Evaluation of a reagent-impregnated strip for detection of nitrate reduction by bacterial isolates.
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Bacteria↗
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Hematuria and proteinuria as predictors of Schistosoma haematobium infection.
An investigation of a population-based stratified random sample of 11,970 inhabitants of Minya Governorate in Egypt included examining urine specimens for Schistosoma haematobium ova using the filtration technique and for hematuria and proteinuria using reagent strips. Age- and gender-specific sensitivity, specificity, predictive values, and likelihood ratios of reagent strip-detected hematuria and proteinuria as indicators of S. haematobium infection were assessed. Results showed that in this population with a 9.0% infection rate, sensitivity (from 45.9 to 70.9) and specificity (from 65.9 to 86.3) were much lower than in previous reports. The most clinically valuable parameters, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratio (LR), were highest with the presence of hematuria > or = +++ and proteinuria > or = ++, especially in males less than 20 years of age. Using the LR allowed effective altering of the pretest probability of infection among age and gender subgroups. The study concluded that reagent strip-detected hematuria and proteinuria, although valuable, are less reliable predictors of S. haematobium within communities than previously reported and their usefulness is improved with stratification by age and gender. In addition, predictive values and likelihood ratios provide practical information for predicting the presence or absence of infection within population subgroups.
Adolescent↗
Evaluation of reagent-impregnated strips for identification of Enterobacteriaceae.
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Bacteriological Techniques↗
Control of morbidity due to Schistosoma haematobium on Pemba Island: programme organization and management.
A programme to control urinary schistosomiasis was initiated on Pemba island in January 1986 with the objectives of eliminating morbidity due to S. haematobium by utilizing a primary health care approach of strengthening the existing health care delivery system and creating a sound basis for future control of other parasitic and communicable diseases. The plan of action included training of rural health assistants to undertaken an intervention phase targeted to schools for selective population chemotherapy surveys at six-month intervals during the first two years, using indirect diagnostic techniques (observation of gross haematuria and detection of microscopic haematuria by chemical reagent strips) to identify individuals for treatment with praziquantel at a dose of 40 mg/kg body weight. The evaluation of the indirect techniques indicated that both sensitivity and specificity of the chemical reagent strips to detect infection were greater than 90%. After three selective population chemotherapy surveys, the prevalence of gross haematuria was reduced by 94.2% (15.8% to 0.9%) and both gross and microscopic haematuria were reduced by 76.4% (54.1% to 12.8%) among school children. Community involvement and health education were stressed in this programme. The use of dispensary laboratories to maintain control of urinary schistosomiasis is now being evaluated.
Adolescent↗
Precision and costs of techniques for self-monitoring of serum glucose levels.
The poor correlation between serum and urine glucose measurements has led to the development of new techniques for monitoring the blood glucose level in diabetic patients. Either a nurse or the patient can perform these tests, which involve spreading a single drop of blood onto a reagent strip. A colour change that is proportional to the serum glucose level can be read visually or with a reflectance meter. Evaluated against simultaneous serum glucose levels determined by the hospital biochemistry laboratory, those of the new techniques employing reflectance meters all showed excellent correlation (r2 = 0.85 to 0.96). Reagent strips used without meters showed poorer correlation (r2 = 0.69 to 0.90). The instruction given to the patients and one nurse enabled them to obtain more accurate results with one of the meters than nurses not specially trained (r2 = 0.94 and 0.92 v. 0.85 respectively). The mean cost per glucose determination with the new techniques was 75, compared with +1.45 for the laboratory determinations done with automated equipment. It was concluded that the new techniques compared well with the reference method, particularly when reflectance meters were used, and that they were easily applied by the patient, as well as the medical staff, at a reasonable cost.
Blood Glucose↗
The combination of two screening methods in a home culture program for children with recurrent bacteriuria. An evaluation of a culture method plus a nitrite reagent test strip.
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Bacteriological Techniques↗
Urinary schistosomiasis on Pemba Island: low-cost diagnosis for control in a primary health care setting.
In the 1970s and early 1980s indirect diagnosis of urinary schistosomiasis, using urinalysis reagent strips for proteinuria and haematuria, was proposed as a possible alternative to the more accurate but very time-consuming parasitological methods. The recent experience o f the Schistosomiasis Control Programme for Pemba Island, which used a combination of (1) observations o f grossly bloody urine specimens, (2) results from reagent strips for measuring haematuria, and (3) treatment with praziquantel, is the first large-scale example o f a simple, inexpensive and promising alternative for controlling the morbidity caused by this parasite.
Journal Article↗
Relation between intensity of Schistosoma haematobium infection and clinical haematuria and proteinuria.
In an endemic area on Lake Volta, Ghana, urinary blood and protein levels as determined by chemical reagent strips in persons infected with Schistosoma haematobium, particularly in children aged between 5 and 14, correlated positively with urinary egg counts. Geometric mean S haematobium egg counts were 10 or more times higher in urine specimens with at least 10 mg/dl of protein and detectable haematuria than in those without detectable blood or protein. Chemical reagent strips were both specific and sensitive for detection of urinary blood associated with S haematobium infection. This simple technique could be useful for screening entire populations in which urinary schistosomiasis is endemic so that heavily infected persons needing specific treatment can be identified.
Adolescent↗
[Recent advances on routine urinalysis].
Urine qualitative/semiquantitative tests with reagent-strip and microscopic examination(sediments) are most popular and basic clinical laboratory tests. However, the accuracy and precision of those tests have not been more reliable than that of clinical chemistry or hematology, mainly due to the instability of urine specimen and subjective analysis procedure. Automated analyzer with compact size and high quality of both reagent-strip method and sediments(formed elements or particles) have been commonly used in many laboratories and guidelines on urinalysis of JCCLS(Japan), NCCLS(USA) and ECLM(EU) are publishing in succession recently. These advances are expected to lead to a solution for those problems in the urinalysis field.
Forecasting↗
A kinetic study of the hydrolysis of the N-tosylalanine ester of 3-hydroxy-5-phenylpyrrole and related compounds by human leukocyte elastase.
The tosylalanine ester of 3-hydroxy-5-phenylpyrrole (HOPPy) is localized on reagent strips (Ames LEUKOSTIX) and used diagnostically to test urine for the presence of human leukocyte elastase (HLE) as an indication of urinary tract infection. We have determined the kinetic constants for the HLE-catalyzed hydrolysis of this substrate and the related substrates Tos-Ala-ONp, Cbz-Ala-OPPy, and Cbz-Ala-ONp, in solution at three different pH values. In the reagent strip matrix, diazo coupling of 4-diazo-3-hydroxy-1-napthylsulfonate (HONapN+2) with the enzymatic hydrolysis product HOPPy generates a purple color. We have also studied the kinetics of the reaction of HOPPy with HONapN+2 and other related diazonium salts such as 4-diazo-3-hydroxy-7-nitro-1-napthylsulfonate, 4-diazo-3-hydroxy-1,7-napthyldisulfonate, and 2-methoxy-4-(N-morpholinyl)benzene diazonium chloride. Tos-Ala-OPPy is the most reactive substrate among the compounds examined and kinetic studies indicate that deacylation is rate-limiting for HLE hydrolysis. The presence of decanol accelerates the enzymatic hydrolysis of Tos-Ala-OPPy with a kcat/KM = 10(7) M-1 s-1, which is close to the diffusion-controlled limit. For the diazo coupling reaction, the rate is affected by the substituents on the naphthalene ring and by the buffer in which the reaction occurs. This research has elucidated some important mechanistic features for the reaction of these compounds and may lead to improved methods for the detection of leukocyte elastase.
Alanine↗
The public health significance of urinary schistosomiasis as a cause of morbidity in two districts in Mali.
Schistosoma haematobium-related morbidity was studied in the perennial irrigation area of Office du Niger and the small reservoirs area of Plateau Dogon in Mali. Questionnaire, clinical, parasitologic, and ultrasound examination data were collected from 1,041 individuals at the baseline survey in 1991; 705 were re-examined one year after treatment. At baseline, the overall prevalence of S. haematobium infection was 55.2%; half of those infected had no clinical symptoms and 30% had pathologic lesions. Both infection and morbidity were more frequent in children than in adults, with a peak prevalence at 7-14 years of age. The rates of lesions were more than twice as high in those heavily infected as in lightly infected individuals. Reagent strip testing for microhematuria was more sensitive in detecting individuals with pathologic lesions than in detecting individuals with infection. One year after treatment with praziquantel, more than 80% of the urinary tract lesions had cleared. It is concluded that S. haematobium-related morbidity is frequent in Mali, but passive case detection for treatment would not cover a great deal of early stages of the disease; active intervention using reagent strip testing for microhematuria at the most peripheral levels would be an efficient system for morbidity control and monitoring of control operations.
Adolescent↗
Haematuria, pigmenturia and proteinuria in exercising horses.
The effects of exercise on urinary excretion of red blood cells, pigments (haemoglobin and myoglobin) and protein were studied in 8 mares performing treadmill exercise at speeds eliciting 40, 60 and 95% of the maximal oxygen consumption (VO2max). Gross haematuria and pigmenturia were observed in all horses during exercise at the 2 higher intensities, while these findings were detected in only one of 8 mares during exercise at 40% of the VO2max. For the remaining 7 mares exercised at 40% of the VO2max, increased urinary excretion of red blood cells (RBCs) and pigments was evident after centrifugation of urine samples and reagent strip analysis of the supernatant fractions. An increase in urine flow (UF) during exercise at 40% of the VO2max may have contributed to the infrequent observation of gross haematuria and pigmenturia during exercise at this intensity. A transient increase in UF following exercise at 60 and 95% of the VO2max resulted in rapid resolution of gross haematuria and pigmenturia, but increased urinary excretion of RBCs and pigments remained evident by reagent strip analysis for up to 60 min following exercise. Mean +/- s.e. urinary protein excretion increased from a resting value of 2.2 +/- 0.2 mg/min to 5.6 +/- 0.9, 14.5 +/- 4.7 and 78.4 +/- 18.6 mg/min after exercise at 40, 60 and 95% of the VO2max, respectively. These results demonstrate that exercise induced haematuria and pigmenturia and post exercise proteinuria are common in horses. Their occurrence is transient and does not appear to be associated with any lasting changes in renal function.
Analysis of Variance↗
Diagnosis of urinary schistosomiasis: a novel approach to compare bladder pathology measured by ultrasound and three methods for hematuria detection.
We aggregated published data from field studies documenting prevalence of Schistosoma haematobium infection and bladder pathology determined by ultrasonography or hematuria detected by reagent strip, questionnaire, or visual examination. A mathematical expression was used to describe the associations between prevalence of pathology/morbidity and infection. This allows for indirect comparison of these methods, which are rarely used simultaneously. All four methods showed a similar, marked association with infection. Surprisingly, ultrasound revealed higher prevalences of pathology in schools than in communities with the same prevalence of infection, implying a need for age-related cut-off values. Reagent strip testing yielded a higher prevalence than questionnaire, which in turn was higher than by visual examination. After correction for morbidity due to other causes, a consistent ratio in prevalence of hematuria of 3:2:1 resulted for the three respective methods. The simple questionnaire approach is not markedly inferior to the other techniques, making it the best option for field use.
Hematuria↗
Evaluation of ames Multistix-SG for urine specific gravity versus refractometer specific gravity.
A comparison of urine specific gravity by a commercially available multiple reagent strip (Multistix-SG; Ames Division, Miles Laboratory) versus refractometer specific gravity (TS Meter; American Optical Corporation) was performed on 214 routine urine specimens. Agreement to +/- 0.005 was found in 72% of the specimens (r = 0.80). Urine specific gravity by the Multistix-SG showed a significant positive bias at urine pHs less than or equal to 6.0 and a negative bias at urine pHs greater than 7.0 in comparison to refractometer specific gravity. At concentrated (specific gravity greater than or equal to 1.020) specific gravities, up to 25% of urine specimens were misclassified as not concentrated by Multistix-SG specific gravity in comparison to refractometer specific gravity. The additional cost of the specific gravity reagent to a multiple reagent test strip in addition to the poor performance relative to refractometer specific gravity leads to the conclusion that including this specific gravity methodology on a multiple reagent strip is neither cost effective nor clinically useful.
Humans↗
Diagnosis of active urinary schistosomiasis using homologous adult Schistosoma haematobium antigen.
The role of antigen prepared from Schistosoma haematobium adult worm (ShAWA, W.H.O. Geneva) in diagnosis of active urinary schistosomiasis, by counterimmunoelectrophoresis (CIEP), was evaluated by comparison with simpler methods as sedmentation of urinary ova and detection of haematuria by chemical reagent strips. Sixty patients (30 school boys and 30 adults) passing living S. haematobium eggs, as detected, by nucleopore filtration technique (NF), and 30 controls were studied. Results showed statistically significantly higher (P < 0.001) egg counts in school boys than adults. Sensitivities of haematuria detection, ova sedimentation and CIEP were 93.3%, 80%, 50%, 70%, 73.3%, 33.3% in school boys and adults respectively. It was concluded that direct parasitological examination of urine samples is more superior than CIEP using homologous ShAWA to detect active urinary schistosomiasis both qualitatively and quantitatively. Haematuria detected by chemical reagent strips can identify a high proportion of active urinary schistosomiasis in epidemiological surveys in endemic areas. Nucleopore filtration is more superior than ova sedimentation method for detection of active urinary schistosomiasis.
Adolescent↗
CSF rhinorrhoeae: significance of the glucose oxidase strip test.
Many authoritative medical textbooks recommended use of glucose oxidase reagent strips to distinguish cerebrospinal fluid rhinorrhoea from clear nasal discharge following head injury. A study of 50 subjects with clear nasal and lacrimal secretions, demonstrated a large proportion of positive results for glucose (44 per cent). Thirteen secretions (26 per cent) contained glucose in a concentration within the normal range for CSF. The recommended use of glucose oxidase test strips for differentiating CSF leakage from other clear nasal secretions is therefore without foundation.
Cerebrospinal Fluid Rhinorrhea↗
[Preliminary evaluation of usable indicators during a control program for urinary bilharziosis in Niger].
The performance of several indirect screening tests was evaluated during the start-up phase of a urinary schistosomiasis control program in Niger. Urine tests were carried out on a total of 354 children attending 3 primary schools on five consecutive days. Tests included filtration of 10 ml of urine, search for microscopic hematuria using reagent strips, and gross examination of urine. In addition a questionnaire was administered on the first day to identify signs of dysuria and hematuria. Repeat testing had a strong effect on the epidemiological profile of urinary schistosomiasis in the 3 schools. Although day-to-day counts varied greatly, egg excretion could be considered as high in all infected subjects. The screening sensitivity of urine filtration was low when the level of endemicity was moderate (up to 55 p. 100). Microscopic hematuria was common. However the sensitivity of this method was overestimated in comparison with urine filtration alone and use of reagent strips can be inconvenient. Using carefully defined diagnostic criteria, gross examination of urine was as effective as urine filtration and easier to perform. The value of the questionnaire for evaluation of morbidity was low despite relatively good performance of the diagnostic techniques. The children's responses concerning hematuria were not objective and questions concerning dysuria were poorly understood and time-consuming. In the next phase of study, these findings will be validated by ultrasound imaging.
Child↗
Effects of hydroxypropyl cyclodextrins on the reactivation of SDS-denatured aminoacylase.
Cyclodextrins are natural-occurring circular oligosaccharides with an internal hydrophobic cavity and external hydrophilic edges. Because cyclodextrins bind with protein aromatic residues, they can prevent protein aggregation, and their ability to bind with detergents enables them to act as stripping reagents to release proteins from protein-detergent complexes. In this research, we investigated the effects of three hydroxypropyl cyclodextrins (HPCDs) on the refolding of aminoacylase from SDS-denatured states. It was found that the three HPCDs could effectively assist aminoacylase reactivation though they have different abilities. HP-gamma-CD, which has the largest cavity among the three HPCDs, was the most efficient one. Spectroscopic results further indicated that the secondary structure recovery of aminoacylase could be completed with the help of low concentrations of HPCDs. However, the activity of the released protein could not fully recover even though high concentrations of HPCDs were used. The concentration-dependent effects of HPCDs also indicated that cyclodextrins could also act as folding assistants in addition to acting as stripping reagents during the refolding of detergent-denatured proteins.
Amidohydrolases↗