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N Schenkman

Publications and source records attributed to N Schenkman.

4 recordsLinked to original sources

Gahat: a Napalese cure for urolithiasis?

OBJECTIVES: Gahat (Vigna unguiculata) is a legume used for centuries in Nepal and Pakistan to treat the symptoms associated with urinary calculi. We prospectively evaluated the effect of Gahat consumption on 24-hour urine parameters in an attempt to assess its in vivo effect in normal volunteers. METHODS: Eight non-stone-forming volunteers collected 24-hour urine specimens while on their routine diets for baseline data. Urine was analyzed for pH, volume, calcium, citrate, phosphate, sodium, magnesium, uric acid, and oxalate. The Gahat was prepared according to local custom. No additives were used to enhance flavor. The pureed mixture (8 ounces) was ingested three times daily for 2 days. Subjects were instructed to maintain their normal diet, including fluid intake and activity during the study period. Twenty-four hours after the start of Gahat intake, a second 24-hour urine collection was initiated while volunteers continued the Gahat. Results of the urine samples before and after Gahat intake were analyzed, using the paired Student t test. RESULTS: There were no significant differences in urinary electrolytes between the urine samples before and after Gahat intake. Magnesium, urine volume, and uric acid differences approached clinical significance. CONCLUSIONS: Gahat increased urinary magnesium through an unknown mechanism and had no effect on other routine 24-hour urine electrolytes. The increase in urinary volume is attributed to the increase in fluid consumption by the subjects. If this legume is effective in preventing or dissolving urinary calculi, it may act through mechanisms not identified in 24-hour urine electrolytes.

Citrates↗

Imaging characteristics of indinavir calculi.

PURPOSE: Indinavir sulfate is an effective protease inhibitor of the human immunodeficiency virus type 1. Use is associated with a significant incidence of crystallization and stone formation in the urinary tract, and these calculi are not visible on plain radiographs. Previously all urinary stones, including uric acid and matrix, were believed to be radiodense on computerized tomography (CT). We conducted a retrospective study to evaluate the radiographic appearance of indinavir calculi. MATERIALS AND METHODS: Retrospective chart review of 36 patients taking indinavir sulfate and presenting with renal colic was performed with attention to presentation, urinalysis, radiographic evaluation and management. Specifically, imaging characteristics on CT were addressed. RESULTS: All patients complained of ipsilateral flank pain and 35 had nausea and/or vomiting. Of 30 patients with dysuria or urgency the majority had hematuria, and most had pyuria and/or proteinuria. No stones were visualized on abdominal radiography. Diagnosis was confirmed on 1 of 13 excretory urograms and 4 of 11 renal ultrasounds. None of 12 CT scans was diagnostic of renal lithiasis. CONCLUSIONS: Indinavir sulfate is a protease inhibitor with poor solubility and significant urinary excretion. Crystallization and stone formation are demonstrated in as many as 20% of patients taking the medication. Most patients present with flank pain, nausea or vomiting and hematuria. Previously CT was thought to identify all urinary calculi with clarity but it cannot reliably confirm the presence of indinavir calculi.

Adult↗

ALS and pet exposure.

To examine animal exposure in ALS patients, a case-control study was undertaken on 40 ALS patients and 40 closely matched controls. Exposure to pets of any kind and to small dogs in the period from birth until 10 years before onset of ALS symptoms was significantly increased. Affected men showed a trend toward increased exposure to neurologically ill pets, but there was no significant difference when male and female cases were grouped. No differences between ALS cases and controls were observed in exposure to any other single animal species. There may be a link between ALS and exposure to house pets.

Adult↗