonium acid urate (mean 24.1) of the total stone mass. No patient had a pure ammonium acid urate stone, although 11 (25%) had stones with ammonium acid urate as the predominant crystal. RESULTS: In the 44 patients 1 or more potential risk factors for ammonium acid urate were identified. Of the patients 11 (25%) had a history of inflammatory bowel disease with 10 (22.7%) having undergone ileostomy diversion, 6 (13.6%) admitted to a history of significant laxative use or abuse, 18 (40.9%) were morbidly obese, 16 (36.4%) had a history of recurrent urinary tract infections and 9 (20.5%) had a history of recurrent uric acid stones. CONCLUSIONS: Patients clearly at risk for stones with an ammonium acid urate component include those with a history of inflammatory bowel disease and ileostomy diversion or laxative abuse. Other factors that may potentially enhance ammonium acid urate stone formation include morbid obesity, recurrent uric acid calculi and recurrent urinary tract infection. A careful history followed by further metabolic evaluation is warranted in these patients.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10022703&dopt=Abstract constipation laxative
Pharmacology. 1988;36 Suppl 1:144-51.
Anthraquinone laxatives: metabolism and transport of danthron and rhein in the rat small and large intestine in vitro.
Sund RB, Elvegard SO.
Department of Pharmacology, University of Oslo, Norway.
A previous in vitro study by Sund and Hillestad in 1982 showed that dihydroxy-diphenylmethane laxatives undergo intestinal metabolism, and suggested a regionally dependent transport asymmetry of gut glucuronides. The present study was initiated since such experiments on anthraquinone diphenols are lacking. Everted sacs of rat jejunum and stripped colon were filled with Krebs-Henseleit solution (K-H) on the serosal (BL) side, and bathed at the mucosal (LU) side with K-H containing either danthron (3-4 nmol/ml) or rhein (10 nmol/ml). After 60 min incubation at 37 degrees C, LU and BL solutions and gut tissue were analysed for parent diphenol and metabolites by reverse-phase high-pressure liquid chromatography. Reference metabolites were isolated and purified from urine and bile of rats infused with danthron or rhein. The studies showed: (1) only small amounts of unchanged drug were present on the contraluminal side; (2) in both tissues, danthron was transformed into its monoglucuronide (G) and monosulphate (S); the ratio G:S was 6-8:1 in jejunum, and even greater in colon; (3) in jejunum, G and S were mainly secreted (LU:BL distribution ratios greater than 10:1); (4) in the colon, however, the main G fraction was absorbed (BL:LU ratios of 3:1), whereas a slight net secretion of S seemed to take place; (5) residuals (%) in gut tissue were small; (6) rhein was more slowly taken up and metabolized, but seemed otherwise to behave as danthron. The results are in principle similar to those obtained by indirect conjugate assay in the study on diphenylmethanes.(ABSTRACT TRUNCATED AT 250 WORDS)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3368513&dopt=Abstract constipation laxative
Rev Gastroenterol Mex. 1998 Jan-Mar;63(1):28-32.
[A comparative study of 2 methods of preparation for colonoscopic procedure]
[Article in Spanish]
Garcia Guerrero VA, Bernal Sahagun F, Sobrino Cossio S, Abdo Francis JM.
Unidad de Endoscopia, Hospital General de Mexico, SSA.
BACKGROUND: Although ingestion of polyethylene glycol solution has become the standard preparation for colonoscopy since 1980, there is investigation of new safe, comfortable and cheap methods. OBJECTIVE: We carried out a prospective study in order to compare the utility and tolerance related to the preparation of the colon for colonoscopy, using a dioctyl sodium sulfosuccinate enema (SD) versus our conventional preparation. METHOD: Group A was prepared the day previous to the study with liquid diet, oral laxative and application of an SD, prior to the endoscopy received another SD. Group B was prepared three days with liquid diet, the day previous to the colonoscopy they ingested oral laxative and used a water enema (W(e)), and they used another W(e) the day of the procedure. The patients' tolerance in each case was compared using a scale assigned as good, fair and poor. The cleaning obtained in the colon was also evaluated in a scale of good, regular and bad, considering three colon segments. RESULTS: Forty-four patients had been studied, 19 men and 25 women; each group with 22 patients. In group A: the preparation tolerance was good in 14 cases (63.6%), fair in seven (31.8%) and poor in one (4.5%); also, the obtained cleaning up to the cecum was good in nine cases (40.9%) and fair in 13 (59%). In group B: the tolerance was good in five cases (22.7%) fair in 12 (54.5%) and poor in five (22.7%); the obtained cleaning in this group up to the cecum was good in two cases (9%), fair in 19 (86.3%) and poor in one (4.5%). CONCLUSIONS: The SD preparation was better tolerated and more effective in order to achieve the cleaning of the colon than the conventional one.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10068746&dopt=Abstract constipation laxative
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