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Rapid methods for biochemical testing of anaerobic bacteria.

Rapid biochemical tests for nitrate, indole, gelatin, starch, esculin, and o-nitrophenyl-beta-D-galactopyranoside were performed on 112 strains of anaerobic bacteria. All tests were incubated under aerobic conditions, and results were recorded within 4 h. The tests for nitrate, indole, and starch showed a 95% or greater correlation when compared to the standard biochemical tests. Tests for esculin and gelatin showed an agreement of 86 and 77%, respectively. PathoTec test strips for nitrate, indole, esculin, o-nitrophenyl-beta-D-galactopyranoside, Voges-Proskauer, and urease were also tested and showed encouraging results.

Anaerobiosis↗

[Leukocyte esterase in the rapid detection of intraamniotic infection].

Several lines of evidence support the view that premature rupture of the membranes and premature labor are associated with bacterial infection of the amniotic cavity. The standard method of diagnosing intraamniotic infection is amniotic fluid culture, but the results become available only after 72 hours. Methods for more rapid diagnosis of bacterial invasion are therefor needed. We examined leukocyte esterase activity for this purpose. Amniotic fluid obtained from 62 women in preterm labor was cultured for aerobic, anaerobic and mycoplasma species. Leukocyte esterase activity was measured with a Bio-dynamics test strip. The sensitivity of the test was 50.0% and its specificity 93.4%. It was found to be a simple and rapid method for the detection of intraamniotic infection.

Amniotic Fluid↗

[Detection of saliva traces using test strips].

The test strip Rapignost-Amylase (Behring) for the rapid determination of alpha-amylase in the urine is also suitable for the determination of salivary amylase in stains stored up to 6 weeks at room temperature. The stains are extracted with physiological saline (extraction time 30 min), then the application zone of the strip is wetted with the extract. Positive amylase-reaction is recognised as a reddish-violet colouration of the reaction zone. Biological stains with low amylase concentrations (urine semen, vaginal secretion, mucus) react amylase negative. The method is uncomplicated and can be completed within 30 min. The test strips are easily available and stable during storage. Therefore the determination of saliva with test strips should be preferred to the clinical methods if the storage times of the stain are not longer than 4-6 weeks. It is a suitable procedure to determine salivary stains for use in forensic biology.

Forensic Medicine↗

Evaluation of the Strep-A-Fluor identification method for group A streptococci.

Strep-A-Fluor (Bio Spec, Inc., Dublin, Calif.) is a new test designed for the rapid identification of group A streptococci. A filter paper strip impregnated with a synthetic substrate is used to detect a specific aminopeptidase present in group A streptococci by UV fluorescence. In a blind study, 305 beta-hemolytic streptococcal isolates were correctly categorized as group A or non-group A.

Bacteriological Techniques↗

Unsatisfactory performance of flow cytometer UF-100 and urine strips in predicting outcome of urine cultures.

UF-100 flow cytometer and urine strip results were cross-interpreted to predict culture outcomes. The best negative predictive value was obtained with bacteria at > or =1,000/microl, white blood cells at > or =20/microl, or leukocyte esterase positivity. Nine of 24 false negatives were clinically significant. Thus, UF-100 and urine strip results do not accurately predict the outcome of cultures.

Adolescent↗

The strip test for hypolactasia also works without ethanol.

Detection of urinary galactose with a special test strip has been shown to work well with the lactose tolerance test with ethanol. In this study the strips were used in combination with a lactose load alone or with another alcohol, beta-pyridylcarbinol, and the results were compared with those of the urinary lactose tolerance test with ethanol (ULTTE) as the reference method. Sixty-nine patients were studied. With lactose alone the specificity was 83%, the sensitivity 88%, and the kappa coefficient 0.61. It is concluded that the strip test for hypolactasia works without ethanol with sufficient reliability for the daily clinical work of a general practitioner. Adding beta-pyridylcarbinol to the test does not markedly increase the validity of the test.

Adult↗

An evaluation of NicCheck I: a dipstick method for analyzing nicotine and its metabolites.

This study examined the reliability of a test strip for assessing urinary nicotine and its metabolites. Urine samples from smokers were tested by two independent raters using the NicCheck I test strips. Each rater compared the test strip color to a five-color chart. Correlations between the rater's codings and between the coding and other measures of nicotine consumption were examined. Significant correlations were found between the two independent ratings of the test strip color and between the codings and other measures of nicotine consumption. This preliminary evaluation suggests that NicCheck I is sensitive to differences in nicotine consumption.

Adult↗

[Results obtained using de "Meckrognost Harnstoff" strip method in estimating plasma urea concentrations in dogs (author's transl)].

The "Merckognost Harntoff" strip method described in a previous paper was recently modified by the manufactures. An important alterations consisted in the method by which samples were applied to the strips, viz. using micropipetters rather than by dipping. In view of the findings in the comparative study reported, the results obtained on dipping are regarded as superior, the method also being easier to handle. However, the prescribed correction factor should be used.

Animals↗

Development of a rapid method using nucleic acid sequence-based amplification for the detection of astrovirus.

We have developed a rapid method to detect astrovirus in fecal specimens utilizing nucleic acid sequence-based amplification (NASBA) and several detection methodologies, including a sandwich hybridization assay based on DNA-tagged liposomes (liposome-strip detection assay). RNA was extracted from 65 stool specimens that were positive for astrovirus by enzyme immunoassay and was amplified by both NASBA and reverse transcriptase PCR (RT-PCR). Also extracted and amplified were 19 specimens containing rotavirus, 20 specimens containing norovirus, five specimens containing adenovirus, 15 water negative control specimens, and eight specimens containing astrovirus reference strains. NASBA products were detected by electrochemiluminescence detection (ECL) and by liposome-strip detection; RT-PCR products were detected by ethidium bromide staining following gel electrophoresis and by liquid hybridization assay (LHA). There was no significant difference in the detection rates of NASBA- and RT-PCR-based assays, with one exception in which the NASBA/ECL assay detected astrovirus in eight specimens that tested negative by the RT-PCR/LHA assay. These results suggest that these NASBA-based detection methods have detection rates that are as good as or better than those of RT-PCR-based methods. Both NASBA and liposome-strip detection may be useful for field studies and environmental testing because these methods are rapid and do not require specialized equipment.

Astroviridae Infections↗

[Diabur-Test 5000 - a new test strip for urinary sugar control in diabetic patients (author's transl)].

Diabur-test 5000, a new test strip for estimation of urinary glucose, was compared with the hexokinase glucose-6-phosphate dehydrogenase method in more than 2500 urine samples. By combination of two test ranges glucose concentrations of up to 5% can be detected by the strip test. After a reading time of 2 minutes, very precise estimation of urinary glucose is possible in eight steps from negative to 5%. False estimations of more than one color step virtually do not occur. Ketone bodies, salicylic acid and several antibiotics do not influence the test strip. Ascorbic acid shows a slight influence only in concentrations above 40 mg/dl. This influence disappears with glucose concentrations of more than 0.5%. Good correlation with the reference method, wide range of readings and simple handling make the test strip suited for the laboratory and particularly for self control of diabetic patients.

Anti-Bacterial Agents↗

Evaluation of Visidex II--a new strip for blood glucose measurement.

We have evaluated a new blood glucose test-strip (Visidex II, Ames), which does not require washing with water after contact with blood. Visidex II showed a significant negative bias when compared with a similar diagnostic strip (BM 20-800, Boehringer) and with the Beckman II glucose analyser (p less than 0.001 in both cases), and a poorer correlation with either method than BM strips with the Beckman II. A significant number (6.3%) of Visidex strips in this study were unreadable due to removal of the colour pads on blotting, and some difficulty was reported by patients in reading values around 6-8 mmol/l. Visidex II can safely be stored in the refrigerator and developed strips may be stable longer than BM strips. A significant error in reading was noted if the incubation time was varied by +/- 5 seconds. Further experience and perhaps some modifications may be necessary before Visidex II can be recommended for widespread use.

Blood Glucose↗

[Treatment and glycemic control of 1200 diabetic patients enrolled at the National Institute of Disease-Disability Insurance diabetes convention].

We have studied the characteristics of insulin therapy and home blood glucose monitoring of 1.200 diabetic patients (590 males, 610 females), mainly type I adults (age: 43 +/- 19 years, mean +/- 1 SD), attending a licensed diabetes center in Belgium which benefits from a National Health Service convention system for providing education and home blood glucose monitoring kits and disposables to diabetic subjects. 50% of these patients were treated with 2 daily insulin injections, while 22% were treated with 3 and 24% with 4 daily injections. 4% of the subjects were treated with a continuous subcutaneous insulin infusion. Patients treated with four daily injections were younger than those treated with other insulin schemes (p < 0.001). Home blood glucose monitoring strip consumption was 2.2 patient-1 day-1. The mean HbA1C level was 8.63 +/- 1.55% [8.54 +/- 1.46 in males and 8.72 +/- 1.62% in females (NS)]. In more than one third of the subjects treated with injections, HbA1C was lower than 8% HbA1C was also below 8% in 50% of patients using 1100-1200 strips year-1.

Adolescent↗

Confirmation of nasogastric tube position by pH testing.

INTRODUCTION: In 2004, the Medicines and Healthcare products Regulatory Agency (MHRA) advised that nasogastric (NG) tube position should be confirmed using pH strips or paper. However, gastric pH is raised by the use of H2-blockers and proton-pump inhibitors (PPIs) potentially producing false negative pH tests resulting in delayed feeding. In addition, colorimetric differentiation using pH strips may be more prone to bias and inaccuracy than direct pH measurements largely used to establish the threshold. METHOD: To quantify this problem a 1 day survey of all the patients requiring NG and nasointestinal (NI) feeding was undertaken, to establish the numbers of patients receiving H2-Blockers or PPIs, with or without a safe swallow and the methods currently being used to confirm tube positioning. A second observational study was performed to establish the accuracy of six pH strips available to NHS trusts against four unlabelled pH solutions. RESULTS: Forty-two per cent of patients receiving NG feeding were on H2-blockers or PPIs, including 13% who had a safe swallow for acidic drinks that could be subsequently aspirated to confirm position. In the second study 'testers' correctly identified pH's 3, 4, 5 and 6 with Mackery-Nagel 0-6, BDH 0-6 and 0-14 strips but overestimated pH 4 as pH 5 with Johnson 0-11 paper, underestimated pH 6 as pH 5 with Pehanon 0-12 paper and with Litmus classified pH 3-5 as acid (all), but half also classified pH 6 as acid. CONCLUSION: Theoretically 29% of NG tube positions could not be confirmed by pH testing because of the usage of PPIs or H2-blockers and lack of swallow. Some pH strips are either inaccurate or their result misinterpreted by staff. Large surveys and trials of the actual efficacy and accuracy of pH testing are required.

Cross-Sectional Studies↗

A follow-up study on three caries activity tests.

The purpose of this research was to study the efficacy of three CAT's (Dentocult SM, Dentocult LB and Dentobuff Strip) in revealing caries condition and predicting caries progress, and provide a reference for application by comparing the three tests. Oral condition and results of the three CAT's of 82 children aged 3 to 4 were recorded and followed up. The examination was checked again two years later. The caries incidence, dft and CSI data from the two examinations were analyzed statistically. The results were that each Dentocult SM degree showed significant variances in incidence rate, as did the dft and CSI results in the second examination. The dft and CSI of both examinations exhibited a high degree of statistical significance. The same may be said of the Dentocult LB findings for the two years. No noticeable variances in caries incidence rate, dft and CSI from the Dentobuff Strip test were observed in both years' study, nor was there any statistical significance drawn from the findings, except for those of the second exam. No gender differences were observed in the distribution by degree with the three CATs The conclusion is that Dentocult SM is the best of the three tests for the diagnosis of the presence of caries and prognosis of its progress, Dentocult LB is second best whereas the Dentobuff Strip shows no detection capability. The findings serve as an application reference.

Analysis of Variance↗

Comparison of indirect diagnostic methods for hypolactasia.

The aim of this study was to continue our previously published work and to compare the different indirect diagnostic methods for hypolactasia with the lactase to sucrase ratio obtained by jejunal biopsy. The following tests were performed in 63 adult patients: the breath hydrogen test, the lactose tolerance test with ethanol (serum galactose measurement after oral lactose load with ethanol), the urinary lactose tolerance test (urinary galactose measurement after oral lactose load with ethanol), and the strip test (like the former but using a special test strip for urinary galactose). Specificities of all these tests were good (96-98%). The 3-h breath hydrogen test was less sensitive (69%) than the other methods (81-94%). The strip test is recommended for the general practitioner for the diagnosis of this common cause of abdominal complaints.

Adolescent↗

Versatile, non-clotting-based heparin assay requiring no instrumentation.

A non-clotting-based heparin assay requiring no instrumentation has been developed by attaching protamine (a heparin antidote) to a porous filter paper strip and monitoring the subsequent capillary migration of heparin sample through the paper. The area of paper to which heparin adsorbed, which is proportional to the concentration of heparin in the sample, is made visible by spraying Methylene Blue NNX solution onto the paper strip when the sample reservoir has emptied. The dye interacts with heparin to cause a metachromatic shift of the dye's absorption maximum from blue to purple. Heparin concentrations in the samples are estimated according to the length of the purple region on the paper strip. Heparin in plasma (2 to 35 int. units/mL) can be differentiated in approximately 6 min. The plasma heparin values derived by the new method agree reasonably well with those obtained by conventional assays (r greater than 0.99, n = 48).

Extracorporeal Circulation↗