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Evaluation of ceftazidime concentration released in agar from an E test strip.

The aim of this study was to evaluate, using high-performance liquid chromatography, the concentration of ceftazidime in agar released from an E test strip, sampling at the edge of the strip at different points (1, 2, 4, 8, 16, 32, 64, and 128 microg/ml) at 6, 15, and 24 h after its deposition on uninoculated plates. From 6 to 24 h, the ceftazidime concentration in agar increased at the graduations 1, 2, and 4 microg/ml (+140, +82, and +58%, respectively), remained fairly constant at 8 microg/ml (-1.9%), and decreased at 16, 32, 64, and 128 microg/ml (-25, -44, -36, and -58%, respectively). In the 6-24 h range, the ceftazidime concentrations between 16 and 1 microg/ml were +/-1 serial dilution of the values reported on the strip, confirming the accuracy of the E test in agar.

Agar↗

Bedside urinary chloride measurement: assessment in the acute setting.

In 100 random urine samples from hospitalized patients, the results of a rapid bedside test for urinary chloride (Quantab chloride titrators) were compared with those of the hospital laboratory. Renal chloride retention (less than or equal to 20 mEq/L) was recognized using the titrator in 25 of 27 samples. There were no falsely low results in samples containing greater than 20 mEq/L by laboratory analysis. The titrator strips should aid in rapid diagnosis of conditions in which the recognition of renal salt retention is important.

Chlorides↗

Color vision in diabetic school children.

The color vision of 64 diabetic school children was studied. Acquired color vision defects due to diabetes could not be found in any of the children. Two of the children had a congenital red-green color vision defect. In the examination, three different pseudoisochromatic plate tests (Isihara, Standard Pseudoisochromatic Plates part 2, and Lanthony Tritan Album) were used as well as the Nagel anomaloscope and three different cap arrangement tests (Panel D 15, Lanthony Desaturated Panel, and Farnsworth-Munsell 100 hue). The plate tests and the anomaloscope examination were fast, reliable, and well accepted by the children. The cap arrangement tests took more time, and many of the children neither liked nor properly performed these tests. Twelve color dependent glucose strip tests for diabetes care at home were also studied. A few of the youngest school children made mistakes in interpreting the colors of these strips, although their color vision was normal.

Adolescent↗

[Examination of urine in the office].

Urinalysis is a major basic examination that makes demands on the physician's knowledge and experience. The assessment of the color and smell already provide the doctor with important diagnostic information. For rapid orientation, test strips (pH, sugar, nitrite, bilirubin, protein, ketone bodies, urobilinogen, erythrocytes, leukocytes, etc.) and dip-slides (orientation for the presence of bacteria, semiquantitative determination) are available.

Diagnosis, Differential↗

A test strip method for visual and reflectometric reading of blood glucose.

A double field glucose oxidase test strip, B-M Haemoglucotest 1-44 R, was tested for stability of reaction and comparability of visual and reflectometric readings (evaluating four reflectometers) with a standard laboratory glucose oxidase analysis and showed excellent precision and accuracy within the whole range when estimated immediately. Readings after 1 and 7 days showed a systematic and increasing error with time, with spuriously high and low values in the lower (less than or equal to 4.0 mmol/l) and higher (greater than or equal to 8.1 mmol/l) part of the range, respectively. In the lower range, however, the error was in the order of 1 mmol/l only, thus stability of the reaction allows mailing the strips to the clinic for rechecking.

Blood Glucose↗

Validation and inter-examiner agreement of mutans streptococci levels in plaque and saliva of 10-year-old children using simple chair-side tests.

Since there are few validation studies of chair-side tests of oral mutans streptococci, we compared a commercially available strip test with the conventional laboratory assay. Two plaque samples obtained from the mesial surfaces of the upper right and lower left permanent molars of sixty-five 10-year-old children (boys = 38, girls = 27) were cultured and incubated using chair-side site strip tests (Dentocult SM, Orion Diagnostica). Two plaque sampling tools, namely dental floss and micro-brush, were compared, and inter-examiner agreement between recordings of three examiners was assessed. Paraffin-stimulated saliva was then collected for laboratory and chair-side assays. The plaque and saliva chair-side tests correlated well with each other (Spearman rho, r = 0.72) and with the laboratory method, showing coefficients of 0.76 and 0.80 for saliva and plaque, respectively. Compared to the laboratory method, the sensitivity (Sn), specificity (Sp), accuracy (A), and kappa (K) values of the salivary and plaque chair-side tests were 0.63, 0.75 (Sn), 0.93, 0.90 (Sp), 0.82, 0.85 (A), and 0.58, 0.66 (K), respectively. Agreement between the two plaque sampling techniques was good (0.91). Inter-examiner agreement of plaque scores ranged between 0.65 and 0.86 when all density categories were analysed separately; when dichotomized into low and high categories, complete agreement was found. Agreement between the plaque and saliva chair-side tests and the laboratory salivary assay was good, and in terms of sensitivity, accuracy, and kappa values, the site strip plaque test surpassed the salivary chair-side test.

Child↗

Audit in a diabetic clinic.

Diabetic control was assessed in 82 established insulin-dependent diabetics using a microcapillary system for home preprandial blood glucose sampling. At initial assessment control in the majority (62%) was found to be unsatisfactory (at least 1 preprandial blood glucose greater than 13.0 mmol/l or frequent and severe hypoglycaemia). Sixty-three of these patients were assessed on more than one occasion. Only 24% were satisfactorily controlled at their first assessment, but this proportion had risen to 60% after 12 months. The ability of patients to perform unsupervised blood glucose levels using Ames Glucometers or BM-Glycemie 20-800 test strips was also assessed: 86% of the meter results were within one-third of the laboratory-based results, but there was evidence of bias towards the under-reading of higher glucose values using BM-Glycemie 20-800 test strips. Random blood glucose estimations performed in the diabetic clinic were of little value.

Blood Glucose↗

[Predictive value of reactive strips in urinary infection].

The microbiologic method to confirm or not the diagnosis of urinary tract infection is usually the culture and Gram-stain of the clean-catch midstream urine. Nevertheless, this is a costly and time-consuming method. We tried to evaluate the positive and negative predictive value of the nitrite and leucocyte-esterase reactive strips as an alternative method. When both the two parameters are negative it is fairly safe to exclude the urinary tract infection.

Humans↗

Conjugate release materials in lateral-flow assays.

Conjugate release materials are considered to be the most problematic area in lateral-flow strip development. This article describes how these materials can be optimised to give a high and consistent degree of conjugate release for a minimum of 18 months.

Equipment Design↗

[Usefulness of protein/creatinine ratio in spot urine using test strips].

The influence of concentration and dilution has been the major issue of urinalysis. This study is to evaluate the usefulness of protein (P)/creatinine (C) ratio (P/C ratio) in spot urine by test strips method. For this purpose, the basic performance of creatinine test strips is evaluated and judging criteria for the urine P/C ratio is defined. Our evaluation revealed that the creatinine test strips were basically not affected by substances which have similar composition to creatinine, such as creatine, but by some medical agents and disinfectant. Its minimum detective sensitivity was 6.0 mg/dl, while that of protein test strips was 1.3 mg/dl. We determined judging criteria for the P/C ratio as follows: Below 80 mg/gCr, Normal; 80 to 500mg/gCr, 1 +; over 500 mg/gCr, 2+. The P/C ratio based on the quantitative and test strips methods provided good consistency of 82.2%. In low-creatinine urine samples (11 to 99mg/dl), 181 of 216 samples (83.8%) were tested negative on single-protein tests; while the P/C ratio provided fewer negative results, 134 of 216(62.0%). Moreover, in high-creatinine urine samples (200 to 600 mg/dl), 70 of 122 samples (57.4%) were tested negative on single protein tests; while the P/C ratio provided negative results in almost all the samples, 120 of 122 (98.4%). These urine samples were mostly collected at a medical examination. The results above showed that the P/C ratio obtained by easy and quick test strip method is equivalent to the quantitative method in performance and useful for spot urine testing.

Creatinine↗

Tear glucose estimation--an alternative to blood glucose estimation.

Dextrostix, being very sensitive to measure glucose level by glucose oxidase method, was chosen to measure tear glucose level to evaluate the relationship of tear glucose to blood glucose level in 94 cases. It was found that in our population the measurement of tear glucose has definite value in interpretation of glucose status of individual. So, it was suggested to use this simple method of detection of tear glucose to interpret hyperglycaemic state of the patients. The present study was undertaken (1) to sort out a definite relationship between tear and plasma glucose concentration and (2) to devise a rapid method for detection of tear glucose level semiquantitatively with glucose oxidase impregnated strips and to evaluate its role as indicator of plasma glucose level.

Blood Glucose↗

[Biochemical glucose test x glucose strip test: results of 464 determinations in pre-term infants].

The preterm infant frequently requires glucose level monitorization. This paper compared determinations of blood glucose by two methods: glucose strip test and biochemistry. There was determined 464 pairs of glucose levels by both methods in 40 preterm infants receiving glucose infusion. The hypoglycemia interval showed that the precision of strips was lower than the biochemical method. The same was found in hyperglycemia interval, but the result was a few better. Concluding, the authors emphasize the use of glucose strip test only for screening and the biochemical test for treatment.

Blood Glucose↗

Glucorrhea revisited. Prolonged promulgation of another plastic pearl.

Glucose oxidase test strips were used to evaluate the presence of glucose in nasal secretions and tears in a group of normal children. Substantial amounts of glucose were present in 15 of 17 samples of nasal discharge and 10 of 15 samples of tears. The use of glucose oxidase test strips for diagnosis of cerebrospinal fluid rhinorrhea, therefore, is without merit.

Cerebrospinal Fluid Rhinorrhea↗

Reliability of glucose measurement by glucose test strips in tropical conditions.

The reliability of glucose test strips and reflectance meters after storage in tropical conditions was assessed. In a first experiment, sealed bottles containing glucose test strips were stored for 1 month in closed sterilising ovens at 40 degrees C, one in dry (0% humidity) and the other in wet (75% humidity) conditions. Results were compared to measurements obtained with glucose test strips stored under standard Western conditions, in non-diabetic and diabetic patients, using the same standard reflectance meter. A second experiment was performed similarly, comparing the values obtained with reflectance meters stored in different conditions, using standard glucose test strips. Reproducibility was assessed on the basis of duplicate measurements for each condition of storage. We observed that temperature and humidity did not significantly affect the glucose test strips (1st experiment), while a slight underestimation of capillary blood glucose was found using reflectance meters stored at 50 degrees C, irrespective of the humidity (2nd experiment). All the correlation coefficients between duplicates were greater than 0.975 irrespective of the conditions of storage for glucose test strips and reflectance meters. Therefore, glucose test strips and reflectance meters appear fairly reliable at the grass-root level in the tropics, if used carefully.

Blood Glucose↗

Rapid identification of pathogenic Neisseria species and Branhamella catarrhalis.

Two systems, the Identicult-Neisseria (IDN; Scott Laboratories, Inc., Fiskeville, R.I.) strip and the Neisseria/Haemophilus Identification Test Kit (NHI; Vitek Systems, Inc., Hazelwood, Mo.) card, were compared with the 4-h Minitek system (BBL Microbiology Systems, Cockeysville, Md.) for their ability to rapidly identify 157 pathogenic Neisseria and Branhamella catarrhalis isolates. IDN, limited in its identification to four species, when incubated at 35 degrees C for 10 min identified 99% of the isolates. However, when IDN was incubated at 22 degrees C for 20 min, it identified only 92% of the isolates. The NHI card, a rapid semiautomated system with the ability to identify 25 organisms to the species level, correctly identified all of the isolates. A test for beta-lactamase production included in the NHI card identified the 12 Neisseria gonorrhoeae and 10 B. catarrhalis beta-lactamase-positive isolates included in the study. The IDN strip (35 degrees C) and the NHI card compared favorably with the Minitek system.

Moraxella catarrhalis↗

Visual interpretation of blood glucose test strips.

Patients with type II, non-insulin-dependent diabetes mellitus (NIDDM) typically are middle-aged or older and often have diabetic retinopathy. The visual acuity of these patients also is likely to be reduced beyond what is normally associated with age. Because Medicaid does not reimburse NIDDM patients for a blood glucose meter unless they are insulin-dependent, many low-income diabetes patients are required to monitor their blood glucose levels by visually comparing the color spot on the blood glucose test strip with a series of standard color blocks. Unless patients can accurately assess their blood glucose levels by visual interpretation of the test strips, they will have difficulty maintaining adequate glycemic control. In this study, 60 nondiabetic adults, ages 20 to 78 years, were unable to adequately assess blood glucose levels visually, even under optimal lighting conditions. Younger adults made the same number of errors as older adults, and poor visual acuity and high blood glucose values were associated with more errors. These findings suggest that patients with poor visual acuity or those who read their blood glucose strips in less-than-adequate lighting will make even more errors than our test subjects.

Adult↗

Ketone bodies in milk and blood of dairy cows: relationship between concentrations and utilization for detection of subclinical ketosis.

The objective of this study was to investigate the relationship between the concentrations of the different ketone bodies in milk and blood and to evaluate these concentrations for the detection of subclinical ketosis. A total of 60 multiparous cows were used. Concentrations of acetone, acetoacetate, and beta-hydroxybutyrate were analyzed quantitatively in blood and milk, and the Ketolac strip test was used for semiquantitative determination of beta-hydroxybutyrate in milk. Cows were defined subclinically ketotic when their concentration of blood beta-hydroxybutyrate was over 1200 micromol/L. High correlation coefficients were observed between blood acetone and blood acetoacetate, and between blood and milk acetone. On the contrary, concentrations of milk and blood beta-hydroxybutyrate were poorly correlated with the other concentrations of ketone bodies. The Ketolac strip test overestimated the concentrations of beta-hydroxybutyrate in milk. For the detection of subclinical ketosis, the best sensitivity-specificity combination was obtained with the determination of acetoacetate in blood or milk, with threshold concentrations of 125 and 50 micromol/L, respectively. Determination of beta-hydroxybutyrate in the milk via an enzymatic analysis or via the Ketolac strip test provided valuable results, with threshold concentrations of 70 and 100 micromol/L, respectively. The simplicity of use of the Ketolac strip test makes it a valuable way to investigate subclinical ketosis.

3-Hydroxybutyric Acid↗

A comparison of pH determination methods in food animal practice.

The accuracy of a portable pH meter in measuring blood pH in neonatal calves, urine pH, and ruminal fluid pH in cows has been assessed. Thirty-five diarrheic and 15 healthy beef calves were used for blood gas analysis; 57 healthy dairy cows provided voided urine samples; and ruminal fluid samples were obtained from 10 dairy cows with ruminal fistulas on 4 separate days. Measurements of blood pH were obtained from an automated blood gas analyzer and the portable pH meter. Measurements of urine and ruminal fluid pH were determined with the benchtop pH meter, urinalysis strips, narrow range pH paper, and the portable pH meter. The portable pH meter was more accurate in measuring urine pH and ruminal fluid pH in cows than blood pH in neonatal calves. The urinalysis strips and the narrow range pH paper were found adequate to evaluate urine and ruminal pH.

Animals↗