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[Adulteration of urine drug testing--an exaggerated cause of concern]

https://arctichealth.org/en/permalink/ahliterature10489
Source
Lakartidningen. 2000 Feb 16;97(7):703-6
Publication Type
Article
Date
Feb-16-2000
Author
O. Beck
M. Bohlin
F. Bragd
J. Bragd
O. Greitz
Author Affiliation
Klinisk farmakologi, Karolinska laboratoriet, Karolinska sjukhuset. olof.beck@mb.ks.se
Source
Lakartidningen. 2000 Feb 16;97(7):703-6
Date
Feb-16-2000
Language
Swedish
Publication Type
Article
Keywords
Adolescent
Creatinine - urine
English Abstract
Humans
Phencyclidine - analysis - diagnostic use
Reagent Strips - standards
Specimen Handling
Substance Abuse Detection - methods - standards
Sweden
Urinalysis - methods - standards
Abstract
In a study performed at a Stockholm clinic for young people with drug abuse problems, where urine adulteration was suspected to be fairly frequent, a total of 594 patient specimens were subjected to Adultacheck test strip screening for nitrite, glutaraldehyde, pH, and creatinine. Creatinine measurement was also performed at the laboratory, together with drug screening using EMIT reagents, and a subsample was spiked with phencyclidine to verify EMIT test function. The frequency of dilute urine (creatinine
PubMed ID
10740378 View in PubMed
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Antibiotic resistance patterns of bacteria causing urinary tract infections in the elderly living in nursing homes versus the elderly living at home: an observational study.

https://arctichealth.org/en/permalink/ahliterature269775
Source
BMC Geriatr. 2015;15:98
Publication Type
Article
Date
2015
Author
Mark Fagan
Morten Lindbæk
Nils Grude
Harald Reiso
Maria Romøren
Dagfinn Skaare
Dag Berild
Source
BMC Geriatr. 2015;15:98
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Infective Agents, Urinary - classification - pharmacology
Cross-Sectional Studies
Drug Resistance, Bacterial
Escherichia coli - drug effects
Escherichia coli Infections - diagnosis - drug therapy - epidemiology
Female
Homes for the Aged - statistics & numerical data
Humans
Independent Living - statistics & numerical data
Male
Norway - epidemiology
Nursing Homes - statistics & numerical data
Practice Guidelines as Topic
Proteus Infections - diagnosis - drug therapy - epidemiology
Proteus mirabilis - drug effects
Sex Factors
Urinalysis - methods
Urinary Tract Infections - diagnosis - drug therapy - epidemiology - microbiology
Abstract
Antibiotic resistance is a problem in nursing homes. Presumed urinary tract infections (UTI) are the most common infection. This study examines urine culture results from elderly patients to see if specific guidelines based on gender or whether the patient resides in a nursing home (NH) are warranted.
This is a cross sectional observation study comparing urine cultures from NH patients with urine cultures from patients in the same age group living in the community.
There were 232 positive urine cultures in the NH group and 3554 in the community group. Escherichia coli was isolated in 145 urines in the NH group (64%) and 2275 (64%) in the community group. There were no clinically significant differences in resistance. Combined, there were 3016 positive urine cultures from females and 770 from males. Escherichia coli was significantly more common in females 2120 (70%) than in males 303 (39%) (p?
Notes
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PubMed ID
26238248 View in PubMed
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Assessment of a four hour delay for urine samples stored without preservatives at room temperature for urinalysis.

https://arctichealth.org/en/permalink/ahliterature124780
Source
Clin Biochem. 2012 Jul;45(10-11):856-8
Publication Type
Article
Date
Jul-2012
Author
Kika Veljkovic
Karina Rodríguez-Capote
Vipin Bhayana
Robin Pickersgill
John Beattie
Lorna Clark
Peter A Kavsak
Author Affiliation
McMaster University, Department of Pathology and Molecular Medicine, 1200 Main Street West, Hamilton, ON, Canada L8N 3Z5. kika.veljkovic@medportal.ca
Source
Clin Biochem. 2012 Jul;45(10-11):856-8
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Canada
Carboxylic Ester Hydrolases - urine
Glucose - analysis
Hemoglobins - analysis
Humans
Hydrogen-Ion Concentration
Ketones - urine
Nitrites - urine
Preservatives, Pharmaceutical - chemistry
Retrospective Studies
Specific Gravity
Specimen Handling - methods - standards
Temperature
Time Factors
Urinalysis - methods - standards
Urine - chemistry
Abstract
To determine whether urine storage at room temperature for up to 2h versus 4h changes urinalysis results.
We compared the rejection rate at eight different hospital laboratories and concordance of urinalysis results (n=83; two laboratories) between urines analyzed within 2h and 4h after collection.
The rejection rate at the two hour cutoff was significantly higher as compared to the four hour cutoff. The concordance between urinalysis results was 97-100% between the two and four hour analyses.
Urine may be stored for up to 4h at room temperature without significant changes to the urinalysis results.
PubMed ID
22548911 View in PubMed
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Can urine cultures and reagent test strips be used to diagnose urinary tract infection in elderly emergency department patients without focal urinary symptoms?

https://arctichealth.org/en/permalink/ahliterature164413
Source
CJEM. 2007 Mar;9(2):87-92
Publication Type
Article
Date
Mar-2007
Author
James Ducharme
Shane Neilson
Jeffery L Ginn
Author Affiliation
Department of Emergency Medicine, Dalhousie University, Atlantic Health Sciences Corporation, Saint John, NB. paindoc22000@yahoo.com
Source
CJEM. 2007 Mar;9(2):87-92
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bacterial Infections - urine
Canada
Cohort Studies
Female
Humans
Male
Sensitivity and specificity
Urinalysis - methods
Urinary Tract Infections - diagnosis
Urine - chemistry - microbiology
Abstract
To compare the results of urine cultures and reagent strip testing in 2 groups of elderly emergency department (ED) patients: an asymptomatic group unlikely to have urinary tract infection (UTI), and a group who had vague symptoms and were considered at risk for UTI.
We performed a prospective observational convenience study with 2 groups of 100 patients aged 65 or older. The asymptomatic group consisted of afebrile patients presenting to the ED with non-infectious complaints, while the symptomatic group included patients presenting with acute confusion, weakness or fever but no apparent urinary symptoms. We defined a positive urine culture as a single organism count greater than 100,000 CFU/mL in mid-stream specimens, or greater than 1000 CFU/mL in catheter specimens. We considered reagent strips positive if they demonstrated any reaction to the leukocyte-esterase assay, the nitrite assay or both.
Of the 33 positive cultures, 10 had negative reagent strips. Thirteen of the 14 positive nitrite tests were culture positive for a specificity of 92.8% and a sensitivity of 36.1%. Positive cultures did not infer a diagnosis of UTI. Of the 67 positive reagent strips, 41 (61.2%) were associated with negative cultures. Likelihood ratios (LRs) in both groups affirmed the inability of the reagent strips to help significantly in decision making, with positive and negative LR in the indeterminate range (control group: 2.8 and 0.31, symptomatic group: 2.7 and 0.46, respectively).
In the elderly, reagent testing is an unreliable method of identifying patients with positive urine [corrected] cultures. Moreover, positive urine culture rates are only slightly higher in patients with vague symptoms attributable to UTI than they are in (asymptomatic) patients treated for non-urologic problems, which suggests that many positive cultures in elderly patients with non- focal systemic symptoms are false-positive tests reflecting asymptomatic bacteriuria and not UTIs. Blood cultures, regarded by many as the criterion standard for UTI, do not have sufficient specificity to confirm the diagnosis of UTI in elderly patients with non-specific symptoms.
Notes
Erratum In: CJEM. 2007 Jul;9(4):285
PubMed ID
17391578 View in PubMed
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[Comparative evaluation of the predictive value of UroVysion and AURKA FISH tests of urine sediment cells for the diagnosis of bladder cancer].

https://arctichealth.org/en/permalink/ahliterature107282
Source
Vopr Onkol. 2013;59(4):483-6
Publication Type
Article
Date
2013
Author
I E Vorobtsova
E D Kouzova
I S Kolesnikova
Source
Vopr Onkol. 2013;59(4):483-6
Date
2013
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Humans
In Situ Hybridization, Fluorescence - economics
Male
Middle Aged
Neoplasm Recurrence, Local - diagnosis - economics - urine
Predictive value of tests
Russia
Urinalysis - methods
Urinary Bladder Neoplasms - diagnosis - economics - urine
Urine - cytology
Abstract
Informative value of two tests based on FISH of exfoliated urothelial cells in urine sediment (AURKA and UroVysion) was compared in the group of patients (31 persons) with the history of bladder cancer. Coincidence in results of both FISH assays was found in 93.5%. These preliminary data offer the possibility of replacing the expensive UroVysion kit by the less expensive AURKA FISH probe and it could be used for monitoring of recurrence in bladder cancer patients.
PubMed ID
24032224 View in PubMed
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Determination of natural and depleted uranium in urine at the ppt level: an interlaboratory analytical exercise.

https://arctichealth.org/en/permalink/ahliterature169856
Source
Health Phys. 2006 May;90(5):494-9
Publication Type
Article
Date
May-2006
Author
E A Ough
B J Lewis
W S Andrews
L G I Bennett
R G V Hancock
P A D'Agastino
Author Affiliation
Department of Chemistry and Chemical Engineering, Royal Military College of Canada, 11 General Crerar Crescent, Kingston, ON, Canada. edough@telus.net
Source
Health Phys. 2006 May;90(5):494-9
Date
May-2006
Language
English
Publication Type
Article
Keywords
Canada
Humans
Laboratories - statistics & numerical data
Microchemistry - methods
Military Personnel
Occupational Exposure - analysis
Quality Assurance, Health Care - methods
Radiation Dosage
Radioactive Waste - analysis
Radiometry - methods
Reproducibility of Results
Sensitivity and specificity
Uranium - urine
Urinalysis - methods
Abstract
An analytical exercise was initiated in order to determine those procedures with the capability to measure total uranium and uranium (238U/235U) isotopic ratios in urine samples containing >0.02 microg U kg-1 urine. A host laboratory prepared six identical sets of twelve synthetic urine samples containing total uranium in the range of 25 to 770 ng U kg-1 urine and with 238U/235U isotopic ratios ranging from 138 (100% NU) to 215 (51% DU). Sets of samples were shipped to five testing laboratories (four based in Canada and one based in Europe). Each laboratory utilized one of the following analytical techniques: sector field inductively coupled plasma mass spectrometry (ICP-SF-MS), quadrupole inductively coupled plasma mass spectrometry (ICP-Q-MS), thermal ionization mass spectrometry (TIMS), and instrumental/delayed neutron activation analysis (I/DNAA), in their analyses.
PubMed ID
16607181 View in PubMed
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Diphenidine, a new psychoactive substance: metabolic fate elucidated with rat urine and human liver preparations and detectability in urine using GC-MS, LC-MS(n) , and LC-HR-MS(n).

https://arctichealth.org/en/permalink/ahliterature281405
Source
Drug Test Anal. 2016 Oct;8(10):1005-1014
Publication Type
Article
Date
Oct-2016
Author
Carina S D Wink
Julian A Michely
Andrea Jacobsen-Bauer
Josef Zapp
Hans H Maurer
Source
Drug Test Anal. 2016 Oct;8(10):1005-1014
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Animals
Chromatography, Liquid - methods
Cytochrome P-450 CYP2D6 - analysis - chemistry - metabolism
Designer Drugs - analysis - chemistry
Gas Chromatography-Mass Spectrometry - methods
Humans
Japan
Liver - chemistry - metabolism
Methylation
Microsomes, Liver - chemistry - metabolism
Piperidines - analysis - chemistry
Rats
Rats, Wistar
Sweden
Urinalysis - methods
Abstract
Diphenidine is a new psychoactive substance (NPS) sold as a 'legal high' since 2013. Case reports from Sweden and Japan demonstrate its current use and the necessity of applying analytical procedures in clinical and forensic toxicology. Therefore, the phase I and II metabolites of diphenidine should be identified and based on these results, the detectability using standard urine screening approaches (SUSAs) be elucidated. Urine samples were collected after administration of diphenidine to rats and analyzed using different sample workup procedures with gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-(high resolution)-mass spectrometry (LC-(HR)-MS). With the same approaches incubates of diphenidine with pooled human liver microsomes (pHLM) and cytosol (pHLC) were analyzed. According to the identified metabolites, the following biotransformation steps were proposed in rats: mono- and bis-hydroxylation at different positions, partly followed by dehydrogenation, N,N-bis-dealkylation, and combinations of them followed by glucuronidation and/or methylation of one of the bis-hydroxy-aryl groups. Mono- and bis-hydroxylation followed by dehydrogenation could also be detected in pHLM or pHLC. Cytochrome-P450 (CYP) isozymes CYP1A2, CYP2B6, CYP2C9, and CYP3A4 were all capable of forming the three initial metabolites, namely hydroxy-aryl, hydroxy-piperidine, and bis-hydroxy-piperidine. In incubations with CYP2D6 hydroxy-aryl and hydroxy-piperidine metabolites were detected. After application of a common users' dose, diphenidine metabolites could be detected in rat urine by the authors' GC-MS as well as LC-MS(n) SUSA. Copyright © 2016 John Wiley & Sons, Ltd.
PubMed ID
26811026 View in PubMed
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Emergency physicians versus laboratory technicians: are the urinalysis and microscopy results comparable? A pilot study.

https://arctichealth.org/en/permalink/ahliterature202082
Source
J Emerg Med. 1999 May-Jun;17(3):399-404
Publication Type
Article
Author
S. Kerr
C. Marshall
D. Sinclair
Author Affiliation
Department of Emergency Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Source
J Emerg Med. 1999 May-Jun;17(3):399-404
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Clinical Competence
Clinical Laboratory Techniques - standards
Emergency Medicine - standards
Female
Humans
Male
Microscopy
Middle Aged
Nova Scotia
Pilot Projects
Reagent kits, diagnostic
Sensitivity and specificity
Urinalysis - methods - standards
Urine - cytology - microbiology
Abstract
In the literature to date, there are no studies that directly evaluate microscopic urine examination results obtained by a physician compared to those of a trained laboratory technician. Our purpose in undertaking this study was to determine whether there would be comparable results obtained by these two groups. The study took place in an Emergency Medicine Department with 45,000 visits annually. Each urine sample obtained on patients presenting to the Emergency Department was divided into two lots: one was sent to the laboratory and the other was analyzed by the emergency physician. A comparison of both dipstick and microscopic results by physician and laboratory staff was then made using sensitivity, specificity, and Kappa analysis. Statistical analysis of the data revealed close agreement between the emergency physician and laboratory technician with respect to the following components of urinalysis: red blood cell urinalysis and microscopy, leukocyte esterase, and nitrite testing. Microscopy for white cells and bacteria and testing for proteinuria were not in close agreement. Urinalysis by emergency physicians is comparable to laboratory technicians for a number of the testing components. However, in this limited pilot study, emergency physicians were not able to consistently perform urinalysis for the laboratory standard.
PubMed ID
10338228 View in PubMed
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Estimating salt intake in a Caucasian population: can spot urine substitute 24-hour urine samples?

https://arctichealth.org/en/permalink/ahliterature263503
Source
Eur J Prev Cardiol. 2014 Oct;21(10):1300-7
Publication Type
Article
Date
Oct-2014
Author
Ulla Toft
Charlotte Cerqueira
Anne Helms Andreasen
Betina Heinsbæk Thuesen
Peter Laurberg
Lars Ovesen
Hans Perrild
Torben Jørgensen
Source
Eur J Prev Cardiol. 2014 Oct;21(10):1300-7
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Biological Markers - urine
Creatinine - urine
Denmark
European Continental Ancestry Group
Female
Humans
Male
Middle Aged
Models, Biological
Natriuresis
Predictive value of tests
Reproducibility of Results
Sex Factors
Sodium Chloride, Dietary - urine
Time Factors
Urinalysis - methods
Abstract
A simple and valid alternative for 24-hour urine collection to estimate populational 24-hour urinary sodium excretion would be desirable for monitoring sodium intake in populations.
To assess the validity of the predicted 24-hour urinary sodium excretion using spot urine and two different prediction methods in a Danish population.
Overall, 473 Danish individuals provided a para-aminobenzoic acid-validated complete 24-hour urine collection and a spot urine sample. Data were collected in the DanThyr study (248 women aged 25-30 years and 60-65 years) and the Inter99 study (102 men and 113 women aged 30-60 years), respectively. The measured 24-hour urine sodium excretion was compared with the predicted 24-hour sodium excretion from a causal urine specimen, using both the Tanaka prediction method and a prediction model developed in a Danish population.
The measured 24-hour sodium excretion (median, 5th to 95th percentile) was men 195 (110 to 360) and women 139 (61 to 258), whereas the predicted 24-hour sodium excretion for the Tanaka model was men 171 (117 to 222) and women 153 (92 to 228) and for the Danish model was men 207 (146 to 258); women 134 (103 to 163). The Spearman correlation between predicted and measured 24-hour sodium excretion was 0.39 and 0.49 for the Tanaka and the Danish model, respectively. For both prediction models, the proportion of individuals classified in the same or adjacent quintile was 74% for men and 64% for women.
Both prediction models gave a reasonable classification of individuals according to their sodium excretion. However, the median daily sodium intake was estimated more precisely by the Danish model, especially among men.
PubMed ID
23559538 View in PubMed
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Impact of dioxins on antipyrine metabolism in firefighters.

https://arctichealth.org/en/permalink/ahliterature280047
Source
Toxicol Lett. 2016 May 27;250-251:35-41
Publication Type
Article
Date
May-27-2016
Author
Yury I Chernyak
Alla P Merinova
Andrey A Shelepchikov
Sergey I Kolesnikov
Jean A Grassman
Source
Toxicol Lett. 2016 May 27;250-251:35-41
Date
May-27-2016
Language
English
Publication Type
Article
Keywords
Adult
Antipyrine - analogs & derivatives - metabolism - urine
Body Burden
Case-Control Studies
Chromatography, High Pressure Liquid
Cytochrome P-450 CYP1A2 - biosynthesis - genetics
Cytochrome P-450 CYP1A2 Inducers - adverse effects
Dioxins - adverse effects
Enzyme Induction
Firefighters
Genotype
Humans
Linear Models
Liver - drug effects - enzymology
Male
Middle Aged
Models, Biological
Occupational Exposure - adverse effects
Phenotype
Risk assessment
Siberia
Smoking - adverse effects - metabolism
Substrate Specificity
Urinalysis - methods
Abstract
Antipyrine (AP) metabolism was used to assess factors associated with the activity of hepatic oxidative enzymes in firefighters. Emphasis was placed on 3-hydroxymethylantipyrine (3HMAP), the metabolite with the greatest dependence on dioxin-inducible cytochrome P4501A2 (CYP1A2) activity. AP urinary metabolites were measured by HPLC in 38 male subjects from Eastern Siberia. Subjects were divided into three groups having similar ages and BMIs: current firefighters (n=11); former firefighters (n=17) and non-firefighters (n=10). Multiple regression models were constructed using the three major AP metabolites as a dependent variable to assess the influence of age, smoking as urinary cotinine concentration, dioxin exposure (as either WHO-TEQ or body burden), group, and CYP1A2*F (-163C>A) genotypes. Models for the proportion of dose excreted as the metabolite 3HMAP produced the best fit (adjusted R(2)=0.46, p
PubMed ID
27067104 View in PubMed
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19 records – page 1 of 2.