Reference Range for Specific Gravity of Urine
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Leukocyte Esterase Activity in Vaginal Fluid of Pregnant and Non-Pregnant Women with Vaginitis/Vaginosis and in Controls
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by PubMed Central Infect Dis Obstet Gynecol 2003;11:19–26 Leukocyte esterase activity in vaginal fluid of pregnant and non-pregnant women with vaginitis/vaginosis and in controls Per-Anders Mårdh 1, Natalia Novikova 1, Ola Niklasson 1, Zoltan Bekassy 1 and Lennart Skude 2 1Department of Obstetrics and Gynecology, University Hospital, Lund and 2Department of Clinical Chemistry, County Hospital, Halmstad, Sweden Objectives: Todeterminethe leukocyteesterase (LE) activity invaginal lavage fluid ofwomen with acuteand recurrentvulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis(BV), and in pregnant and non-pregnantwomen without evidenceof the threeconditions. Also tocompare the resultof LEtestsin women consultingat differentweeks inthe cycle andtrimesters of pregnancy.The LEactivity was correlatedto vaginal pH, numberof inflammatory cells instained vaginal smears,type of predominatingvaginal bacteria andpresence of yeast morphotypes. Methods: Onehundred and thirteen women with ahistoryof RVVC,i.e. with at least fourattacks of the conditionduring the previousyear and who had consultedwith anassumed new attack ofthe condition,were studied.Furthermore, we studied16 women with VVC,15 women with BV,and 27 women attendingfor control of cytological abnormalities, who all presentedwithout evidenceof either vaginitisor vaginosis. Finally, 73 pregnantwomen wereinvestigated. The LEactivity invaginal fluid duringdifferent weeks inthe cycle of 53 of the women was measured. Results: Inthe non-pregnantwomen, anincreased LE activity was foundin 96, 88, 73 and56% of those with RVVC,VVC and BV andin the non-VVC/BVcases,respectively. In 73% of pregnantwomen inthe second trimester,and 76% of thosein the third,the LEtestwas positive.In all groupsof non-pregnantwomen tested, the LEactivity correlatedwith the numberof leukocytesin vaginal smears,but it didnot in those who were pregnant.There was nocorrelation between LE activity andweek incycle. -
Ileal Neobladder: an Important Cause of Non-Anion Gap Metabolic Acidosis
The Journal of Emergency Medicine, Vol. 52, No. 5, pp. e179–e182, 2017 Ó 2017 Elsevier Inc. All rights reserved. 0736-4679/$ - see front matter http://dx.doi.org/10.1016/j.jemermed.2016.12.036 Clinical Communications: Adult ILEAL NEOBLADDER: AN IMPORTANT CAUSE OF NON-ANION GAP METABOLIC ACIDOSIS Jesse W. St. Clair, MD and Matthew L. Wong, MD, MPH Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts and Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts Reprint Address: Matthew L. Wong, MD, MPH, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Rosenberg Building, 2nd Floor, 1 Deaconess Road, Boston, MA 02446 , Abstract—Background: The differential diagnosis for a disease, or medications such as acetazolamide. non-anion gap metabolic acidosis is probably less well Commonly used mnemonics to remember the differential known than the differential diagnosis for an anion gap for the non-anion gap metabolic acidosis include metabolic acidosis. One etiology of a non-anion gap acidosis ‘‘ABCD’’ for ‘‘Addison’s, Bicarbonate loss, Chloride is the consequence of ileal neobladder urinary diversion (administration), and Drugs,’’ as well as ‘‘HARDUP’’ for the treatment of bladder cancer. Case Report: We pre- for ‘‘Hyperchloremia, Acetazolamide and Addison’s, sent a case of a patient with an ileal neobladder with a severe non-anion gap metabolic acidosis caused by a Renal Tubular Acidosis, Diarrhea, Ureteroenterostomies, urinary tract infection and ureteroenterostomy. Why and Pancreaticoenterostomies’’ (Table 1) (1). Should an Emergency Physician Be Aware of This?: Part Ureteroenterostomies are when the ureter has an of the ileal neobladder surgery includes ureteroenteros- abnormal connection with a segment of intestine. -
Interpretation of Canine and Feline Urinalysis
$50. 00 Interpretation of Canine and Feline Urinalysis Dennis J. Chew, DVM Stephen P. DiBartola, DVM Clinical Handbook Series Interpretation of Canine and Feline Urinalysis Dennis J. Chew, DVM Stephen P. DiBartola, DVM Clinical Handbook Series Preface Urine is that golden body fluid that has the potential to reveal the answers to many of the body’s mysteries. As Thomas McCrae (1870-1935) said, “More is missed by not looking than not knowing.” And so, the authors would like to dedicate this handbook to three pioneers of veterinary nephrology and urology who emphasized the importance of “looking,” that is, the importance of conducting routine urinalysis in the diagnosis and treatment of diseases of dogs and cats. To Dr. Carl A. Osborne , for his tireless campaign to convince veterinarians of the importance of routine urinalysis; to Dr. Richard C. Scott , for his emphasis on evaluation of fresh urine sediments; and to Dr. Gerald V. Ling for his advancement of the technique of cystocentesis. Published by The Gloyd Group, Inc. Wilmington, Delaware © 2004 by Nestlé Purina PetCare Company. All rights reserved. Printed in the United States of America. Nestlé Purina PetCare Company: Checkerboard Square, Saint Louis, Missouri, 63188 First printing, 1998. Laboratory slides reproduced by permission of Dennis J. Chew, DVM and Stephen P. DiBartola, DVM. This book is protected by copyright. ISBN 0-9678005-2-8 Table of Contents Introduction ............................................1 Part I Chapter 1 Sample Collection ...............................................5 -
A Dipstick Test Combined with Urine Specific Gravity Improved the Accuracy of Proteinuria Determination in Pregnancy Screening
Kobe J. Med. Sci., Vol. 56, No. 4, pp. E165-E172, 2010 A Dipstick Test Combined with Urine Specific Gravity Improved the Accuracy of Proteinuria Determination in Pregnancy Screening NATSUKO MAKIHARA1, MINEO YAMASAKI1,2, HIROKI MORITA1, and HIDETO YAMADA1* 1Division of Obstetrics and Gynecology, Department of Surgery-related, and 2Division of Integrated Medical Education, Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. Received 12 July 2010/ Accepted 20 August 2010 Key Words: dipstick test, pregnancy proteinuria, protein/creatinine ratio, urine specific gravity Proteinuria screening using a semi-quantitative dipstick test of the spot urine in antenatal clinic is known to have high false-positive rates. The aim of this study was to assess availability of a dipstick test combined with the urine specific gravity for the determination of pathological proteinuria. A dipstick test was performed on 582 urine samples obtained from 283 pregnant women comprising 260 with normal blood pressure and 23 with pregnancy-induced hypertension. The urine protein (P) and creatinine (C) concentrations, specific gravity (SG), P/C ratio were determined, and compared with dipstick test results. The P concentration increased along the stepwise augmentations in dipstick test result. Frequencies of the urine samples with 0.265 or more P/C ratio were 0.7% with − dipstick test result, 0.7% with the ± result, 3.3% with the 1+ result, and 88.9% with the ≥2+ result. However, if the urine specific gravity was low, frequencies of the high P/C ratio were 5.0% with ± dipstick test result and 9.3% with the 1+ result. -
Acute Kidney Injury and Chronic Kidney Disease: Classifications and Interventions for Children and Adults Teresa V
Acute Kidney Injury and Chronic Kidney Disease: Classifications and Interventions for Children and Adults Teresa V. Lewis, PharmD, BCPS Assistant Professor of Pharmacy Practice University of Oklahoma College of Pharmacy Adjunct Assistant Professor of Pediatrics University of Oklahoma College of Medicine 1 Disclosures • Teresa V. Lewis, Pharm.D., BCPS • Nothing to disclose Objectives 1. When given specific patient details, identify those with increased Identify which adult or pediatric patients are at risk for development of acute kidney injury (AKI) and recommend appropriate preventive interventions. 2. Design an evidence-based plan to manage AKI for a given patient. 3. Compare and contrast the RIFLE, pRIFLE, and Kidney Disease Improving Global Outcomes (KDIGO) classification systems for AKI. 4. List risk factors for development of chronic kidney disease (CKD). 5. Compare and contrast the Kidney Disease Outcomes Quality Initiative (KDOQI) staging of CKD with the Kidney Disease Improving Global Outcomes (KDIGO) CKD staging criteria. 6. Design an evidence-based plan to prevent progression of CKD for a given patient. 3 Kidney Development and Maturation • Nephrogenesis • Begins around 9 weeks of gestation • Complete by 36 weeks of gestation • Immature renal function at birth • Lower renal blood flow • Immature glomeruli • Immature renal tubule function • Kidney function will be similar to adult values by age 2 years 4 Presentation Outline • Diagnostic Workup • Acute Kidney Injury • Drug Induced Nephrotoxicity • Chronic Kidney Disease 5 DIAGNOSTIC WORK-UP Blood Urea Nitrogen (BUN) • Normal: 8-20 mg/dL • Amino-acids metabolized to ammonia and converted in liver to urea • Urea is filtered and reabsorbed in proximal tubule (dependent on water reabsorption) • Normal BUN:Serum creatinine (Scr) ratio is 10-15:1 • Elevated BUN:Scr ratio suggests true or effective volume depletion 7 Serum Creatinine (Scr) • Freely filtered • Actively secreted • Scr lags behind glomerular filtration rate (GFR) by 1-2 days due to: 1. -
Specific Gravity, Urine
Lab Dept: Urine/Stool Test Name: SPECIFIC GRAVITY, URINE General Information Lab Order Codes: USG Synonyms: N/A CPT Codes: 81003 – Urinalysis; automated, without microscopy Test Includes: Specific gravity measurement by colorimetric reagent strip. Logistics Test Indications: Useful for evaluating the concentrating and excretory power of the kidney. Lab Testing Sections: Urinalysis Phone Numbers: MIN Lab: 612-813-6280 STP Lab: 651-220-6550 Test Availability: Daily, 24 hours Turnaround Time: 2 - 4 hours Special Instructions: Indicate method of collection on request form (catheterized, clean- catch, or void). Deliver to lab within 30 minutes of collection. Refrigerate specimen if there is a delay in transport of 30 minutes or more. Specimen Specimen Type: Urine Container: Urine cup Draw Volume: Entire urine collection Processed Volume: Minimum volume: 1 mL Collection: Collect a clean-catch urine specimen as follows: Males: Clean glans with soap and water. Rinse area with wet gauze pads. While holding foreskin retracted, begin voiding. After several mL’s have passed, collect midstream portion without stopping flow of urine. Place the cap on the cup and tighten securely. Refrigerate specimen after collection and promptly forward to the lab. Females: Thoroughly clean urethral area with soap and water. Rinse area with wet gauze pads. While holding labia apart, begin voiding. After several mL’s have passed, collect midstream portion without stopping the flow of urine. Place the cap on the cup and tighten securely. Refrigerate specimen after collection and promptly forward to the lab. Note: Indicate type of specimen (catheterized or void) and time of collection on the label. Special Processing: N/A Patient Preparation: See above Sample Rejection: Less than 1 mL urine; mislabeled or unlabeled specimens Interpretive Reference Range: Age: Specific Gravity: Infant (0 days - 1 year): 1.002 - 1.006 >1 year: 1.001 - 1.030 Critical Values: N/A Limitations: Radiographic dyes in urine increase the specific gravity by hydrometer or refractometer. -
Evaluation of Gross and Microscopic Hematuria
EVALUATION OF GROSS AND MICROSCOPIC HEMATURIA APRIL GARDNER, MSBS, PA - C ASSOCIATE PROGRAM DIRECTOR THE UNIVERSITY OF TOLEDO PA PROGRAM OBJECTIVES • Define the terms gross hematuria and microscopic hematuria. • Identify etiologies of hematuria. • Identify risk factors for a urologic cancer in a patient with gross or microscopic hematuria. • Define the term “full evaluation.” • Identify indications for a full evaluation. • Identify labs and diagnostics to evaluate hematuria. • Identify the appropriate follow-up for patients with hematuria. 2 CASE #1 Ms. T is a healthy 50 year-old female, s/p TAH/BSO 15 years ago for severe endometriosis. She presents today for her annual physical exam required by her employer. She has no new complaints and there is no history of any urologic complaints. Physical exam is completely normal Urine dipstick shows 1+ blood, pH 6.0, negative for ketones, glucose, nitrites and leukocyte esterase Microscopic evaluation shows 8 RBCs, no WBCs, bacteria, yeast, crystals, or casts CASE #1 • Should you prescribe an antibiotic for Ms. T today? • Does she need any further follow-up? • If yes, what would follow-up include? CASE #2 Mr. D is a 38 year-old healthy, monogamous married male with 4 children, presenting for a vasectomy consultation. He denies any complaints, including urologic complaints. He takes no medications. He tells you he ran a marathon 2 days ago and then finished building a deck in his backyard yesterday. Physical exam is completely normal Urine dipstick shows 1+ blood, pH 6.0, negative for protein, ketones, glucose, nitrites and leukocyte esterase Microscopic evaluation shows 3 RBCs, no WBCs, bacteria, yeast, crystals, or casts CASE #2 • Should you prescribe an antibiotic for Mr. -
Storm in a Pee Cup: Hematuria and Proteinuria
Storm in a Pee Cup: Hematuria and Proteinuria Sudha Garimella MD Pediatric Nephrology, Children's Hospital-Upstate Greenville SC Conflict of Interest • I have no financial conflict of interest to disclose concerning this presentation. Objectives • Interpret the current guidelines for screening urinalysis, and when to obtain a urinalysis in the pediatric office. • Interpret the evaluation of asymptomatic/isolated proteinuria and definitions of abnormal ranges. • Explain the evaluation and differential diagnosis of microscopic hematuria. • Explain the evaluation and differential diagnosis of gross hematuria. • Explain and discuss appropriate referral patterns for hematuria. • Racial disparities in nephrology care 1. APOL-1 gene preponderance in African Americans and risk of proteinuria /progression(FSGS) 2. Race based GFR calculations which have caused harm 3. ACEI/ARB usage in AA populations: myths and reality Nephrology Problems in the Office • Hypertension • Proteinuria • Microscopic Hematuria • Abnormal Renal function The Screening Urinalysis • Choosing Wisely: • Don’t order routine screening urine analyses (UA) in healthy, asymptomatic pediatric patients as part of routine well child care. • One study showed that the calculated false positive/transient abnormality rate approaches 84%. • Population that deserves screening UA: • patients who are at high risk for chronic kidney disease (CKD), including but not necessarily limited to patients with a personal history of CKD, acute kidney injury (AKI), congenital anomalies of the urinary tract, acute nephritis, hypertension (HTN), active systemic disease, prematurity, intrauterine growth retardation, or a family history of genetic renal disease. • https://www.choosingwisely.org/societies/american-academy-of-pediatrics-section-on- nephrology-and-the-american-society-of-pediatric-nephrology/ Screening Urinalysis: Components A positive test for leukocyte esterase may be seen in genitourinary inflammation, irritation from instrumentation or catheterization, glomerulonephritis, UTIs and sexually transmitted infections. -
Urine Specific Gravity
Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Urine Specific Gravity Urine Specific Gravity (SG) Specific gravity (SG) is a measurement of the kidneys' ability to concentrate urine. The test compares the density of urine against the density of distilled water, which has an SG of 1.000. Because urine is a solution of minerals, salts, and compounds dissolved in water, the SG is a measure of the density of the dissolved chemicals in the specimen. As a measurement of specimen density, SG is influenced by both the number of particles present and the size of the particles. Osmolality is a more exact measurement and may be needed in certain circumstances. Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. • The range of urine SG depends on the state of hydration and varies with urine volume and the load of solids to be excreted under standardized conditions; when fluid intake is restricted or increased, SG measures the concentrating and diluting functions of the kidney. Loss of these functions is an indication of renal dysfunction. Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. • Reference Values • Normal • 1.005-1.030 (usually between 1.010 and 1.025) • Concentrated urine: 1.025-1.030+ • Dilute urine: 1.001-1.010 • Infant < 2 years old: 1.001-1.018 Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. • Procedure • Test SG with the use of a multiple-test dipstick that has a separate reagent area for SG. -
Reliability of Three Urinalysis Methods Used in the Assessment of Hydration
International Journal of Sport, Exercise and Health Research 2018; 2(2): 100-105 Research Article Reliability of three urinalysis methods used in the IJSEHR 2018; 2(2): 100-105 © 2018, All rights reserved assessment of hydration www.sportscienceresearch.com Received: 30-08-2018 Aric J. Warren1, Matthew S. O’Brien1, Doug B. Smith2 Accepted: 18-10-2018 1 Associate Professor, Department of Athletic Training, Oklahoma State University Center for Health Sciences, 1111 W. 17th Street, Tulsa, OK 74107, USA 2 Professor, Oklahoma State University, School of Kinesiology, Applied Health and Recreation, Stillwater, OK 74078, USA Abstract Objective: The purpose of this study was to determine the intratester and intertester reliability of three common methods of assessing hydration; urine color chart (UCC), dipstick reagent strip (DRS) and refractometer (REF). Methods: Twenty-three male collegiate wrestlers (n = 23, age = 20.09 ± 1.35, weight = 78.73 ± 11.25 kg, height = 174.49 ± 7.23 cm) provided urine samples on three separate occasions totaling 69 samples (n = 69). Samples were analyzed with repeated measures by three testers, three trials, and three separate methods of assessment. Results: All methods had very high intertester reliability as demonstrated by Cronbach’s Alpha coefficients; DRS (r = .985), UCC (r = .973) and REF (r = .968). Intraclass correlation coefficient ranges were also very high; DRS .983 - .994, UCC 964-.983, and REF .829-.996. Conclusions: The three modes of urine hydration assessment are highly reliable, and are a practical, noninvasive method to evaluate hydration status in the field. Keywords: Hydration; Reliability; Urinalysis. INTRODUCTION Athletes that compete in body weight restrictive sports such as wrestling, judo, and rowing sometimes go to extreme measures to qualify for a specific weight class or event. -
Diabetic Ketoacidosis
Diabetic ketoacidosis Diabetic Ketoacidosis Dr. Christiane Stengel Dipl. ECVIM-CA (IM) FTÄ für Kleintiere High blood glucose with the presence of ketones in the urine and bloodstream, often caused by having/giving too little insulin or during illness. Dr. Christiane Stengel Diabetic ketoacidosis v Diabetes mellitus not diagnosed so far (common) v Or „derailed“ Diabetes (possible) & a “triggering condition” lead to increased „counter- regulatory“ hormones: o Glucagon ↑ o Cortisol ↑ o Adrenalin ↑ o GH ↑ v Low insulin and high glucagon increased glucagon:insulin-ratio medpets.de v Bacterial infections v Endocrine disease o Urinary tract o Hypercortisolism o Pneumonia o Hypothyroidism o Pyometra /prostatitis o Hyperthyroidism o Pyoderma o Acromegaly v Inflammatory v Physiological condition endocrine change o Pancreatitis o Dioestrus v Iatrogenic v Miscellaneous o Steroid administration o Chronic kidney disease o Neoplasia Dr. Christiane Stengel Diabetic ketoacidosis v Vomiting, lethargy, anorexia, weakness, (PU/PD), triggering effect signs v Severe dehydration (hypovolaemic shock) o Glukosuria osmotic diuresis o Ketonuria osmotic diuresis o Fluid loss from vomiting o Decreased fluid intake from anorexia and lethargy A. Kussmaul v Tachycardia, change in pulse quality, colour and capillary refill time v Increased breathing effort (often with normal frequency) due to metabolic acidosis (Kussmaul breathing) , ketone smell v Haematology v Biochemistry profile ± ketones in plasma v Urinalysis and urine culture v Blood gas analysis v ± abdominal -
Leukocyte Esterase Activity in Vaginal Fluid of Pregnant and Non-Pregnant Women with Vaginitis/Vaginosis and in Controls
Infect Dis Obstet Gynecol 2003;11:19–26 Leukocyte esterase activity in vaginal fluid of pregnant and non-pregnant women with vaginitis/vaginosis and in controls Per-Anders Mårdh 1, Natalia Novikova 1, Ola Niklasson 1, Zoltan Bekassy 1 and Lennart Skude 2 1Department of Obstetrics and Gynecology, University Hospital, Lund and 2Department of Clinical Chemistry, County Hospital, Halmstad, Sweden Objectives: Todeterminethe leukocyteesterase (LE) activity invaginal lavage fluid ofwomen with acuteand recurrentvulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis(BV), and in pregnant and non-pregnantwomen without evidenceof the threeconditions. Also tocompare the resultof LEtestsin women consultingat differentweeks inthe cycle andtrimesters of pregnancy.The LEactivity was correlatedto vaginal pH, numberof inflammatory cells instained vaginal smears,type of predominatingvaginal bacteria andpresence of yeast morphotypes. Methods: Onehundred and thirteen women with ahistoryof RVVC,i.e. with at least fourattacks of the conditionduring the previousyear and who had consultedwith anassumed new attack ofthe condition,were studied.Furthermore, we studied16 women with VVC,15 women with BV,and 27 women attendingfor control of cytological abnormalities, who all presentedwithout evidenceof either vaginitisor vaginosis. Finally, 73 pregnantwomen wereinvestigated. The LEactivity invaginal fluid duringdifferent weeks inthe cycle of 53 of the women was measured. Results: Inthe non-pregnantwomen, anincreased LE activity was foundin 96, 88, 73 and56% of those with RVVC,VVC and BV andin the non-VVC/BVcases,respectively. In 73% of pregnantwomen inthe second trimester,and 76% of thosein the third,the LEtestwas positive.In all groupsof non-pregnantwomen tested, the LEactivity correlatedwith the numberof leukocytesin vaginal smears,but it didnot in those who were pregnant.There was nocorrelation between LE activity andweek incycle.