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PubMed1996

Bladder cancer screening.

Transitional cell carcinoma of the bladder possesses several features that make it an ideal candidate for screening: metastases rarely occur before tumors invade the muscularis propria; superficial disease is treated very successfully by relatively inexpensive and nonmorbid means; this malignancy is almost never found incidentally at autopsy so that early detection cannot harm a patient; and almost all tumors cause hematuria if one tests frequently enough. When compared with a contemporary age, geography, and gender-matched unscreened population, bladder cancer screening in healthy men age 50 years and older by repeated home hematuria testing using chemical reagent strips significantly decreases bladder cancer morbidity and mortality and is cost-effective. A randomized prospective trial of bladder cancer screening in this population is recommended. Additionally, other potential means of bladder cancer screening and other target populations are discussed in this article.

Biomarkers, Tumor↗
PubMed1997

Variable glycation of serum proteins in patients with diabetes mellitus.

OBJECTIVE: To determine whether there were variations in vivo and in vitro in the glycation process among patients with diabetes mellitus and to assess the characteristics of patients with high and low glycation, if this was observed. PATIENTS: Patients (n = 185) attending a Diabetes Day Care Centre or Notre-Dame Hospital in Montreal participated in the in vivo study. Patients found to have high and low glycation were asked to allow the use of their serum for the in vitro part of the study. INTERVENTION: Capillary blood glucose levels were determined by nursing staff 4 times a day over 7.3 (standard deviation [SD]5.3) consecutive days with commercially available glucose oxydase reagent strips and meters. The ratio of the fructosamine concentration to the protein concentration (the F/P ratio) and the glycated hemoglobin were also determined at the same time as the capillary blood glucose level. Glycation was defined as the mean capillary blood glucose/F/P ratio. Patients with high and low glycation (higher or lower than [SD], of the mean) were compared. For the in vitro study, incorporation of carbon-14 glucose in serum proteins incubated with a 30-mmol/L glucose concentration was studied in some of the patients with low and high glycation. RESULTS: The mean capillary blood glucose/F/P ratio was a mean of 2.30 (SD 0.29) g/mL. Of the 185 subjects 31 had high glycation (1.46 [SD 0.19] g/mL) and 27 had low glycation (2.97 [SD 0.035] g/mL, p < 0.001). There was no significant difference in age, sex, diabetic treatment and glycated hemoglobin levels between the 2 groups. However, patients with low glycation had a greater body mass index (29.4 [SD 5.7] kg/m2 v. 26.4 [SD 4.3] kg/m2, p < 0.05). In vitro, incorporation of 14C glucose in serum proteins incubated with a 30mmol/L glucose concentration was higher in the 9 patients with high glycation than in that of the 7 with low glycation (0.031% [SD 0.03%] per gram of proteins v. 0.028% [SD 0.03%] per gram of proteins, p < 0.02). CONCLUSIONS: Glycation may vary among patients with diabetes mellitus who have similar capillary blood glucose concentrations. Glycation appears to be lower in patients with a greater body mass index. Furthermore, alternation in the glycation process itself may explain, in addition to the mean blood glucose level, the difference in fructosamine levels.

Adult↗
PubMed1977

Equine cerebrospinal fluid: reference values of normal horses.

Cerebrospinal fluid (CSF) samples were collected from the atlanto-occipital (AO) and lumbosacral (LS) subarachnoid spaces of 24 horses and 21 ponies that had no clinical evidence of neurologic disease. Depth of needle insertion, pressures, refractive index, rapid reagent strip test (protein, glucose, blood, pH) results, cell counts, content of protein, glucose, sodium, potassium, chloride, calcium, phosphorus, urea nitrogen, and cholesterol, and activities of creatine phosphokinase, aspartate transaminase, lactic dehydrogenase, and alkaline phosphatase were determined. The resulting clinical reference values obtained were discussed in light of the published normal values for CSF from horses, other animals, and man. White cell counts in CSF were found to be from 0 to 6/microliters. Values for protein content were distributed between wider limits than previously reported values. The LS-AO difference is proposed as a criterion for clinical evaluation of CSF protein content. Ponies were found to have more protein in their CSF than did the horses, and CSF from the LS site contained more glucose than that from the AO site. The CSF electrolyte composition was similar to that of previous reports. Enzyme activities in equine CSF are reported for the 1st time.

Animals↗
PubMed1995

Isolation and analysis of nephritic-producing immune complexes in Plasmodium berghei-infected mice.

A nephritic condition was developed by infecting Swiss Webster albino mice with the malarial parasite Plasmodium berghei NK 65. These animals were tested for urinary protein and the presence of circulating immune complexes using reagent strips and a polyethylene glycol (PEG) precipitation assay. The circulating immune complexes were isolated from the sera using both affinity chromatography and PEG precipitation and from the kidney by acid elution. The isolated complexes were dissociated into their individual components and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The components of the complexes were transferred to nitrocellulose sheets and probed for the presence of malarial antigens using a rabbit anti-P berghei antisera. The overall humoral response to the malarial parasite was evaluated using a radial immunodiffusion assay. The present study confirmed that the malarial-infected animals not only developed the nephritic condition (as evident by the high levels of proteinuria) but also, as indicated by the PEG assay, have the presence of high levels of circulating immune complexes in their serum. The apparent absence in the SDS gels of any abnormal protein bands followed by the inability of the Western blot to reveal any malarial antigens provides some of the strongest evidence to date that these malarial proteins are not directly involved in the circulating immune complexes believed to be responsible for producing this nephritic condition.

Animals↗
PubMed1982

Bedside blood glucose determinations in critical care medicine: a comparative analysis of two techniques.

The accuracy of a new reagent test strip (Chemstrip BG) for the quantitative estimation of whole blood glucose concentration was compared to that of a widely used test strip (Dextrostix). To perform the comparative study, venous blood specimens were obtained from 133 patients. Interpretations of reagent strip glucose readings were made by three observers who separately recorded their impressions from the two strips on each patient. These estimated levels were compared to quantitative (glucose oxidase) concentrations measured from the same specimen. Although there were significant correlations (p less than 0.001) between both reagent strips and the measured values, the Chemstrip BG results more closely approximately measured values for the range of glucose concentrations encountered (10-600 mg/dl). In addition, Chemstrip BG was easier to read and measured a wider range of values than Dextrostix and, unlike Dextrostix, Chemstrip BG strips could be stored for review at a later time. This new glucose test strip accurately and rapidly determines whole blood glucose concentration at the bedside.

Blood Glucose↗
PubMed1968

Comparison of reagent-impregnated paper strips and conventional tests for distinguishing Escherichia from Aerobacter: correlation with colonial morphology.

The means for distinguishing Escherichia from Aerobacter (Enterobacter) differ in laboratories and range from complete dependence on colonial reactions on typical gram-negative media to reliance on one or more of the classical indole, methyl red, Voges-Proskauer, citrate (IMViC) parameters. Three colonial types (one prejudged as Escherichia) of lactose-positive rods were catalogued on each of the most commonly used selective media, MacConkey Agar, Endo Agar, and E M B Agar. Each cultural type was presumptively diagnosed and then compared with the expected outcome of individual IMViC tests. The distribution of preliminary identifications was similar from growth patterns on MacConkey Agar and E M B Agar, but it differed markedly from Endo Agar. When organisms initially diagnosed by cultural methods were compared by single IMViC tests, it was found that for each colonial type one of the biochemical parameters was best suited. Thus, for those types initially considered Escherichia, the methyl red or Voges-Proskauer test results agreed most consistently; for other types, the citrate reaction was most satisfactory. In addition, when newly formulated reagent-impregnated paper strip methods for indole, Voges-Proskauer, and citrate were evaluated and compared to the standard methods, agreement was 97% for indole, 90% for Voges-Proskauer, and 95% for Simmons' citrate.

Bacteriological Techniques↗
PubMed2005

Effect of adverse storage conditions on performance of glucometer test strips.

OBJECTIVE: A study was conducted to assess the impact of adverse storage environments, i.e., not manufacturer recommended, on the performance of reagent test strips used with a point of care testing (POCT) glucometer to measure whole blood glucose levels. DESIGN/SETTING: Glucose reagent test strips were placed in open, i.e., uncapped, and closed, i.e., capped vials. These vials were those used by the manufacturer to package and store the reagent test strips. One of each type of vial was placed in the manufacturer-recommended storage environment at room temperature and the adverse environments (incubator, direct light to mimic sunlight exposure, humidity, and refrigerated). The Accu-Chek Easy glucometer and reagent test strips as well as Accu-Chek Easy high and low glucose control solutions, manufactured by Roche, were used for this study. MAIN OUTCOME MEASURES: On day-3, day-7, and then once every 7 days, one strip from each vial in each environment was tested with the same glucometer using both a high and a low glucose control. The strip was considered failed for a type of vial and storage environment when either control was out of the reference range on a regular testing day and still out of range when tested the subsequent day. Testing continued up to 50 days. RESULTS: For the tested environments it was found that, overall, test strip stability lasted longer for closed vials than open vials. For open vials in adverse storage conditions, the refrigerator environment offered the longest stability at 35 to 50 days and direct light and humidity offered the shortest periods of stability at 3 to 14 days. CONCLUSIONS: The results of this study support the manufacturer's recommendations to store POCT glucose test strips in their original vial, capped, and at room temperature, though refrigeration may offer an alternative storage environment with acceptable stability. As compliance with testing, quality control, and storage instructions is often an issue with POCT, the manufacturers of these systems for blood glucose measurement should design storage systems that allow the patient to store the glucose meter and the reagent strips in the same location. Manufacturers may also need to consider designing storage systems that are more portable, knowing that patients must take the glucose meters and test strips with them when they travel. Roche's Accu-Chek Compact system is an example of such a design. The glucose test strips are incorporated into a drum that is stored in the Accu-Chek meter itself. When a patient performs a fingerstick blood glucose measurement, the drum advances to move a test strip outside the meter. When the test is complete, the test strip is ejected for disposal. Future studies to clarify the effect of adverse storage conditions, particularly refrigeration, on the integrity of POCT test systems and reagent strips is warranted with currently marketed brands.

Blood Glucose↗
PubMed1973

Evaluation of the PathoTec "Rapid I-D System" and two additional Experimental reagent-impregnated paper strips.

The PathoTec "Rapid I-D System" and two experimental test strips for ornithine decarboxylase and beta-galactosidase have been evaluated for accuracy and ability to identify 1,252 members of the Enterobacteriaceae obtained from fresh clinical specimens. Accuracy of identification with the commercially available test system was 94.7%; this level increased to 98.5% with the addition of the two experimental test strips. Average individual accuracy of the 12-strip test system on a side-by-side basis with similar conventional procedures was 98%. In addition, 103 gram-negative nonfermentors were accurately grouped. The PathoTec System was applicable to 95% of the primary isolation plates used and provided biochemical data within 4 h after inoculation. The conventional test procedures were applicable to 100% of the primary isolation plates used and produced data within 48 h.

Bacteriological Techniques↗