Comparison of Common Field/Clinical Measures to Standard Laboratory Measures of Hydration Status

Context: Accurately determining hydration status is a preventative measure for exertional heat illnesses (EHI). Objective: To determine the validity of various field measures of urine specific gravity (Usg) compared to laboratory instruments. Design: Observational research design to compare measures of hydration status: urine reagent strips (URS) and a urine color (Ucol) chart to a refractometer. Setting: We utilized the athletic training room of a Division I-A collegiate American football team. Participants: Trial 1 involved urine samples of 69 veteran football players (age=20.1+1.2yr; body mass=229.7+44.4lb; height=72.2+2.1in). Trial 2 involved samples from 5 football players (age=20.4+0.5yr; body mass=261.4+39.2lb; height=72.3+2.3in). Interventions: We administered the Heat Illness Index Score (HIIS) Risk Assessment, to identify athletes at-risk for EHI (Trial 1). For individuals “at-risk” (Trial 2), we collected urine samples before and after 15 days of pre-season “two-a-day” practices in a hot, humid environment(mean on-field WBGT=28.84+2.36oC). Main Outcome Measures: Urine samples were immediately analyzed for Usg using a refractometer, Diascreen 7® (URS1), Multistix® (URS2), and Chemstrip10® (URS3). Ucol was measured using Ucol chart. We calculated descriptive statistics for all main measures; Pearson correlations to assess relationships between the refractometer, each URS, and Ucol, and transformed Ucol data to Z-scores for comparison to the refractometer. Results: In Trial 1, we found a moderate relationship (r=0.491, p<.01) between URS1 (1.020+0.006μg) and the refractometer (1.026+0.010μg). In Trial 2, we found marked relationships for Ucol (5.6+1.6shades, r=0.619, p<0.01), URS2 (1.019+0.008μg, r=0.712, p<0.01), and URS3 (1.022+0.007μg, r=0.689, p<0.01) compared to the refractometer (1.028+0.008μg). Conclusions: Our findings suggest that URS were inconsistent between manufacturers, suggesting practitioners use the clinical refractometer to accurately determine Usg and monitor hydration status.

[Urinary specific gravity--comparative measurements using reagent strips and refractometer in 340 morning urine samples]

The specific gravity of urine (SG) indicates the number and weight of solute particles in urine; its measurement is helpful in interpreting proteinuria detected by dipstick tests and in monitoring adequate hydration in patients with nephrolithiasis. Four methods for measuring SG or osmolality of urine are currently available (depression of the freezing-point, urometry, refractometry, cation exchange on a reagent strip). Using a recently developed reagent strip, we have measured SG in morning urines of 340 non-selected outpatients and compared the results with SG measurements by refractometry of the same urines. In 86.2% of all urines, a good positive correlation between SG measured by reagent strip and refractometry was noted (r = 0.913, p = 0.0001). In 13.8% of the urines, however, the SG measured by reagent strip deviated by more than +/- 5 from the value obtained by refractometry; in 90% of these urines, glucosuria (reagent strip values too low or too high), proteinuria (values too high), or bacteriuria/leukocyturia (values too low or too high) could be found. In alkaline urine (pH > 7.0), SG values obtained by reagent strip have to be corrected by +5.

Exames laboratoriais importantes no diagnóstico da Piometra canina

Canine Pyometra is a uterine disease that occurs in sexually mature bitches, with higher incidence in nulliparous and animals over 4 years and is characterized by presenting an accumulation of pus in the uterine lumen, usually occurring in diestrus. Laboratory tests are important tools for the detection of metabolic abnormalities associated with sepsis and renal function, which are serious consequences of pyometra. In blood the main findings are normochromic non-regenerative anemia, presence of dehydration, and sometimes thrombocytopenia. The WBC count may be normal but most often occurs a neutrophilic leukocytosis with a left shift, monocytosis and the presence of toxic neutrophils. In less than 1 / 3 of the animals the presence of azotemia is present and a density lower than 1035 is detected in the urine of almost 90% of bitches which may be in normal range at the onset of the desease. Urinary protein loss is rare but the protein may be elevated in the reagent strip due to urinary contamination by uterine secretion. The increase of gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), aspartate aminotransferase (AST) and creatine kinase (CK) may be present, indicating disorders in the liver. Currently, additional laboratory tests are being studied for the diagnosis of pyometra and its prognosis, such as the measurement of C-reactive protein and fibrinogen for monitoring the recovery of the inflammatory process and the urine electrophoresis to characterize the origin of proteinuria in these animals . The aim of this work is to review the literature on the main laboratory tests that aid the diagnosis of Pyometra

False positive dipstick for urinary blood in childhood

BACKGROUND: In view of the obvious practical advantages, the most common test for hematuria is currently a reagent strip. METHODS: A standardized microscopic examination of the sediment was performed in 20 asymptomatic children referred for evaluation of chronic isolated microhematuria detected by means of a reagent strip. RESULTS: In 6 of the 20 children the microscopic examination failed to confirm the result of the dipstick test. CONCLUSIONS: Confirmation for the presence of hematuria by microscopy is the most important step in children with a positive dipstick for urinary blood.

O monitoramento domiciliar das condições crônicas e a tomada de decisão por idosos diabéticos e hipertensos

Introdução: A prevalência de doenças crônicas, sobretudo na população idosa, nos coloca diante da necessidade de modelos longitudinais de cuidado. Atualmente os sujeitos estão sendo cada vez mais responsabilizados pelo gerenciamento de sua saúde através do uso de dispositivos de monitoramento, tais como o glicosímetro e o aferidor de pressão arterial. Esta nova realidade culmina na tomada de decisão no próprio domicílio. Objetivos: Identificar a tomada de decisão de idosos no monitoramento domiciliar das condições crônicas; identificar se as variáveis: sexo, escolaridade e renda influenciam a tomada de decisão; identificar a percepção dos idosos quanto às ações de cuidado no domicílio; identificar as dificuldades e estratégias no manuseio dos dispositivos de monitoramento. Materiais e métodos: Estudo quantitativo, exploratório e transversal. Casuística: 150 sujeitos com 60 anos de idade ou mais, sem comprometimento cognitivo, sem depressão e que façam uso do glicosímetro e/ou do aferidor de pressão arterial no domicílio. Instrumentos para seleção dos participantes: (1) Mini Exame do Estado Mental; (2) Escala de Depressão Geriátrica e (3) Escala de Atividades Instrumentais de Vida Diária de Lawton e Brody; Coleta de dados: realizada na cidade de Ribeirão Preto - SP entre setembro de 2014 e outubro de 2015. Instrumentos: (1) Questionário Socioeconômico; (2) Questionário sobre a tomada de decisão no monitoramento da saúde no domicílio (3) Classificação do uso de dispositivos eletrônicos voltados aos cuidados à saúde. Análise dos dados: Realizada estatística descritiva e quantificações absolutas e percentuais para identificar a relação entre tomada de decisão de acordo com o sexo, escolaridade e renda. Resultados: Participaram 150 idosos, sendo 117 mulheres e 33 homens, com média de idade de 72 anos. Destes, 113 são hipertensos e 62 são diabéticos. Quanto à tomada de decisão imediata, tanto os que fazem uso do aferidor de pressão arterial (n=128) quanto do glicosímetro (n=62) referem em sua maioria procurar ajuda médica, seguida da administração do medicamento prescrito e opções alternativas de tratamento. Em médio prazo destaca-se a procura por ajuda profissional para a maioria dos idosos em ambos os grupos. Foi notada pequena diferença na tomada de decisão com relação ao sexo. Quanto à escolaridade, os idosos com mais anos de estudos tendem a procurar mais pelo serviço de saúde se comparado aos idosos de menor escolaridade. A renda não mostrou influencia entre os usuários do glicosímetro. Já entre os usuários do aferidor de pressão arterial, idosos de maior renda tendem a procurar mais pelo serviço de saúde. A maioria dos participantes se refere ao monitoramento domiciliar da saúde de maneira positiva, principalmente pela praticidade em não sair de casa, obtenção rápida de resultados e possibilidade de controle contínuo da doença. As principais dificuldades no manuseio do glicosímetro estão relacionadas ao uso da lanceta e fita reagente, seguida da checagem dos resultados armazenados. Já as dificuldades no uso do aferidor de pressão arterial estão relacionadas a conferir o resultado após cada medida e ao posicionamento correto do corpo durante o monitoramento. Em ambos os grupos as estratégias utilizadas são pedir o auxílio de terceiros e tentativa e erro. Conclusão: Os idosos tem se mostrado favoráveis às ações de monitoramento domiciliar da saúde. De maneira geral, de imediato decidem por ações dentro do próprio domicílio para o controle dos sintomas e isto reforça a necessidade do investimento em informação de qualidade e educação em saúde para que o gerenciamento domiciliar possa vir a ser uma vertente do cuidado integral no tratamento das condições crônicas.

Development and validation of dry reagent time-resolved fluoroimmuno assays for zeranol and alpha-zearalenol to assist in distinguishing zeranol abuse from Fusarium spp. toxin contamination in bovine urine

Zeranol, an oestrogenic growth promoter in food animals, is banned within the European Union (EU). However, commercially available immunoassay kits for zeranol cross-react with toxins formed by naturally occurring Fusarium spp. fungi, leading to false-positive screening results. This paper describes the validation of a specificity enhanced, rapid dry reagent time-resolved fluoroimmunoassay (TR-FIA) for zeranol (recovery 99%, limit of detection 1.3 ng ml(-1)) demonstrating that up to 150 ng ml(-1) of Fusarium spp. toxins in urine do not lead to false-positive results. This assay will assist EU Member States to implement Council Directive 961 23\EC, which requires states to monitor for potential abuses of zeranol. A similar TR-FIA for the Fusarium spp. toxin a-zearalenol, using the same sample extract, is also described (recovery 68%, limit of detection 5.6 ng ml(-1)). Only the addition of diluted sample extract is required to perform these dry-reagent TR-FIAs, the results being available within 1 h of extract application. The EU-funded project 'Natural Zeranol' (FAIR5-CT97-3443) will use these fluoroimmunoassays to screen bovine urine in four Member States to gather data on the seasonality of Fusarium spp. toxin contamination of urine and the incidence of zeranol screening test positives.

A specificity-enhanced time-resolved fluoroimmunoassay for zeranol employing the dry reagent all-in-one-well principle

A simple dry chemistry time-resolved fluorescence immunoassay (TR-FIA) method was developed for the measurement of zeranol in bovine urine samples. The samples were purified by immunoaffinity chromatography and a specificity-enhanced zeranol antibody was employed in the immunoassay. This resulted in a highly selective method, which had only negligible reactivity with Fusarium spp, toxins. The all-in-one-well dry chemistry concept made the assay very simple to use because all the assay-specific reagents were already present in the reaction wells in dry form. Only the addition of diluted sample extract was required to perform the competitive one-step TR-FIA and the results were available in less than 1 h. The analytical limit of detection (mean + 3s) for the immunoassay was 0.16 ng ml(-1) (n=12) and the functional limit of detection for the whole method, estimated by the analysis of zeranol-free samples, was 1.3 ng ml(-1) (n=20). The recovery of zeranol at the level of 2 ng ml(-1) was 99% (n=18) and the within-assay variation ranged between 4.5 and 9.0%.

Stereoselective analysis of carvedilol in human plasma and urine using HPLC after chiral derivatization

An enantioselective high-performance liquid chromatographic method for the analysis of carvedilol in plasma and urine was developed and validated using (-)-menthyl chloroformate (MCF) as a derivatizing reagent. Chloroform was used for extraction, and analysis was performed by HPLC on a C18 column with a fluorescence detector. The quantitation limit was 0.25 ng/ml for S(-)-carvedilol in plasma and 0.5 ng/ml for R(+)-carvedilol in plasma and for both enantiomers in urine. The method was applied to the study of enantioselectivity in the pharmacokinetics of carvedilol administered in a multiple dose regimen (25mg/12h) to a hypertensive elderly female patient. The data obtained demonstrated highest plasma levels for the R(+)-carvedilol(AUCSS 75.64 vs 37.29ng/ml). The enantiomeric ratio R(+)/S(-) was 2.03 for plasma and 1.49 0 - 12 for urine (Aeo-12 17.4 vs 11.7 pg). Copyright (c) 2008 John Wiley & Sons, Ltd.

Microalbuminuria in diabetes mellitus: efficacy of a new screening method in comparison with timed overnight urine collection

Diabetic nephropathy and end-stage renal failure are still a major cause of mortality amongst patients with diabetes mellitus (DM). In this study, we evaluated the Clinitek-Microalbumin (CM) screening test strip for the detection of microalbuminuria (MA) in a random morning spot urine in comparison with the quantitative assessment of albuminuria in the timed overnight urine collection ("gold standard"). One hundred thirty-four children, adolescents, and young adults with insulin-dependent DM Type 1 were studied at 222 outpatient visits. Because of urinary tract infection and/or haematuria, the data of 13 visits were excluded. Finally, 165 timed overnight urine were collected in the remaining 209 visits (79% sample per visit rate). Ten (6.1%) patients presented MA of > or =15 microg/min. In comparison however, 200 spot urine could be screened (96% sample/visit rate) yielding a significant increase in compliance and screening rate (P<.001, McNemar test). Furthermore, at 156 occasions, the gold standard and CM could be directly compared. The sensitivity and the specificity for CM in the spot urine (cut-off > or =30 mg albumin/l) were 0.89 [95% confidence interval (CI) 0.56-0.99] and 0.73 (CI 0.66-0.80), respectively. The positive and negative predictive value were 0.17 (CI 0.08-0.30) and 0.99 (CI 0.95-1.00), respectively. Considering CM albumin-to-creatinine ratio, the results were poorer than with the albumin concentration alone. Using CM instead of quantitative assessment of albuminuria is not cost-effective (35 US dollars versus 60 US dollars/patient/year). In conclusion, to exclude MA, the CM used in the random spot urine is reliable and easy to handle, but positive screening results of > or =30 mg albumin/l must be confirmed by analyses in the timed overnight collected urine. Although the screening compliance is improved, in terms of analysing random morning spot urine for MA, we cannot recommend CM in a paediatric diabetic outpatient setting because the specificity is far too low.

Some surface profiles of a strip after plane-strain indentation by rigid bodies with serrated surfaces

This paper is concerned with the surface profiles of a strip after rigid bodies with serrated (saw-teeth) surfaces indent the strip and are subsequently removed. Plane-strain conditions are assumed. This has application in roughness transfer of final metal forming process. The effects of the semi-angle of the teeth, the depth of indentation and the friction on the contact surface on the profile are considered.

Prags Boulevard in Copenhagen : from run-down strip to boulevard

Prags Boulevard will form a 2km long pedestrian spine running east-west between the historic cities of Copenhagen and Amager. It is located on a some-what run down site, which accommodated illicit functions such as casual drug use and drinking, as well as sheds for squatters. The renovation of this site by the city of Copenhagen forms part of the Holmbladsgade renovation project, and a two-phase competition was held in 2001 to develop a green area and meeting place, transforming it into a place that residents would want to visit rather than avoid. The designer, local landscape architect Kristine Jensens recognises that though the site is linear it ‘has no traffic importance’, though as she notes ‘we like the project because it runs straight east west from the city pulse to the water of Oresund’. In developing the project, she has attempted to allow it to ‘run parallel’ to its existing illicit uses, using a ‘light touch’ of insertions. While it would be hard to describe the project as truly light in its touch (graphically, it is a very bold scheme), there is no doubt that it is parallel: in terms of use it runs alongside rather than against existing uses; in terms of its type it’s all about length, like a boulevard, although it clearly differs from a boulevard in other respects.

Simultaneous kinetic spectrophotometric determination of norfloxacin and rifampicin in pharmaceutical formulation and human urine samples by use of chemometrics approaches

A kinetic spectrophotometric method with aid of chemometrics is proposed for the simultaneous determination of norfloxacin and rifampicin in mixtures. The proposed method was applied for the simultaneous determination of these two compounds in pharmaceutical formulation and human urine samples, and the results obtained are similar to those obtained by high performance liquid chromatography.