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Urine culture screening in lithotripsy compared with traditional methods.

The authors compare biochemical screening tests with microscopy, cultures, and patient symptoms in 257 patients who visited the Urology-Lithotripsy Unit. They conclude that strip screening and microscopy were poor methods to screen for UTI in patients with stents and raise the question whether all stent patients or just symptomatic stent patients should have urine cultures. The authors also suggest that UTI can be eliminated as a diagnosis in 45% of non-stent patients by using strip screening and not doing further testing. These recommendations have quality improvement and cost effectiveness implications.

Acute Disease↗

The use of the Rapignost strip for estimating urinary amylase levels.

The Rapignost-Amylase urinary test strip (Behringwerke Laboratories) provides an estimation of urine amylase which takes a few minutes and is easy to perform. During a period of 9 months, 84 patients had their urine tested with this strip by casualty officers in the Accident and Emergency Department of St George's Hospital, London. In addition, urine amylase, and plasma amylase and creatinine were measured in the chemical pathology laboratory. In all but one instance, the result of the strip test agreed with the laboratory result. The Rapignost strip should prove useful in screening for acute pancreatitis in situations where there is likely to be a delay in obtaining a laboratory amylase result.

Acute Disease↗

Assessment of a new blood glucose strip: comparison of Visidex, Visidex II, and Chemstrip bG with Glucose Analyzer determination of blood glucose.

Chemical test strips for estimating blood glucose are reliable, rapid, and convenient when properly used. Ames (Miles Laboratories, Elkhart, Indiana) has recently introduced a new product, Visidex II, which does not require water for development. This study compares the Visidex II with its predecessor Visidex, an established test strip, the Bio-Dynamics Chemstrip bG (Boehringer-Mannheim, Indianapolis, Indiana), and plasma glucose as measured by standard laboratory methods. Determination of blood glucose by visual inspection by all chemical test strips gave an estimation of true plasma glucose, and was reliable in predicting those values that were hypo- and hyperglycemic, although Chemstrip bG tended to underestimate in the hypo- and euglycemic ranges. Visidex II is more convenient to use than Visidex and is equally reliable in estimating true plasma glucose. In addition, strips from 20 patient samples were read daily for 7 days. Reacted Chemstrip bG test strips began to deteriorate within 24 h, and showed a 27% decline in estimations by day 3. Reacted Visidex II strips were stable for 1 day, but then rapidly declined to 50% of the original estimation by day 4.

Blood Glucose↗

[Determination of low blood glucose levels in newborns with the reflectance photometer (author's transl)].

The paper reports the examination of a new test strip Reflotest-Hypoglycemie, which was developed specifically for the hypoglycemic range. In 2 series of 110 respectively 120 samples of capillary blood taken from premature and full term infants the blood glucose concentrations were determined using Reflotest-Hypoglycemie and the hexokineasured with the test strip agree well with the results of hexokinase method in a range less than 50 mg/dl. Bilirubin and hematocrit values do not affect the glucose test. Glutathion and ascorbic acid interfere with the test strip method but this error is neglectable because of physiological low concentrations of these substances.

Blood Glucose↗

Evaluation of a new chemical dip strip for detecting ketonemia in the emergency setting.

The utility of a new urine dipstick, Chemstrip uK, was evaluated using serum in place of urine to quantify serum ketones in 29 acutely ill patients with suspected ketosis treated in the emergency department. The serum Chemstrip uK method accurately predicted the level of ketonemia as assessed by the Acetest tablet method (r = .94; P less than .0001). There were no false-negative and no false-positive results. The use of this strip is recommended for evaluating subjects with suspected ketosis.

Adolescent↗

Analytical validation of the new plasma calibrated Accu-Chek Test Strips (Roche Diagnostics).

BACKGROUND: The Accu-Chek Inform glucose monitor is a point-of-care system for testing blood glucose. New test strips, calibrated to deliver glucose plasma-like values, were launched on the market in May 2005. The aim of our study was to perform analytical validation of these new strips. METHODS: We compared the new plasma strips with whole blood strips; results for the plasma strips with plasma values obtained using a clinical analyzer and with whole blood values given by the glucose electrode of a blood gas analyzer; and the influence of the type of blood (capillary or venous) on the results obtained by the glucose monitor with the plasma calibrated strips. RESULTS: Plasma strips give on average 7% higher results than the previous whole blood strips. However, the results given by the plasma strips on capillary whole blood, even if well correlated, are not completely comparable with those given by an analyzer for venous plasma. Nevertheless, these plasma strips and the glucose electrode of a blood gas analyzer give comparable results. CONCLUSIONS: Accu-Chek Inform plasma strips are a good method for monitoring of blood glucose values in patients with diabetes.

Blood Chemical Analysis↗

Evaluation of five cowside tests for use with milk to detect subclinical ketosis in dairy cows.

The objective of this study was to evaluate the characteristics of five ketone tests for use with milk to detect subclinical ketosis [defined as > 1200 mumol of beta-hydroxybutyrate (BHBA)/L of blood] in dairy cows. The tests studied were the Ketolac BHB strip to detect BHBA (Hoechst, Unterschleissheim, Germany) and four tests based on sodium nitroprusside to detect acetoacetate (Rothera tests) [Ketostix strip (Bayer, Etobicoke, ON, Canada), Bioketone powder (Societé d' Analyses Biopharmaceutiques, Laval, QC, Canada), Ketocheck powder (Great States, St. Joseph, MO), and Utrecht powder (University of Utrecht, Utrecht, The Netherlands)]. Milk samples (n = 529) from 266 cows in 25 Ontario dairy herds were used for this investigation. The Ketolac BHB strip at 50 and 100 mumol of BHBA/L of milk showed sensitivities of 92 and 72%, respectively. This test was more sensitive for subclinical ketosis than were any of the Rothera tests. The sensitivities of the Rothera tests were 43, 33, 28, and 5%, respectively, for Utrecht powder, Bioketone powder, Ketocheck powder, and Ketostix strip. The Rothera tests were highly specific, as was the Ketolac BHB strip at 200, 500, and 1000 mumol of BHBA/L of milk (specificity, > 97%). The prevalence of subclinical ketosis was highest during the first 6 wk of lactation, and a peak was detected during the 2nd wk of lactation. Of the tests evaluated in this study, Ketolac BHB strip was the most useful to monitor subclinical ketosis in dairy herds.

3-Hydroxybutyric Acid↗

The Quantab strip in the measurement of urinary chloride and sodium concentrations.

The "Quantab" strip (Ames) measures chloride in fluids. For sodium chloride solutions and urine we found very good correlations between the Quantab reading and the chloride concentration as measured by chemical assay (r = 0.95 for chloride and r = 0.85 for sodium in urine). The strip gave reproducible results over the temperature range 4 to 37 degrees C. There was very little inter- and intra-observer variation in reading the strip. Although 10 to 23 min is required to complete the reaction, the strip reading is stable thereafter. We suggest that the strip could be useful in epidemiological studies of urinary sodium concentration and clinically in helping patients adhere to a low-salt diet.

Chlorides↗

A simple method for the measurement of blood cholinesterase activities under field conditions.

A new separation method using a hand-driven discoidal micro-centrifuge was developed. It is suitable for separating red cells from plasma in field conditions. The amounts of plasma produced are sufficient to be used for the dip-stick estimation of pseudocholinesterase activity. The strip estimations of plasma pseudochoninesterase activity correlated well with the spectrophotometric method of plasma cholinesterase. The test paper methods seem to be reliable under field conditions in acute organophosphate poisonings. To verify the results of the paper strip methods the blood method absorbed on paper can be used. This method is applicable for the measuring of blood cholinesterase activities and thus monitoring humans exposed to organophosphates under field conditions.

Butyrylcholinesterase↗

Comparison of two strip test methods of whole blood glucose measurement in the neonatal period.

UNLABELLED: The aim of this study was to compare the performance and accuracy of the BM Strip test used in conjunction with Reflectance photometry, and the new non-wipe strip test (Advantage) against a reference plasma glucose method. In total, 114 newborns consecutively admitted to the Neonatal Unit over a 6 mo period were enrolled into the study. Each newborn had their venous blood glucose measured by the BM Strip test and Advantage glucometer and the venous haematocrit was also determined. Plasma glucose was measured in the laboratory by the hexokinase method. The mean difference between the BM Strip test and plasma glucose was significantly less than the corresponding value for the Advantage glucometer (0.312, 95% confidence interval (CI) 0.11-0.51 vs 0.766, 95% CI 0.57-0.95], although the limits of agreement between both methods and plasma glucose were wide. Haematocrit did not influence significantly the accuracy of either test. CONCLUSION: The new Advantage glucose meter does not offer any advantage over the BM Strip test. Owing to the wide limits of agreement of both methods compared with plasma glucose, their clinical value is limited in the neonatal period.

Blood Chemical Analysis↗

Comparison of various methods for differentiation of staphylococci and micrococci.

A modified oxidase test (Remel, Lenexa, Kans.) and susceptibility to furazolidone and lysostaphin (Remel) were evaluated in conjunction with the Staph-Ident strip (Analytab Products, Plainview, N.Y.) to accurately differentiate between staphylococci and micrococci. A total of 414 clinical isolates of catalase-positive, gram-positive cocci were each tested with the Staph-Ident strip and by glucose fermentation, acid production from glycerol, susceptibility to furazolidone and lysostaphin, and the oxidase test. Based on the reference methods of glucose fermentation and acid production from glycerol, 396 (95.6%) of the organisms were classified as Staphylococcus species and 18 (4.4%) were classified as Micrococcus species. Of the staphylococci, 99% were oxidase negative and susceptible to furazolidone; 82% were susceptible to lysostaphin. All of the micrococci were oxidase-positive and resistant to furazolidone and lysostaphin. Of the staphylococci, 99% were identified to species by the Staph-Ident strip. However, six (33%) of the micrococci were incorrectly identified as Staphylococcus species (three each of Staphylococcus hominis and Staphylococcus saprophyticus). Because of the demonstrated sensitivity and specificity of the oxidase and furazolidone susceptibility tests, it is suggested that either of these methods be used in the clinical laboratory to accurately differentiate between staphylococci and micrococci. It is also suggested that when working with the Staph-Ident strip, additional testing such as furazolidone susceptibility or oxidase activity should be performed to provide increased accuracy in the differentiation and characterization of members of the family Micrococcaceae.

Bacteriological Techniques↗

Impact of an instructional program on nurses' accuracy in capillary blood glucose monitoring.

This experiment examined the accuracy of capillary blood glucose monitoring using the visual glucose oxidase strip (Chemstrip) procedure. Also, the effects of a certification program for nurses on the accuracy of glucose oxidase strip monitoring by registered nurses were analyzed. Seventy nurses and 123 patients participated. Data were collected from nurses' recordings of visual Chemstrip procedure results and from the concurrent laboratory blood glucose determinations for 3 months. The data included 70 Chemstrip recordings and 70 concurrent laboratory blood glucose recordings in the experimental group and 68 Chemstrip and 68 concurrent laboratory glucose recordings in the control group. Data analysis revealed that the accuracy of the nurses' performance of the glucose oxidase strip procedure was inadequate. A certification program did, however, dramatically improve the accuracy of the procedure. Proximity of time between the certification program and the performance of the glucose oxidase strip procedure did not affect accuracy.

Blood Glucose↗

Clinical usefulness of an enzyme strip for estimation of blood sugar ("Dextrostix") in a tropical medical practice: a 10-year experience.

A series of studies were carried out to assess the usefulness and accuracy of measuring blood sugar levels in a tropical medical practice using an enzyme test strip ("Dextrostix"). The results showed that the method is simple, accurate and reproducible, especially when the colour changes on the strips are interpreted electronically by the reflectance meter or Eyetone instrument. The results are independent of packed cell volume. Sequestrene-containing blood samples maintain a constant level of glucose for 5 hours. The Eyetone can be used for approximate determination of blood glucose levels greater than 400 mg per 100 ml by exposing the strips to blood for only 30 seconds and multiplying the result by two. Where there is no mains supply, the instrument can be operated from a car battery.

Blood Glucose↗

Comparison of Visidex and Chemstrip bG with Beckman Glucose Analyzer determination of blood glucose.

Chemical test strips for estimating blood glucose have been shown to be reliable, rapid, and convenient when properly used. This study compares a new product, the Ames Visidex (Miles Laboratories, Elkhart, Indiana), and an established product, the Bio-Dynamics Chemstrip bG (Boehringer-Mannheim, Indianapolis, Indiana) with plasma glucose as measured by standard laboratory methods. Determination of blood glucose by visual inspection of both chemical strips gave an estimation of true plasma glucose in the hypoglycemic and euglycemic ranges. Both strips were reliable in predicting those values that were hyperglycemic (greater than 180 mg/dl).

Blood Glucose↗

Assessment of a new visual blood glucose strip.

A new double-tipped strip for home glucose monitoring without a meter is described. Comparison between values obtained with the new method by trained nursing staff and those obtained with a glucose-oxidase analyzer demonstrates close correlation between the two methods (r = +0.95, a = +22.2 mg/dl, b = +1.14). The mean concentration in 117 strip tests over an analyzer range of 5-775 mg/dl (0.3-43.0 mmol/L) was 52 mg/dl (2.9 mmol/L) greater than the analyzer estimate. Forty-seven percent of samples were read as the color block closest to the analyzer estimate. Samples in the lower glucose range tended to read one block high. The technique is faster to perform than most other visual blood glucose strip methods, and is a useful addition to the equipment available for home glucose monitoring. Modifications to the strip by the manufacturers appear to have overcome the low value over-reading error.

Autoanalysis↗

Effect of storage in light and dark on accuracy of blood glucose test strips.

Two-hundred and twenty-five BM 20-800 blood glucose test strips were developed from a series of blood samples spanning their glucose range. Groups of 75 strips were stored under three differing sets of conditions. The change with time of the mean indicated blood glucose concentration of the strips during storage in light or dark conditions was recorded. Strips stored on a ward chart in the light faded slowly with time. Storing with a Sellotape covering accelerated the fading process. In contrast developed strips were found to be stable when stored in a sealed tin in the dark. Three rules of thumb have been derived to allow retrospective estimation of the initial indicated blood glucose concentration of strips stored for up to 10 days on a bedside chart in the light without a Sellotape covering. Sealed tin storage would allow clinic based quality control of home blood glucose monitoring.

Blood Glucose↗