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Nutrition, Metabolism, and... Oct 2021Prior studies have shown an association between positive urinary protein and an elevated risk of long-term mortality in patients with acute ischemic stroke (AIS);...
BACKGROUND AND AIMS
Prior studies have shown an association between positive urinary protein and an elevated risk of long-term mortality in patients with acute ischemic stroke (AIS); however, data on the short-term prognostic significance of urinary protein and urinary ketone bodies in patients with AIS is sparse.
METHODS AND RESULTS
A total of 2842 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. Patients were divided into urinary protein positive and negative, urinary ketone bodies positive and negative by urine dipstick. Cox and logistic regression models were used to estimate the effect of urinary protein and urinary ketone bodies on all cause in-hospital mortality and poor outcome upon discharge (modified Rankin Scale score ≥3) in AIS patients. Patients with positive urinary protein was associated with a 2.74-fold and 1.62-fold increase in the risk of in-hospital mortality (adjusted HR 2.74; 95% CI, 1.54-4.89; P-value = 0.001) and poor outcome upon discharge (aOR, 1.62; 95% CI 1.26-2.08; P-value <0.001) in comparison to negative urinary protein after adjusting for potential covariates. Moreover, Patients with positive urinary ketone bodies was associated with 2.11-fold in the risk of poor outcome upon discharge (aOR 2.11; 95% CI 1.52-2.94; P-value <0.001) but not in-hospital mortality (P-value = 0.066) after adjusting for potential covariates.
CONCLUSIONS
Urinary protein at admission was independently associated with in-hospital mortality and poor functional outcome at hospital discharge in acute stroke patients and urinary ketone bodies also associated with poor functional outcome at hospital discharge.
Topics: Aged; Aged, 80 and over; Biomarkers; China; Disability Evaluation; Female; Hospital Mortality; Humans; Inpatients; Ischemic Attack, Transient; Ischemic Stroke; Ketone Bodies; Male; Middle Aged; Patient Admission; Patient Discharge; Predictive Value of Tests; Prognosis; Proteinuria; Reagent Kits, Diagnostic; Risk Assessment; Risk Factors; Urinalysis
PubMed: 34518087
DOI: 10.1016/j.numecd.2021.07.010 -
Female Pelvic Medicine & Reconstructive... Jun 2020The objectives of this were to determine the correlation of greater than or equal to 3 red blood cells per high-power field (RBCs/HPF) with a positive urine dipstick for...
OBJECTIVES
The objectives of this were to determine the correlation of greater than or equal to 3 red blood cells per high-power field (RBCs/HPF) with a positive urine dipstick for blood and to identify clinically relevant factors than can influence this relationship.
METHODS
The charts of women with positive blood urine dipsticks were reviewed from August 2012 to August 2013. The cohort of women was divided into 2 groups; those with urine with greater than or equal to 3 RBCs/HPF on microscopy and those without. Relevant clinical and demographic variables were extracted from the electronic medical record. Data analysis was conducted using SAS version 9.4 (SAS Institute, Cary, NC).
RESULTS
Most of the 203 patients eligible for analysis were Caucasian, and the total cohort had a mean age of approximately 62.8 years. Microscopy confirmed greater than or equal to 3 RBCs/HPF in 25.6% of the urine samples. A dipstick finding of moderate or large blood was significantly more likely to have greater than or equal to 3 RBCs/HPF on univariate and multivariable analyses (P < 0.001). Factors significantly associated with greater than or equal to 3 RBCs/HPF were increasing age, recurrent urinary tract infections, and urinary specific gravity of greater than 1.010.
CONCLUSIONS
Lower urinary specific gravities appear to be associated with underestimating microhematuria, likely owing to the underrepresentation of the true number of red blood cells. Urine dipstick indicators of moderate or large blood increase the likelihood the microscopy samples demonstrated greater than or equal to 3 RBCs/HPF. These findings suggest that clarification of microhematuria detection and evaluation guidelines should be considered, given both important clinical and economic consequences.
Topics: Aged; Case-Control Studies; Female; Hematuria; Humans; Mass Screening; Middle Aged; Predictive Value of Tests; Reagent Strips; Retrospective Studies; Urinalysis
PubMed: 31107342
DOI: 10.1097/SPV.0000000000000733 -
Analytical and Bioanalytical Chemistry Jul 2020This review presents the state-of-the-art of optical sensors for determination of biogenic amines (BAs) in food by publications covering about the last 10 years.... (Review)
Review
This review presents the state-of-the-art of optical sensors for determination of biogenic amines (BAs) in food by publications covering about the last 10 years. Interest in the development of rapid and preferably on-site methods for quantification of BAs is based on their important role in implementation and regulation of various physiological processes. At the same time, BAs can develop in different kinds of food by fermentation processes or microbial activity or arise due to contamination, which induces toxicological risks and food poisoning and causes serious health issues. Therefore, various optical chemosensor systems have been devised that are easy to assemble and fast responding and low-cost analytical tools. If amenable to on-site analysis, they are an attractive alternative to existing instrumental analytical methods used for BA determination in food. Hence, also portable sensor systems or dipstick sensors are described based on various probes that typically enable signal readouts such as photometry, reflectometry, luminescence, surface-enhanced Raman spectroscopy, or ellipsometry. The quantification of BAs in real food samples and the design of the sensors are highlighted and the analytical figures of merit are compared. Future instrumental trends for BA sensing point to the use of cell phone-based fully automated optical evaluation and devices that could even comprise microfluidic micro total analysis systems.
Topics: Biogenic Amines; Colorimetry; Food Analysis; Food Quality; Luminescent Measurements; Optical Devices; Spectrum Analysis, Raman
PubMed: 32382967
DOI: 10.1007/s00216-020-02675-9 -
ACS Sensors Dec 2021A range of biosensing techniques including immunoassays are routinely used for quantitation of analytes in biological samples and available in a range of formats, from...
A range of biosensing techniques including immunoassays are routinely used for quantitation of analytes in biological samples and available in a range of formats, from centralized lab testing (e.g., microplate enzyme-linked immunosorbent assay (ELISA)) to automated point-of-care (POC) and lateral flow immunochromatographic tests. High analytical performance is intrinsically linked to the use of a sequence of reagent and washing steps, yet this is extremely challenging to deliver at the POC without a high level of fluidic control involving, e.g., automation, fluidic pumping, or manual fluid handling/pipetting. Here we introduce a microfluidic siphon concept that conceptualizes a multistep ″dipstick″ for quantitative, enzymatically amplified immunoassays using a strip of microporous or microbored material. We demonstrated that gravity-driven siphon flow can be realized in single-bore glass capillaries, a multibored microcapillary film, and a glass fiber porous membrane. In contrast to other POC devices proposed to date, the operation of the siphon is only dependent on the hydrostatic liquid pressure (gravity) and not capillary forces, and the unique stepwise approach to the delivery of the sample and immunoassay reagents results in zero dead volume in the device, no reagent overlap or carryover, and full start/stop fluid control. We demonstrated applications of a 10-bore microfluidic siphon as a portable ELISA system without compromised quantitative capabilities in two global diagnostic applications: (1) a four-plex sandwich ELISA for rapid smartphone dengue serotype identification by serotype-specific dengue virus NS1 antigen detection, relevant for acute dengue fever diagnosis, and (2) quantitation of anti-SARS-CoV-2 IgG and IgM titers in spiked serum samples. Diagnostic siphons provide the opportunity for high-performance immunoassay testing outside sophisticated laboratories, meeting the rapidly changing global clinical and public health needs.
Topics: COVID-19; Enzyme-Linked Immunosorbent Assay; Humans; Immunoassay; Microfluidics; SARS-CoV-2
PubMed: 34854666
DOI: 10.1021/acssensors.1c01524 -
Journal of Evaluation in Clinical... Aug 2022Restricting the performance of microscopic urinalyses only to patients in whom it was specifically requested has been shown to reduce their number in laboratories...
BACKGROUND
Restricting the performance of microscopic urinalyses only to patients in whom it was specifically requested has been shown to reduce their number in laboratories servicing both inpatients and outpatients.
OBJECTIVE
To determine the effect of such restriction solely in in-patients in a 400-bed regional hospital.
METHODS
In 2017, we discontinued routine ('reflex') microscopic urinalysis for all positive dipstick results, and restricted such testing to in-patients in whom it was specifically requested by a doctor. We compared the numbers of patients in three internal medicine departments who had a urinalysis over 2-year periods before and after 2017, and reviewed doctors' complaints.
RESULTS
Before 2017, more than 80% of all dipstick tested samples had one or more abnormalities that led to a microscopic examination. Discontinuation of reflex microscopy reduced microscopic urinalysis to less than 10% of all patients with dipsticks on admission. Requests for repeat urinalysis decreased from 4.3% to 2.5% and there were no complaints after the change in policy.
CONCLUSIONS
Discontinuation of a 'reflex' microscopic urinalysis in patients with abnormal dipstick results did not increase repeat urine testing. Doctors apparently felt that the microscopic urinalysis does not have clinical utility in the vast majority of hospitalized adult patients.
Topics: Adult; Humans; Microscopy; Patients; Reagent Strips; Urinalysis
PubMed: 34812562
DOI: 10.1111/jep.13638 -
The Journal of Small Animal Practice Sep 2020To assess the utility of urine dipstick strips for detection of feline proteinuria when used in combination with urine-specific gravity, compared with urine...
OBJECTIVES
To assess the utility of urine dipstick strips for detection of feline proteinuria when used in combination with urine-specific gravity, compared with urine protein-to-creatinine ratio as the gold standard.
MATERIALS AND METHODS
Retrospective analysis of clinical records of comprehensive urine examination obtained from cats presented to a referral hospital. Diagnostic agreement and test accuracy were calculated for the dipstick test alone and in combination with the urine-specific gravity, using different cut-off values for proteinuria. Receiver-operating characteristic curves were also calculated.
RESULTS
A total of 121 urine samples were included. The diagnostic agreement between dipstick and urine protein-creatinine ratio was poor. A dipstick result of equal or greater than "Trace" (0.1-0.3 g/L) had a sensitivity of 81% and a specificity of 31% to detect proteinuria. Grouping the samples by urine-specific gravity did not increase dipstick agreement with the urine protein-creatinine ratio and only resulted in a slight improvement in the accuracy of detecting proteinuria.
CLINICAL SIGNIFICANCE
The dipstick test was not accurate for detecting proteinuria when combined with urine-specific gravity in cats. Clinicians should not rely on this test and, regardless of the urine concentration, other appropriate quantitative methods such as urine protein-creatinine ratio should always be performed to detect proteinuria in cats.
Topics: Animals; Cat Diseases; Cats; Creatinine; Proteinuria; Reagent Strips; Retrospective Studies; Sensitivity and Specificity; Specific Gravity; Urinalysis
PubMed: 32692434
DOI: 10.1111/jsap.13184 -
Letters in Applied Microbiology May 2022Tomato yellow leaf curl disease which is caused by Tomato yellow leaf curl virus (TYLCV) is economically important and a widely spread tomato disease in China. Rapid and... (Review)
Review
Tomato yellow leaf curl disease which is caused by Tomato yellow leaf curl virus (TYLCV) is economically important and a widely spread tomato disease in China. Rapid and accurate detection methods are important in the control TYLCV. Here, a rapid method was developed to identify TYLCV on the basis of recombinase polymerase amplification (RPA) that can be visualized in 5 min using lateral flow dipsticks. The sensitivity and the specificity of this method were evaluated. This method can detect 0·5 pg DNA after 30 min at 37°C without any expensive instrumentation. In addition, it showed higher sensitivity than a PCR method when purified DNA was used. Moreover, the TYLCV was specifically detected, whereas other viruses infecting tomato produced negative results. The crude tomato extracts used in this assay has potential application in minimally equipped plant clinic laboratories. This method will facilitate the early and rapid detection of TYLCV for the timely application of control measures.
Topics: Begomovirus; Solanum lycopersicum; Plant Diseases; Recombinases
PubMed: 34822723
DOI: 10.1111/lam.13611 -
Danish Medical Journal Dec 2021Utility of dipstick analysis must be investigated in patients admitted to the emergency department. The aim of this study was to evaluate if urine dipstick analysis can...
INTRODUCTION
Utility of dipstick analysis must be investigated in patients admitted to the emergency department. The aim of this study was to evaluate if urine dipstick analysis can be used to detect significant bacteriuria. The cross-sectional study was performed in the Emergency Department of Copenhagen University Hospital - Herlev Hospital, Denmark.
METHODS
We recorded urine dipstick analysis of 500 adult patients admitted to the Emergency Department. Dipstick results were compared with urinary culture.
RESULTS
Sensitivity for leukocyte esterase (LE) was 80.9%, but specificity was 58%. The sensitivity of nitrite was 46.5%, and specificity was 90%. The positive predictive value (PPV) and negative predictive value (NPV) of LE for women were 54.5% and 75.9%; for men, 50.0% and 91.6%. PPV and NPV for nitrite in women were 85.9% and 66.8%; for men, 62.9% and 88.7%. Positive LE and positive nitrite had a PPV of 90.2% for women and 70.4% for men. Negative LE and negative nitrite had an NPV of 80.9% for women and 93.3% for men.
CONCLUSIONS
No single parameter or combination of parameters on the urine dipstick analysis can be used reliably to predict positive urine culture in women. The most accurate predictor of negative urine culture in men is the combination of negative nitrites and negative LE. To minimize unnecessary use of antibiotics, treatment can be delayed in female patients with positive urine dipstick until urine culture results are available.
FUNDING
none.
TRIAL REGISTRATION
not relevant.
Topics: Adult; Bacteriuria; Cross-Sectional Studies; Female; Humans; Male; Reagent Strips; Sensitivity and Specificity; Urinalysis; Urinary Tract Infections
PubMed: 34913433
DOI: No ID Found -
Biosensors Jul 2020Current available methods for the clinical diagnosis of urinary tract infection (UTI) rely on a urine dipstick test or culturing of pathogens. The dipstick test is rapid... (Review)
Review
Current available methods for the clinical diagnosis of urinary tract infection (UTI) rely on a urine dipstick test or culturing of pathogens. The dipstick test is rapid (available in 1-2 min), but has a low positive predictive value, while culturing is time-consuming and delays diagnosis (24-72 h between sample collection and pathogen identification). Due to this delay, broad-spectrum antibiotics are often prescribed immediately. The over-prescription of antibiotics should be limited, in order to prevent the development of antimicrobial resistance. As a result, there is a growing need for alternative diagnostic tools. This paper reviews applications of chemical-analysis instruments, such as gas chromatography-mass spectrometry (GC-MS), selected ion flow tube mass spectrometry (SIFT-MS), ion mobility spectrometry (IMS), field asymmetric ion mobility spectrometry (FAIMS) and electronic noses (eNoses) used for the diagnosis of UTI. These methods analyse volatile organic compounds (VOCs) that emanate from the headspace of collected urine samples to identify the bacterial pathogen and even determine the causative agent's resistance to different antibiotics. There is great potential for these technologies to gain wide-spread and routine use in clinical settings, since the analysis can be automated, and test results can be available within minutes after sample collection. This could significantly reduce the necessity to prescribe broad-spectrum antibiotics and allow the faster and more effective use of narrow-spectrum antibiotics.
Topics: Bacteria; Electronic Nose; Humans; Ion Mobility Spectrometry; Principal Component Analysis; Urinalysis; Urinary Tract Infections; Urine Specimen Collection; Volatile Organic Compounds
PubMed: 32717983
DOI: 10.3390/bios10080083 -
Scientific Reports Nov 2020The objective of this study was to assess the diagnosis value of urinary inflammatory index (UII) and systemic immune-inflammation index (SII) for UTI. Nine inflammatory...
The objective of this study was to assess the diagnosis value of urinary inflammatory index (UII) and systemic immune-inflammation index (SII) for UTI. Nine inflammatory indexes including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, SII and six UIIs were calculated for Receiver operating characteristic curve analysis to select which one is suitable for the screening of UTIs or distinguishing the types of bacteria. UII3, which calculated from leucocyte esterase (LE), nitrite, white blood cells and bacteria, was preferentially used as an indicator for the diagnosis of UTI when the threshold was set at 0.53. UII2 was more suitable for the distinction between groups when the cutoff is set to 0.94. Appropriate urinary inflammation index calculated by rapid urinalysis of urine dipstick and urine sediment can help us to predict urinary tract infection and bacterial type, and reduce the workload and costs of urine culture.
Topics: Aged; Bacteriuria; Blood Platelets; Carboxylic Ester Hydrolases; Female; Humans; Inflammation; Leukocyte Elastase; Leukocytes; Lymphocytes; Male; Mass Screening; Middle Aged; Neutrophils; Nitrites; ROC Curve; Reagent Kits, Diagnostic; Reproducibility of Results; Sensitivity and Specificity; Urinalysis; Urinary Tract Infections
PubMed: 33168850
DOI: 10.1038/s41598-020-76352-3