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FOS immunoreactivity after exposure to conspecific or heterospecific urine: where are chemosensory cues sorted?

Female prairie voles (Microtus ochrogaster) typically require an intact vomeronasal system and exposure to a chemical signal found in urine from male prairie voles to induce uterine growth necessary for reproduction. Urine from male mice (Mus musculus) does not contain an effective cue for activation of female vole reproduction: after 4 days of exposure to stimuli, voles exposed to urine from female or water had still uteri whereas voles exposed to urine from male voles had large uteri. The initial response to urine from male voles included neuronal activity in the vomeronasal system as indicated by FOS immunocytochemistry. Stimuli (urine from a male vole or a male mouse, or water) were painted on the nose of naive female voles 1 h before sacrifice. Female voles exposed to urine from male voles had more FOS-immunoreactive cells in the accessory olfactory bulb than voles exposed to mouse urine or to water. We conclude that exposure to urine from male voles stimulates the vomeronasal pathway (as measured by FOS immunoreactivity) and induces uterine growth in female voles, whereas exposure to urine from male mice (or water) does not. This suggests that some degree of functional specificity of the clinical cue is determined at or before the accessory olfactory bulb, perhaps in the expression of specific receptors within the vomeronasal organ, rather than entirely within the central nervous system.

Animals↗

Urine cytology. It is still the gold standard for screening?

Urine cytology remains the gold standard for bladder cancer screening. It is the test against which all others are compared when evaluating potential bladder tumor markers. The answer to whether urine cytology possess the optimal combination of sensitivity and specificity to retain consideration as the best screening device depends on the goals of the clinical practice. Urine cytology has excellent specificity with few false-positive cases. Its overall sensitivity is poor, but this drawback is explained for the most part by poor criteria for identifying well-differentiated, low-grade TCC. The natural history of such lesions is the occurrence of multiple superficial recurrences in 70% to 80% of patients, with only a minority (10% to 15%) progressing to muscle invasive or metastatic disease. Because patients with low-grade TCC are at low risk for progression, they are monitored primarily for the development of a subsequent tumor. One might argue that the detection of new low-grade lesions is of secondary importance to the early detection of disease progression. The performance characteristics of urine cytology in this regard are much improved. Urine cytology often results in the identification of high-grade malignant cells even before a cystoscopically distinguishable gross lesion is present. Routinely diagnosing grade I TCC may be clinically irrelevant. Ancillary techniques to improve the sensitivity of urine cytology have been insufficiently additive to have much clinical value. Several promising bladder tumor markers have been investigated as potential screening tools and are summarized in Table 3. BTA, nuclear matrix proteins, and fibrin/fibrinogen degradation products share lower specificities than urine cytology and may have high rates of false positivity. Telomerase is highly sensitive and highly specific but is not readily available as a point-of-service test. Hyaluronidase and hyaluronic acid are promising prognostic markers, but hyaluronidase does not detect grade I TCC. Early results from studies of this marker await verification. Combining some of these new markers may optimize their performance status, allowing the advantages of one test to correct the shortcomings of another. Likewise, their combination with urine cytology may prove beneficial. Although adding urine cytology has not increased the sensitivity of some point-of-service tests, few studies have addressed the effect on specificity. Until an obvious winner is declared in the race to find a bladder tumor marker, urine cytology will remain the gold standard screening method because of its comfortable familiarity.

Antigens, Neoplasm↗

The efficacy of DDAVP is related to the circadian rhythm of urine output in patients with persisting nocturnal enuresis.

OBJECTIVE: Desmopressin may be a useful treatment in some, but not all, patients with nocturnal enuresis. We have evaluated a relation between nocturnal urine output in patients with primary monosymptomatic nocturnal enuresis and the treatment response to synthetic vasopressin. DESIGN: Adolescent or adult enuretics and normal subjects were enrolled in the study and admitted to hospital for a 24 hour investigation of the diurnal variation in urine output, plasma vasopressin (AVP) and plasma atrial natriuretic peptide (ANP). The enuretics were characterized prior to investigation as either 1-desamino-8-D-arginine vasopressin (DDAVP) responders or non-responders. During admission the fluid intake was restricted to 25 ml/kg per day. PATIENTS: Twenty-four patients (15-37 years) with primary monosymptomatic nocturnal enuresis and 9 normal subjects (24-31 years). MEASUREMENTS: Circulating levels of AVP, ANP, plasma electrolytes and plasma osmolality were measured (1400, 2000, 2300, 0200, 0500 and 0800 hours) together with urine volume, urine osmolality and urine electrolytes during daytime and nighttime. Tubular reabsorptive capacity for water, osmoles and creatinine were assessed as well as urinary and fractional excretion rates of sodium and potassium. RESULTS: Controls and DDAVP non-responders had a significant decrease in urine output at night concomitant with a significant plasma AVP amplitude in peak/nadir values although both groups lacked a significant nocturnal increase in AVP. In contrast, in DDAVP responders there was no circadian variation in urine output and thus a nocturnal polyuria together with no oscillation in plasma AVP. The DDAVP responding group had a nocturnal urine production significantly larger than the two other groups. However, the mean 24 hour AVP levels were similar in all groups. The excessive urine production at night in DDAVP responders was accompanied by nocturnal natriuresis due to an increased fractional excretion of sodium. In contrast, nocturnal antidiuresis in controls and DDAVP non-responding enuretics coincided with diminished sodium excretion. Average ANP levels were elevated in both enuretic groups compared to normals, whereas a circadian variation was detected only in the latter. CONCLUSION: It is concluded that DDAVP responsiveness is linked to the nocturnal urine production and that no pathophysiological role can be ascribed to AVP or ANP in DDAVP refractory adolescent and adult enuretics. Moreover, it is suggested that an abnormal tubular handling of sodium may contribute to the nocturnal polyuria seen in DDAVP responders.

Adolescent↗

A chart audit of factors related to urine flow and urinary tract infection.

BACKGROUND: Clients with long-term urinary catheters are at risk for urinary tract infection (UTI) and catheter blockage that disrupt client/family daily activities. The United States Centers for Disease Control guideline strongly recommends keeping urine flowing to help prevent UTI in this population, but little is known about factors associated with urine flow and how they are related to UTI. AIM: The purpose of this descriptive study was to identify urine flow factors contributing to UTI in home care clients who had had an indwelling urinary catheter for at least 3 months. METHODS: Twenty-four records were reviewed from one home care agency. The sample of 12 males and 12 females ranged in age from 31-102 (mean 70 years, sd 17.2) and they had used a catheter from 5 to 105 months (mean 27.9, sd 32). FINDINGS: Catheter blockage and low urine output were the only 'urine flow indicators' that were significantly related to UTI. Other 'urine flow indicators' were not related to UTI, including bloodstained urine, pulling on the catheter, leakage, and sluggish urine. Thirteen people experienced blockage and 11 did not. Of the 13 with blockage, six had UTI and seven did not, during the 6 months of the review. It was particularly notable that, of the 11 people with no blockage, none went on to experience UTI. CONCLUSION: This finding raises questions about why some people with blockage developed UTI and some did not. We suggest that nurses taught their clients what to do to get the urine flowing, such as, increasing fluid intake or checking for proper placement. Identifying more information from clients about how they monitor and adjust urine flow will be the next step toward understanding how to prevent UTI in those with long-term catheters.

Adult↗

[Scheduled urine collection using disposable diapers with an acoustic signal emitter].

Usually, urine is collected from infants by means of a urine bag. This procedure has some disadvantages, as it can cause discomfort and may even be painful for the child if repeated application of the bags is necessary. Correct placement is difficult for parents or other untrained people and bag displacement is common especially in older mobile children. Urine collection with disposable diapers followed by urine extraction for analysis might be a simple alternative procedure especially for field studies. Urine output is measured by weighing the diapers. A moisture sensor with a sound signal indicates the moment of urination. Stool contaminated diapers must not be excluded from urine collection, if the stool is quickly removed after defecation using diaper liners. Wet diapers are sealed in plastic bags and may be stored at -20 degrees C until extraction. With a hydraulic press urine is extracted from the diapers for measuring concentrations of urinary constituents. After extracting urine after 1 hour and 10 hours contact time only the pH falls significantly. Concentrations of the other constituents tested (creatinine, urea, phosphorus, calcium, sodium, potassium, magnesium, chloride) and total osmolality are not effected. After freezing the wet diapers for storage osmolality and the concentration of creatinine tend to be slightly lower. For clinical practice these effects can be neglected. However, they must be considered using this urine collection method in research.(ABSTRACT TRUNCATED AT 250 WORDS)

Disposable Equipment↗

Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points.

STUDY OBJECTIVE: We compare the test characteristics of urine dipstick and urinalysis at various test cutoff points in women presenting to emergency departments and an intermediate care center with symptoms of urinary tract infection. METHODS: This was a prospective, observational study of adult women presenting to 1 of 2 community hospital EDs or an intermediate care center with dysuria, urgency, or urinary frequency on history, or suprapubic or costovertebral angle tenderness on examination. Patients who had taken antibiotics in the past 72 hours, had indwelling Foley catheters, symptomatic vaginal discharge, diabetes mellitus, immunodeficiency disorders, or were unable to provide a reliable history were excluded. The patient's clean-catch or catheterized urine specimen was tested immediately by a nurse using a Multistix 9 SG reagent strip. A second aliquot was sent within 1 hour of collection to the hospital laboratory, where a semiautomated microscopic urinalysis and a urine culture were performed. A positive urine culture was defined as more than 100,000 colonies of 1 or 2 uropathogenic bacteria per mL of urine at 48 hours. Dipstick and urinalysis data were compared with urine culture results. Sensitivity, specificity, and predictive values were calculated at various definitions of a positive test, or "test cutoff points," for combinations of leukocyte esterase, nitrite, and blood on dipstick and for RBCs and WBCs on urinalyses. The probability of an erroneous decision to withhold treatment on the basis of a negative test result was defined as "undertreatment," or 1 minus the negative predictive value. "Overtreatment" was defined as 1 minus the positive predictive value. RESULTS: Three hundred forty-three patients were enrolled in this study. Twelve patients were withdrawn because of missing laboratory results. Forty-six percent (152/331) of patients had positive urine cultures. If urine dipstick results are defined as positive when leukocyte esterase or nitrite is positive or blood is more than trace, the overtreatment rate is 47% (156/331) and the undertreatment rate is 13% (43/331). If urinalysis results are defined as positive when WBCs are more than 3 per high-power field or RBCs are more than 5 per high-power field, the overtreatment rate is 44% (146/331) and the undertreatment rate is 11% (36/331). Matched pairs of test characteristics were identified when the analysis was repeated using more than 10,000 colonies per mL as a positive culture. CONCLUSION: In this patient population, similar overtreatment and undertreatment rates were identified for various test cutoff points for urine dipstick tests and urinalysis. Although a urine dipstick may be equivalent to a urinalysis for the diagnosis of urinary tract infection, the limitations in the diagnostic accuracy of both tests should be incorporated into medical decisionmaking.

Adolescent↗

Acute maternal rehydration increases the urine production rate in the near-term human fetus.

OBJECTIVE: We sought to investigate the effect of a decrease of maternal plasma osmolality produced by hypotonic rehydration on the fetal urine production rate in normal near-term human fetuses. STUDY DESIGN: Twenty-one healthy pregnant women attending the clinic for antenatal care were studied between 37 and 40 weeks' gestation. The fetal urine production rate was assessed by serial measurements of 3 diameters of the fetal bladder. The hourly fetal urine production rate was determined by linear regression analysis of the calculated bladder volumes versus time and was initially determined after a period of 4 hours of fluid deprivation. Thereafter, the women were asked to drink 1 L of water, and the hourly fetal urine production rate was assessed again. The hourly fetal urine production rate was only studied during behavioral state 1F because it is dependent on the behavioral state. The fetal behavioral state was determined by assessment of fetal heart rate, fetal eye movements, and fetal body movements. RESULTS: Successful recordings were obtained in 10 of the 21 women. The hourly fetal urine production rate increased significantly after hypotonic rehydration (P <.02). Compared with the initial hourly fetal urine production rate after 4 hours of fluid deprivation, the hourly fetal urine production rate showed an increase of 63.2% after hypotonic rehydration, from 38.2 +/- 16.3 mL/h to 62.4 +/- 34.6 mL/h (mean +/- SD). After rehydration, the baseline fetal heart rate fell significantly, from 141 +/- 6 to 132 +/- 8 beats/min (mean +/- SD; P =.005). CONCLUSION: The fetal urine production rate is augmented after acute maternal oral hypotonic rehydration after 4 hours of fluid deprivation. The current findings demonstrate that the near-term human fetus can handle such acute changes in fluid osmolality by increasing the urine production rate to maintain its fluid homeostasis. This mechanism implies that changes in maternal plasma osmolality and volume probably play an important role in determining amniotic fluid volume. Therefore the application of maternal hydration for the treatment of oligohydramnios should be further investigated.

Adult↗

Consumption of sweetened dried cranberries versus unsweetened raisins for inhibition of uropathogenic Escherichia coli adhesion in human urine: a pilot study.

OBJECTIVES: The aim of this study was to determine whether consumption of sweetened dried cranberries elicits urinary anti-adherence properties against Escherichia coli as previously demonstrated with cranberry juice and/or sweetened cranberry juice cocktail, compared to unsweetened raisins. DESIGN: Uropathogenic E. coli isolates were obtained from five women with culture-confirmed urinary tract infections (UTIs). Four urine samples were collected from each subject. The first urine sample was collected before any study intervention. The second urine sample was collected 2-5 hours after consumption of one box (42.5 g) of raisins. The third urine sample was collected 5-7 days later. The final urine sample was collected 2-5 hours after consumption of approximately 42.5 g of dried cranberries. MATERIALS AND METHODS: E. coli isolates were incubated separately in each of the four urine samples collected from the five subjects. Bacteria were harvested from the urine and tested for the ability to prevent adhesion of P-fimbriated E. coli bacteria using a mannose-resistant hemagglutination assay with human red blood cells (A1, Rh+). RESULTS: Of the urine samples collected after dried cranberry consumption, one demonstrated 50% antiadherence activity, two demonstrated 25% activity, and two did not show any increased activity. None of the control urine samples and none of the postraisin consumption samples demonstrated any inhibitory activity. CONCLUSIONS: Data from this pilot study on only five subjects suggest that consumption of a single serving of sweetened dried cranberries may elicit bacterial antiadhesion activity in human urine, whereas consumption of a single serving of raisins does not. Further studies are needed to verify the antiadhesion effect of sweetened dried cranberries. In addition, dose-response and pharmacokinetics of the active compounds in the dried cranberries need to be determined. If clinical research is positive, dried cranberries could potentially be a viable alternative to cranberry juice consumption for prevention of UTIs.

Adult↗

Concordance of human papillomavirus in the cervix and urine among inner city adolescents.

OBJECTIVES: To evaluate concordance for human papillomaviruses (HPVs) between cervix and urine in sexually active adolescents. METHODS: Cervical swabs and urine were collected from 80 adolescents in Baltimore, MD. Specimens were tested for 34 HPVs by PCR and for cancer-associated HPVs by Hybrid Capture (HC II) Probe B. Cervical vs. urine prevalence was evaluated by logistic regression with general estimating equations. Risk factors for prevalence and viral burden were evaluated by Fisher's exact and Kruskal-Wallis tests, respectively. RESULTS: HPV prevalence by PCR, for any HPV, was very high in the cervix (90.0%) and somewhat lower in urine (75.0%) (odds ratio, 1.07; 95% confidence interval 1.07 to 1.34). Only one adolescent was HPV-positive in urine alone. Among HPV-PCR positives at either or both sites, concordance was 82% for presence of any HPV and 40% for specific HPV types. Multiple infections were common at both sites. On an average, HC II viral burden (relative light unit ratio) was 9-fold higher in cervix than in urine (median, 47.3 vs. 4.9; P = 0.005) but correlated poorly between the two sites of the same individual (r = 0.14). Compared with normal adolescents, those with squamous intraepithelial lesions had a much higher prevalence of HPV by HC II in cervix (100% vs. 28.6, P<0.0001) as well as in urine (86.7% vs. 35.4%, P = 0.002) and a significantly higher viral burden in the cervix (median, 141.8 vs. 7.3, P = 0.0045) but not in urine (median, 22.7 vs. 4.38; P = 0.13). CONCLUSION: There was a very high prevalence of HPV in cervix and urine of sexually active adolescents. Testing urine for HPV may be useful in epidemiologic investigations and in monitoring of infected women.

Adolescent↗

Sensitivity and specificity of HIV-1 testing of urine compared with serum specimens: Rakai, Uganda. The Rakai Project Team.

BACKGROUND AND OBJECTIVES: To evaluate a urine HIV-1 test. STUDY DESIGN: Paired urine and blood samples from a sample of 222 subjects were assayed for HIV-1 using Calypte HIV-1 Urine enzyme immunoassay (EIA) with Western blot (WB) confirmation, and sera were tested by EIA and WB. Masked assays were done on stored, refrigerated urine at Johns Hopkins University (JH), and on fresh specimens at the Rakai Project, Entebbe (RP). We assessed the sensitivity and specificity of the urine relative to serum assays. RESULTS: Compliance with provision of urine samples (95.0%) was higher than provision of serum (90.5%). Ninety-six sera were HIV-positive; 92 were HIV-positive on stored urine at JH (sensitivity 95.8%, CI 91.8-99.8%); and 94 (100%) were positive on fresh samples at the RP laboratory (sensitivity = 100.0%). Among serum HIV-negative subjects, all frozen urine were negative at JH and 97.7% of fresh samples were negative at RP. CONCLUSIONS: The Calypte urine HIV-1 EIA with WB is sensitive and specific. In this population, provision of urine was more acceptable than provision of blood samples.

Blood↗

In vitro loss of tensile strength and elasticity of five absorbable suture materials in sterile and infected canine urine.

The loss of breaking strength and elasticity of five absorbable suture materials (polydioxanone [PDS-II], polyglycolic acid [PGA], polyglactin 910 [PG-910], polyglyconate [GTMC], and chromic gut) after in vitro incubation in sterile, Escherichia coli- and Proteus mirabilis-inoculated canine urine was studied. Biomechanical testing, in a controlled environment, was performed during the 28-day study period. Polydioxanone and chromic gut retained greater than 90% of their original strengths after 28 days of incubation in sterile urine and 87% of original strengths in E. coli-inoculated urine. Polyglyconate retained 24% and 18% of original strength, respectively, after incubation in sterile and E. coli-inoculated urine for 28 days. Polyglycolic acid and PG-910 retained less than 30% of original strength in sterile urine and only 7% in E. coli-inoculated urine after 21 days of incubation. In P. mirabilis-inoculated urine, loss of tensile strength and elongation was significant for all suture materials. Polyglycolic acid and PG-910 lost all strength after 24 hours of incubation. Polydioxanone lost all strength after 7 days of incubation, whereas GTMC retained 19% at day 7. Chromic gut retained 78% at day 7 and 16% after 21 days of incubation, however, the absence of normal phagocytic destruction of chromic gut in this in vitro study may have artificially elevated these values. In sterile urine with chemically modified pH, loss of strength and elongation was greater in alkaline urine than in neutral or acidic urine for all types of suture materials.

Animals↗

Rapid identification by the Micro-ID system of Enterobacteriaceae detected by urine screening.

Previous studies have demonstrated that organisms detected by urine screening can be processed for rapid identification and antimicrobial susceptibility testing directly from urine or urine screening broth. In the present study, an improved method for processing such specimens was evaluated. Organisms were harvested by centrifugation from positive urine screening broth, and inocula were prepared for rapid identification by the Micro-ID system and rapid susceptibility testing by the Autobac system. Nearly 2,500 urine specimens were analyzed by urine screening, and 206 specimens had significant growth of gram-negative, oxidase-negative bacilli. These organisms, prepared by the centrifugation procedure, were identified and tested for susceptibility to antimicrobial agents. For comparison, identifications by the Micro-ID system and antimicrobial susceptibility tests by the Autobac system were performed on the same organisms the next day with inocula prepared from colonies growing from standard urine cultures. The results demonstrated that 95% of the organisms were correctly identified by this procedure, and susceptibility testing by the rapid method gave results in 94% agreement with the standard method. These results demonstrate that organisms detected by urine screening can be accurately identified and tested for antimicrobial susceptibility after centrifugation from urine screening broth. This system provides a practical procedure or same-day reporting of urine culture results.

Anti-Bacterial Agents↗

Diagnosis by AMPLICOR PCR of Chlamydia trachomatis infection in urine samples from women and men attending sexually transmitted disease clinics.

Screening of urine specimens from men for Chlamydia trachomatis infection by a commercial PCR assay (AMPLICOR C. trachomatis Test; Roche Diagnostic Systems, Inc., Branchburg, N.J.) is a sensitive and specific noninvasive diagnostic assay. Since screening of women for C. trachomatis infection with the AMPLICOR C. trachomatis Test has been limited to use with endocervical swab specimens, we conducted an evaluation of the AMPLICOR C. trachomatis Test for the detection of C. trachomatis using female urine samples and compared the results of those obtained by in vitro culture and PCR of endocervical swab specimens. For 713 men we compared the performance of AMPLICOR C. trachomatis Test with urine specimens with that of culture of urethral specimens. For specimens that were PCR positive and culture negative, two additional tests were used to resolve the discrepancies: direct fluorescent-antibody assay (DFA) of sediment from a spun endocervical specimen culture vial and major outer membrane protein-based PCR of the sediment from the endocervical specimen culture vial. Of 525 urine specimens from females, 67 (12.8%) were PCR positive, and 41 (7.8%) endocervical specimens from the 525 women were culture positive. After resolution of the discrepancies, the resolved sensitivity of the urine PCR was 93.3%, whereas the sensitivity of endocervical swab specimen culture was 67.3%. Of 468 female endocervical swab specimens, 47 (10.0%) had a positive PCR result and 33 (7.0%) were culture positive. The resolved sensitivity of the endocervical swab specimen PCR was 86%. Of 415 matched female urine and endocervical swab specimens, there were 49 confirmed infections; 30 (61.2%) specimens were positive by culture of the endocervical swab specimen, 40 (81.6%) were positive by confirmed endocervical swab specimen PCR, 43 (87.8%) were positive by confirmed urine PCR, and all 49 (100%) were positive by either endocervical swab specimen PCR or urine PCR. For men, the resolved sensitivity of the urine PCR was 88%, and the sensitivity of culture was only 50.7%. These results indicate that urine PCR is highly sensitive for the detection of C. trachomatis in both women and men and provides a noninvasive technique for routine screening for chlamydial infection.

Ambulatory Care Facilities↗

Antibacterial activity of human urine.

The fate of bacteria in human urine was studied after inoculation of small numbers of Escherichia coli and other bacterial strains commonly implicated in urinary tract infection. Urine from normal individuals was often inhibitory and sometimes bactericidal for growth of these organisms. Antibacterial activity of urine was not related to lack of nutrient material as addition of broth did not decrease inhibitory activity. Antibacterial activity was correlated with osmolality, urea concentration and ammonium concentration, but not with organic acid, sodium, or potassium concentration. Between a pH range of 5.0-6.5 antibacterial activity of urine was greater at lower pH. Ultrafiltration and column chromatography to remove protein did not decrease antibacterial activity. Urea concentration was a more important determinant of antibacterial activity than osmolality or ammonium concentration. Increasing the urea of a noninhibitory urine to equal that of an inhibitory urine made the urine inhibitory. However, increasing osmolality (with sodium chloride) or increasing ammonium to equal the osmolality or ammonium of an inhibitory urine did not increase antibacterial activity. Similarly, dialysis to decrease osmolality or ammonium but preserve urea did not decrease inhibitory activity. Decreasing urea with preservation of ammonium and osmolality decreased antibacterial activity. Removal of ammonium with an ion exchanger did not decrease antibacterial activity, whereas conversion of urea to ammonium with urease and subsequent removal of the ammonium decreased antibacterial activity. Urine collected from volunteers after ingestion of urea demonstrated a marked increase in antibacterial activity, as compared with urine collected before ingestion of urea.

Dialysis↗

Urine makes the difference: chemical communication in fighting crayfish made visible.

Chemical communication is a widespread phenomenon in aquatic animals but is difficult to investigate because the signals are not visible. Here, we present the results of a study into chemical communication in blindfolded fighting crayfish (Astacus leptodactylus) in which we employed a new method: visualisation of urine using the dye Fluorescein. The probability of urine release is greater during fights than during non-social activities or inactivity. The eventual winners are more likely to release urine during fights than the eventual losers. In both winners and losers, urine release is coupled to offensive behaviours, and the probability of urine release increases with increasing levels of aggression. In A. leptodactylus, urine is carried to the opponent by the forward-projecting gill currents. During spontaneous release, urine is fanned laterally with the aid of the exopodites of the maxillipeds. Aggressive behaviour is effective in intimidating blindfolded opponents only in conjunction with urine release: receivers decrease offensive behaviour and increase defensive behaviour. Aggressive behaviour alone does not intimidate opponents. The loser of a recent fight is deterred equally well by a familiar and an unfamiliar opponent. Hence, in crayfish, individual recognition of the urine scent of a dominant individual does not appear to be significant for the maintenance of dominance hierarchies. Our results suggest that urine contains information about the fighting ability and/or aggressiveness of the signaller. The chemical signals thus far unidentified appear to be important in determining the outcome of a fight.

Aggression↗

Urine attenuation ratio: A new CT indicator of renal artery stenosis.

OBJECTIVE: The purpose of our study was to evaluate the value of a ratio of the attenuation measurements of urine in each kidney (hereafter referred to as the urine CT attenuation ratio) in the detection and lateralization of significant renal artery stenosis (RAS). SUBJECTS AND METHODS: In 33 patients with suspected renovascular hypertension and 43 normotensive patients, 5-mm-thick transverse CT scans of the kidney area were obtained 4 min after helical CT angiography (CTA). The attenuation of urine in each kidney was measured, and its ratio was calculated. All 76 patients underwent intraarterial digital subtraction angiography within 2 days after the CT examination. The results of angiography were correlated with the urine attenuation ratio of both kidneys. RESULTS: Twenty-six patients showed significant RAS: unilaterally in 20 and bilaterally in six patients. Two patients showed moderate stenosis of renal arteries. The other patients with essential hypertension (n = 5) or normal blood pressure (n = 43) showed normal renal arteries. The CT attenuation of urine in each kidney was measured and its ratio calculated in all patients except four patients with unilateral RAS. The urine CT attenuation ratio in 22 patients with significant RAS ranged from 1.11 to 4.76 (mean, 2.07). The two patients with moderate RAS showed ratios of 1.83 and 1.23. The others (n = 48) had a urine CT attenuation ratio that ranged from 1.00 to 1.54 (mean, 1.07). The difference of the ratio between the RAS group and the normal group was statistically significant (p < 0.01). The mean urine CT attenuation ratio was 2.18 in patients with unilateral RAS (n = 16) and 1.75 in patients with bilateral RAS (n = 6). The difference of the ratio between the two groups was not statistically significant (p = 0.16). At a cutoff value of 1.22, the sensitivity, specificity, positive predictive value, and negative predictive value of the urine CT attenuation ratio in the diagnosis of significant RAS were 95%, 96%, 91%, and 98%, respectively. CONCLUSION: The urine CT attenuation ratio is a simple and reliable indicator with which to detect and lateralize significant RAS and is a useful adjunct to helical CTA.

Adult↗

Determination of the dosage of clomipramine for the treatment of urine spraying in cats.

OBJECTIVE: To determine the optimal dosage of clomipramine for the treatment of urine spraying in cats. DESIGN: Randomized controlled multicenter clinical trial. ANIMALS: 67 neutered cats. PROCEDURE: Cats with a minimum 1-month history of spraying urine against vertical surfaces at least twice per week were randomly assigned to be treated with a placebo or with clomipramine at a dosage of 0.125 to 0.25 mg/kg (0.057 to 0.11 mg/lb), 0.25 to 0.5 mg/kg (0.11 to 0.23 mg/lb), or 0.5 to 1 mg/kg (0.23 to 0.45 mg/lb), p.o., every 24 hours for up to 12 weeks. Owners of all cats were given information on behavioral treatment and environmental modification. RESULTS: Prior to treatment, mean number of urine spraying events ranged from 0.9 to 1.3 urine spraying events/d for the 4 groups, and mean percentage of days with urine spraying events ranged from 62% to 69%. All 3 dosages of clomipramine were associated with significant reductions in frequency of urine spraying. Sedation was the most common adverse effect and was identified in 27 of the 50 cats treated with clomipramine; however, treatment was not discontinued in any cat because of sedation. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggest that compared with a placebo, clomipramine significantly reduces the frequency of urine spraying in cats in terms of the number of urine spraying events per day and the number of days with urine spraying events. For cats with urine spraying, the recommended initial dosage of clomipramine is 0.25 to 0.5 mg/kg, p.o., every 24 hours.

Administration, Oral↗

Significance of group B streptococci in urine cultures from males and non-pregnant females.

Over a 2-year period, 1% of 24,000 urine cultures with possible relevant bacteria from males and non-pregnant females greater than or equal to 15 years of age were found to harbour group B streptococci (GBS) in quantities greater than or equal to 10(5) colony forming units (cfu)/ml; a further 0.9% harboured GBS in quantities greater than or equal to 10(4) but less than 10(5) cfu/ml. Patients with GBS in urine were evenly distributed by age. Those with greater than or equal to 10(5) cfu GBS/ml in voided urine more frequently had true bacteriuria (i.e. bacteria in the urine bladder) than did patients with less amounts (p = 0.01) as determined by suprapubic aspiration of 23 patients. One third (3/9) of the aspirated patients with greater than or equal to 10(5) cfu GBS/ml in simultaneously voided urine, had contaminated urine only and no true bacteriuria. The acute symptoms and clinical conditions of 128 patients with greater than or equal to 10(5) cfu GBS/ml urine were studied by matching 128 patients with negative urine cultures (less than 10(2) cfu/ml) and 128 patients with comparable quantity of Escherichia coli. The incidence of acute lower urinary tract symptoms in patients with GBS was greater than that in patients with negative urine cultures (p less than 0.01), and the same as that in patients with E. coli. The incidence of fever was lower in patients with GBS than in those with E. coli (p less than 0.01). The incidence of urinary tract abnormalities was greatest in patients with GBS in urine. No GBS serotype seems to have particular affinity to the urinary tract.

Adolescent↗