In addition, there is a well documented negative association of BMI with urinary pH in both stone formers and non-stone formers, and low urinary pH is the main driver of uric acid stone formation. Absolute urinary excretion rates of stone formation promoters (calcium, phosphate, oxalate and uric acid) as well as urinary supersaturation ratios for calcium oxalate and uric acid are increased in obese individuals. Both calcium and uric acid stones are associated with obesity, but the ratio of calcium stones to uric acid stones is lower in obese compared to non-obese stone formers, suggesting a disproportionate increase of uric acid stone disease in obesity. In large cross-sectional analyses, the prevalence of both symptomatic and asymptomatic kidney stones increased proportionally with the number of metabolic syndrome features present. In recent decades, the prevalence of both kidney stone disease and obesity increased significantly, irrespective of age, sex and race. In addition to BMI, significant weight gain is also associated with a greater risk of developing symptomatic kidney stone disease in the future. The magnitude of the increased risk is larger in women than in men. The strong, positive and independent association of Body Mass Index (BMI) with kidney stone disease is well established. Clearly, however, these co-morbidities contribute significantly to stone-related morbidity and mortality. It is currently unknown if stone disease is a cause of this co-morbidity per se or if it is a consequence of the same underlying conditions that lead to these disorders and kidney stones. Arterial hypertension, obesity, diabetes mellitus, gouty diathesis, dyslipidemia, cardiovascular disease, chronic kidney disease and low bone mass are much more prevalent in kidney stone formers than in non-stone formers. Although kidney stone disease is traditionally considered an isolated renal disorder, there is overwhelming evidence that it is in fact a systemic disease. Hospitalizations, surgery and lost work time associated with kidney stones cause enormous healthcare-related expenditures. Recurrence rates are high, up to 40 % and 75 % at 5 and 10 years, respectively. Kidney stones are a worldwide healthcare problem with a current lifetime risk of ~18.8 % in men and ~9.4 % in women in Western civilizations. Kidney stones - a global epidemic associated with obesity and diabetes
Children were randomized 2:1 to receive either a single dose of oral baloxavir or oral oseltamivir twice daily for 5 days. MiniSTONE-2 (: NCT03629184) was a double-blind, randomized, active controlled trial enrolling children 1-<12 years old with a clinical diagnosis of influenza. We assessed the safety and efficacy of baloxavir in otherwise healthy children with acute influenza.
Baloxavir marboxil (baloxavir) is a novel, cap-dependent endonuclease inhibitor that has previously demonstrated efficacy in the treatment of influenza in adults and adolescents.