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PubMed2002

Evaluation of ventilator-associated lower respiratory tract infection and tracheobronchial aspiration of gastrointestinal contents.

STUDY OBJECTIVE: Ventilator-associated lower respiratory tract infection (LRTI) in a set up of respiratory intensive care unit was evaluated. Also the incidence of tracheobronchial aspiration of gastrointestinal contents was explored among these patients. DESIGN: Twenty eight patients admitted in the respiratory intensive care unit of referral teaching hospital were studied. All patients were evaluated for tracheobronchial aspiration of gastrointestinal contents in the initial 48 hours of initiating mechanical ventilation using methylene blue as marker and glucostix reagent strip. Protected endotracheal aspirate was secured after 48 hours of beginning of mechanical ventilation and was submitted for microbiological assay. RESULTS: Of the 28 mechanically ventilated patients, 82% were found to have developed LRTI. Aerobic gram-negative bacilli accounted for 79% of the infections, Klesiella responsible for 39% while Pseudomonas and Escherichia accounted for 18% each. The remaining 4% were caused by Acinetobacter. Gram-positive cocci were responsible for 21% of infection with Staphylococcus and enterococci 14% and 7% respectively. Tracheobronchial aspiration of GI contents was found to be present in 72% of the patients which was significantly correlated with the incidence of LRTI (p=0.014). Significant association was also found between the incidence of LRTI and mortality (p=0.05). CONCLUSION: The incidence of gastrointestinal aspiration was found to be high and correlation with LRTI was significant. Both glucostix reagent strip and methylene blue were observed to have same positivity rate.

Adolescent↗
PubMed1991

Schistosomiasis in Cross River State, Nigeria: 1. Prevalence and intensity of infection in Adim, Akamkpa Local Government Area.

Mid-stream urine was randomly collected from 248 subjects in Adim. Blood and protein concentrations were determined semi-quantitatively using Combi-7 reagent strips. The urine samples were then processed and any ova of Schistosoma haematobium present were counted per 10 ml urine. Fresh stool samples were also randomly collected, processed and examined for S. masoni and other helminthic ova. The prevalence of S. haematobium in the area was 43.5% and this was found to be age-related but not sex-related. Mean egg count was 137.2 per 10 ml urine. Intense haematuria of 250 ery/microliters and proteinuria of 500 mg/dl accompanied the high egg counts. The stool examination showed no cases of Manson's schistosomiasis but polyparasitism with other intestinal helminths was common particularly among children under 10 years old. This is the first report of urinary schistosomiasis in this area and the high prevalence rate is consistent with the rice farming occupation of the natives of the area. The sensitive nature and the case of application of the reagent strips in determining heavy infections by measuring haematuria and proteinuria is once again confirmed.

Adolescent↗
PubMed1979

The significance of proteinuria and haematuria in Schistosoma haematobium infection.

The intensity and prevalence of proteinuria and haematuria were studied with urinanalysis reagent strips in a Gambian community in which the intensity of infection with Schistosoma haematobium was high. The level of proteinuria present was shown to be related to the intensity of infection. Follow-up for 12 months showed that infected subjects with heavy proteinuria had a good prognosis. These findings suggest that the urinary protein in such subjects is likely to originate from lesions in the bladder and ureters and that advanced glomerular pathology is probably rare. The relationship of the levels of proteinuria and haematuria to the egg count suggests they may be parameters which could have value as indications for chemotherapy. Detailed study showed that the effect of treating all the subjects who had both 30 mg/100 ml or more of protein and at least a trace of haematuria would have been very similar to treating all those with an egg count of 200 ova/10 ml or more. Since urinalysis with reagent strips is very simple and rapid it could have a role in mass chemotherapy campaigns, particularly those aimed at the identification and treatment of heavily infected subjects.

Adolescent↗
PubMed1994

Intra-operative blood glucose measurements. The effect of haematocrit on glucose test strips.

Variations in haematocrit are known to affect the accuracy of reagent strip tests for glucose. We have investigated 10 patients during cardiopulmonary bypass, where intra-operative decreases in haematocrit occur. Whole blood glucose concentrations were measured on five occasions at 30 min intervals during the procedure using the Glucometer II, One Touch II and Reflolux II meters as well as a reference instrument (YSI Model 23 AM). Haematocrits were recorded simultaneously. Overall, for every 10% fall in haematocrit, Glucometer II measurements rose by 22% (r = 0.74, p < 0.00001), One Touch II measurements fell by 3% (r = 0.44, p < 0.002) and the Reflolux II measurements showed no significant variation. The One Touch II showed closer agreement to the reference (mean bias 0.3 mmol.l-1 (95% between +0.86 and -0.26)) than the Reflolux II (bias 1.58 (+3.40 to -0.24)) or the Glucometer II (bias 3.25 (+6.18 to 0.32)). Thus, depending on the meter used, spuriously large intraoperative changes in blood glucose may seem to arise where patient haematocrit varies.

Adult↗
PubMedDate not supplied

Evaluation of Micro-Bumintest reagent tablets for screening of microalbuminuria.

The presence of significant microalbuminuria is an important predictor of early diabetic nephropathy. Currently methods available to detect microalbuminuria are not suitable for routine screening. This study assessed the performance of Micro-Bumintest reagent tablets (Ames Laboratory) as a visual screening test for qualitative measurement of urinary albumin. 150 urine specimens from type 1 diabetic patients with a disease duration of less than 1-19 years were assayed over 15 runs using quantitative albumin (radioimmunoassay) and total protein assays. In parallel, 600 determinants were made with the tablets. Each sample was assessed by two readers using a color chart with patterns illustrating typical negative and positive color reactions with a grading from 1 to 7. Urinary protein was determined with an Ames Clinitek 10 urine chemistry analyzer and the Multistix 10 SG reagent strips. The results revealed that as the albumin concentration increased, the percentage of specimens detected visually as presumptive positive (grading = 3) reactions and positive reactions (grading greater than 3) increased. A positive Micro-Bumintest reaction was obtained with an albumin concentration of greater than 40 micrograms/ml. Presumptive positive reactions occur more than 50% of the time at protein concentrations greater than 14 mg/dl. The tablet test is more sensitive than the Clinitek 10/Multistix 10 SG strip system. These data show that the Micro-Bumintest reagent tablets are a sensitive and convenient screening test for detection of microalbuminuria.

Albuminuria↗
PubMed1992

Urine test strips: reliability of semi-quantitative findings under tropical conditions.

Semi-quantitative urinalysis with urine reagent strips (URS) for erythrocyturia (EU), leucocyturia (LU) and proteinuria (PU) was performed in Congolese and Sudanese school children with Schistosoma haematobium and/or S. mansoni infection. Quantitative urinalysis was performed on the same specimen using microscopy and a Neubauer counting chamber for EU and LU and the Coomassie blue dye-binding assay for PU. Microscopically detectable EU of more than 10 cells/microliters was found in 63% of all samples and LU of more than 20 cells/microliters was found in 60% of all samples. With the Coomassie blue method, PU of more than 150 mg/l was detected in 51% of all samples. URS gave positive results of grade 1-3 for EU in 69% of all samples, for LU in 63% of all samples and for PU in 66% of all samples. The sensitivity and specificity of URS compared with standard reference methods were as follow: EU 95% and 75%, LU 81% and 81% and PU 90% and 56%. When the results of all three test were combined, URS differentiated abnormal from normal urine specimens with a sensitivity of 94% and a specificity of 70%. Median quantitative results showed a good correlation with semiquantitative URS readings for all parameters, but there was a wide range of URS scores. We concluded that URS sensitivity detect urinary abnormalities and thus may be used as a general screening method under field conditions when more specific methods cannot be performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Congo↗
PubMed1983

Statistical comparison of blood glucose as determined by several test-strip procedures and by a hexokinase procedure.

We report a new statistical tool for comparing several dry-reagent strip procedures for whole blood glucose, which produce data in both digital and ordinal form, with results by the well-studied hexokinase-glucose-6-phosphate dehydrogenase procedure coupled to NAD+-NADH. Our use of "ordinal comparison unit" allows for a more equitable comparison of such data. These strip procedures produce biases of -2.21 to 1.74 ordinal comparison units over the range of glucose values corresponding to hypoglycemia and hyperglycemia, as compared with results by the hexokinase procedure, but they are essentially equivalent when compared with each other.

Blood Glucose↗
PubMed1991

[Clinical evaluation of a test strip for measuring creatinine in capillary blood of children].

Basing on an enzymatic method for determining creatinine, the new reagent strip "Reflotron Creatinin" of the Reflotron system recently was presented. In this study, it will be compared with another enzymatic test (Creatinin-PAP) and with a Jaffe-based assay (Creatinin-Jaffe for Hitachi 737). The quality control (within-days and within-series) yielded a sufficient accuracy and precision (CV = 4%) for the charge of used test strips. The recovery of double measured values was very good (r greater than 0.94). As regards the method comparison, differences in both charges were seen. The values of the former charge lay 7% on an average below the Jaffe-values, those of the latter 28% below. The slope of the latter regression line was considerably steeper. Comparing both enzymatic tests, the regression analysis gave poor results (y = -0.33 + 1.35 x). Bilirubin had not remarkable influences, whereas an evelated hematocrit slightly depressed the values. It seems necessary to start further studies to clear up the difference in test strip charges and to check more capillary blood samples of newborn and children with a pathologic creatinine level.

Child↗
PubMed1988

New device to improve the accuracy of bedside blood glucose tests.

A new device to improve the accuracy of blood glucose measurements with glucose-oxidase reagent strips is described. The device ensures that an adequate amount of blood is applied onto the reagent pad when the strip is fully inserted. When the strip is withdrawn, the pad is automatically wiped, and so the reaction can be accurately timed. The device also reduces the risk of blood contamination of other surfaces. Use of a prototype of this device enabled more accurate measurement of blood glucose on general wards.

Blood Chemical Analysis↗
PubMed1984

[Blood glucose self-monitoring: visual or automated read-out? Comparative study of 6 methods of blood glucose determination by reactive strips].

Home blood glucose monitoring is becoming increasingly popular in diabetic patients. The purpose of this work was to determine the accuracy of this technique. We have compared plasma glucose obtained in the laboratory and two reagent strips (Dextrostix and Haemoglukotest 20-800). No differences were found among visually-read values and meter-read values using either Dextrometer, Glukometer, Hypocount or Glucochek. Thus, visually-read strips seem to be sufficient for clinical purposes with best results for HGT. The performances of different meters are similar. Nevertheless must patients favoured the use of a meter because of the apparent "objectivity" of the values. Furthermore, meters provide to patients a better involvement in the management of their disease.

Automation↗
PubMed1983

Enzymes as reagents in clinical chemistry.

Clinical chemistry is concerned with the measurement of substances in biological matter, predominantly blood, serum or plasma. Significant, though small, changes may take place as a prelude to a life-threatening situation. Therefore analytical techniques in clinical chemistry must be sensitive, specific and rapid. Many features of an enzyme-catalysed reaction are incorporated in the design of diagnostic reagents. The specificity of an enzyme may be employed to measure a substrate, or to remove interferents in another reaction. The measurement of substances that act as cofactors, inhibitors or activators can be achieved by the use of the appropriate enzyme. Finally, the enzyme, as a catalyst, can be used as a label in various immunoassay techniques. Clinical chemistry tests are carried out in a wide variety of environments, from the large laboratory undertaking many hundreds of analyses down to a clinic performing only a few tests. Enzymes are therefore employed in analytical systems based on widely differing presentations. Thus enzymes may be employed in a solution medium, immobilized on a surface of the reaction vessel or in a reagent strip. The requirements imposed on the reagent enzyme may be different in all of these situations.

Blood Chemical Analysis↗
PubMedDate not supplied

Urinalysis.

Urine analysis is an essential component of patient assessment, which is used for screening, diagnosis and planning care. This article discusses specimen collection and reagent strip testing.

Bilirubin↗
PubMed1975

Inhibitory effect of fluoride on glucose tests with glucose oxidase strips.

Sodium fluoride was inadvertently added as a preservative to the urine of an eight-year-old boy with diabetes mellitus before urinary glucose was measured. On preliminary screening of the urine, the test by glucose oxidase paper reagent strip gave a negative reading for glucose, whereas quantitative urinary glucose assay by the coupled enzyme reaction (hexokinase-glucose 6-phosphate dehydrogenase) gave a glucose concentration of 81.5 g/liter. Inadvertent use of sodium fluoride as a urine preservative may cause a falsely negative result with the glucose tests involving oxidase.

Child↗
PubMed1991

Evaluation of a screening test for detecting urinary tract infection in newborns and infants.

The results of a study of a screening test for urinary tract infection (UTI) in infants under 18 months is reported. Two hundred and forty three urine specimens were tested in the laboratory using AMES Multistix 8SG reagent strips read by photometer. The strips included three potential markers for urinary tract infection: leucocyte esterase, nitrite, and protein. The predictive value of a positive result (PPV) was low. The predictive value of negative test (NPV) when combining the screen of leucocyte esterase, nitrite, and protein was 99.4% with no difference between boys and girls. The test for leucocyte esterase had a 97.6% negative predictive value. An examination of the results by age confirms the good NPV in all age groups. Paediatricians should find Multistix 8SG strips a useful aid in the diagnosis of urinary tract infection in infants, and that costly culture of samples with negative strip tests can be avoided.

Humans↗
PubMed1975

Detection of bacteriuria in pediatric outpatients. A new culture device.

Urine samples from 1,003 pediatric patients were examined for bacteriuria with a culture-nitrite strip test, along with microscopic assessment of pyruia and conventional chemical analysis. The latter two methods proved of little value in reliably detecting or excluding substantial bacteriuria. An overall prevalence of 5.2% was shown. Using Microstix Reagent Strips, 92 urine samples with substantial colony counts were detected. Subculture from the strips disclosed that 52 of these involved single pathogens, interpreted as true bacteriuria. When Microstix growth results were compared with the calibrated loop method on 108 randomly selected specimens, the strip gave only two false negatives and one false positive. Bacteriuria screening should be done in high-risk groups and in asymptomatic children as part of the health evaluation. The index of suspicion should be higher in girls, and reliable interpretation of culture results requires attention to proper specimen collection.

Adolescent↗
PubMed1988

Evaluation of an office method of measuring theophylline serum concentrations.

A strip test for theophylline, with an immunoassay with a colorimetric indicator, has been developed for use in the physician's office (Seralyzer, Ames Division, Miles Laboratories, Elkhart, Ind.). Diluted serum is applied to the plastic reagent strip, which is then inserted into a reflectance photometer that quantitates the color change and displays the serum concentration in 80 seconds. To determine the reliability of this method, control sera (5.0, 10.0, 15.0, 20.0, and 25.0 micrograms/ml of theophylline) and 78 specimens, each from a different patient, were analyzed by Seralyzer and a reference method (EMIT, Syva Co., Palo Alto, Calif.). Nine replicate measurements of a 15.0 micrograms/ml control serum were performed on one day, an all five control sera were analyzed once daily for 20 days. Patient specimens were analyzed at the rate of eight per day. The coefficient of variation (mean/SD X 100) for within day precision of the 15 micrograms/ml control was 5.2% for Seralyzer and 4.1% for EMIT (p less than 0.05). Coefficients of variation for between-day precision of the Seralyzer were less than 10% at concentrations greater than 5 micrograms/ml, but were significantly greater than EMIT measurements at 5 and 10 micrograms/ml (p less than 0.05). There was a strong correlation between the two methods for the 78 patients' specimens (r2 = 0.95). The Seralyzer demonstrated a positive bias of 0.9 microgram/ml. Results analyzed by the two methods differed by greater than 25% in 10 of the 78 specimens (mean error, 3.3 micrograms/ml over the range of 2.9 to 22.2 micrograms/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Asthma↗
PubMed1997

Bedside methods for detecting aspiration in tube-fed patients.

This literature review compares the efficacy of the two most commonly recommended bedside tests for detecting aspiration in tube-fed patients: (1) adding dye to the formula and observing for its appearance in tracheobronchial secretions, and (2) using glucose oxidase reagent strips to test tracheobronchial secretions for glucose-containing enteral formula. The review also describes potential problems and cost associated with each test. Several studies indicate that the dye method is far less sensitive than the glucose reagent method; further, there are anecdotal reports of potential harm to patients when dye is added to tube feedings. Specificity of the glucose method has been challenged by several authors; also, cost is probably greater with this method.

Bronchi↗