Urine Analysis Research Articles

Performance of UF-5000 in rapidly screening out urinary tract infection, predicting Gram-negative bacteria infection

ABSTRACT Urine culture is the gold standard for identifying microorganisms in urine. However, the process is time-consuming and usually takes days to get the results, which impedes timely treatment. This study aimed to evaluate the performance of UF-5000 in excluding bacterial urinary tract infection (UTI) and detecting the presence of Gram-negative bacteria. A total of 1,522 urine specimens were subjected to routine urine analysis and culture. Bacteria, white blood cell counts, and UF-5000 bacteria information flags were compared with urine culture. Bacteria forward scatter (B_FSC), and bacteria fluorescent light intensity (B_FLH) parameters were assessed to determine the optimal angle for discriminating bacterial growth patterns, which was verified in the validation cohort. The optimal cut-off values were 42.2/µL and 100.2/µL to rule out UTI for bacteria at ≥10 4 CFU/mL and ≥10 5 CFU/mL, respectively. The agreement of UF-5000 bacterial classification and urine culture was fair (Kappa = 0.227). Regarding the discrimination of bacterial groups, “Gram Neg?” was associated with a specificity of 94.0% and a positive predictive value of 87.2% in the detection of Gram-negative bacteria. By estimating the B_FSC and B_FLH parameters, the best angle was 28° for distinguishing Gram-negative and Gram-positive bacteria. Among the 136 urine specimens with the low angle pattern (<28°) in the validation cohort, 127 specimens were confirmed to contain Gram-negative bacteria. The UF-5000 analyzer is a suitable and rapid tool to exclude negative urine specimens, and bacterial information flags for Gram-negative bacteria could be trusted by clinicians. IMPORTANCE The strength of our study relied on being the first study assessing the bacteria forward scatter (B_FSC) and bacteria fluorescent light intensity (B_FLH) research parameters with a UF-5000 urine analyzer and establishing the best angle for distinguishing Gram-negative and Gram-positive bacteria. When the bacterial scatter plot angle is less than 28°, the possibility of Gram-negative bacterial infection is more than 80%. Meanwhile, we find that UF-5000 bacterial information flags have a significant advantage in detecting Gram-negative bacteria with a specificity of over 90% and a positive predictive value of over 80%.

Management of children with kidney injuries of various severity: a series of clinical observations

BACKGROUND: Kidney injury takes approximately 1–5% of all urinary tract and abdominal cavity injuries. Children blunt trauma amounts more than 90% of all kidney damages. Kidney injury is always followed by pain in the lumbar region and abdomen as well as by hematoma and hematuria. Serious renal injuries in children are more often accompanied by stable vital functions and normal general urine analyses compared to adults. Such patients require dynamic observation and instrumental examination so as to determine further curative strategy. CLINICAL CASE DESCRIPTION: This article describes three clinical cases of kidney injury in children. In the first case, ultrasound examination and computed tomography revealed contusion changes in the kidney, subcapsular hematoma and renal parenchyma rupture without damage of the collecting system. Due to clinical findings, ultrasound and computed tomography examination, conservative management was prescribed to one patient, while for the other two with renal parenchyma rupture — surgery. One of these patients had malformation — a gap between the upper and lower segments of the double kidney. Such malformation could aggravate the injury. CONCLUSION: The present series of clinical observations is an example of managing children with kidney injuries of varying severity. Depending on the damage severity, conservative management or surgical tactics are chosen by specialists.

Bladder perforation due to laparoscopic peritoneal dialysis catheterization: A case report and literature review

Rationale: Complications related to the peritoneal dialysis (PD) catheter are the primary cause of treatment failure in PD, and bladder perforation is a rare complication of PD catheter placement. To date, there have been no reported cases of bladder perforation occurring during laparoscopic PD catheter placement. Patient concerns: An 80-year-old woman was admitted to Shaoxing Second Hospital due to a decade-long history of high blood creatinine levels. She was diagnosed with end-stage renal disease and underwent laparoscopic PD catheter placement. On the third day post-operation, she experienced frequent urination and urgency during her initial peritoneal dialysis fluid exchange. Diagnoses: The urine analysis indicated sterility. Both ultrasound and computed tomography scans suggested that the PD catheter was positioned in the bladder. We suspect a bladder perforation following laparoscopic placement of the PD catheter. Interventions: The patient underwent emergency surgery, during which the PD catheter was removed and subsequently replaced using laparoscopy. Additionally, due to a bladder perforation, peritoneal dialysis was temporarily suspended for 10 days postoperatively. Outcomes: On the 11th postoperative day, the patient underwent a low-dose peritoneal dialysis, and the procedure was uneventful. Lessons: During laparoscopy, PD catheter placement still carries the risk of rare complications such as bladder perforation. If postoperative PD catheter patients experience urinary urgency and frequency, there should be a high suspicion of bladder perforation. Early diagnosis and surgical intervention are crucial for improving patient prognosis.

Comorbidity problems in patients with osteoporosis

BACKGROUND: Osteoporosis is a metabolic skeletal disease characterized by decreased bone mass, impaired microarchitecture of bone tissue and, as a consequence, fractures with minimal trauma. The social significance of osteoporosis is determined by its consequences — fractures of the vertebral bodies and bones of the peripheral skeleton, leading to high medical costs and causing a high level of disability, including disability and mortality. Osteoporosis is most often combined with cardiovascular diseases caused by atherosclerosis, which are widespread and are the leading cause of disability and mortality. A small number of studies have been devoted to the study of the features of clinical manifestations of cardiovascular diseases in the combination of coronary heart disease and osteoporosis. AIM: To identify the frequency and severity of comorbid diseases and their risk factors in postmenopausal osteoporosis. MATERIALS AND METHODS: A retrospective and prospective cohort study was conducted from 2013 to 2023. 8250 women with postmenopausal osteoporosis were examined and the data from the medical records of these patients who applied to the Osteoporosis Center of the North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of the Russian Federation from 2013 to 2020 were analyzed. At the prospective stage, two comparison groups of 100 patients with and without postmenopausal osteoporosis were formed from 500 patients with comorbid diseases (coronary heart disease, hypertension, type 2 diabetes, stroke, transient ischemic attack). Bone mineral density was assessed based on the Hologic Discoveri Wi dual-energy X-ray absorptiometry at 2 points in the lumbar spine (L1–L4) and the femoral neck. Along with traditional laboratory examination methods, bone metabolism markers (total calcium, phosphorus, vitamin D, urine analysis for deoxypyridinoline, C-terminal telopeptide of type 1 collagen, osteocalcin, alkaline phosphatase, parathyroid hormone) were assessed dynamically. In all the patients, along with a general clinical examination, an assessment of risk factors for cardiovascular disease and osteoporosis was performed. RESULTS: Body mass index was higher in the group of patients with osteoporosis — 28.4 (26.9–32.4) kg/m2 (p 0.001), versus 27.64 (25.8–30.0) kg/m2 (p 0.05). Bone mineral density in the group of patients with osteoporosis was statistically lower than in the group without osteoporosis. In the group of patients with osteoporosis, the risk of fractures was high and amounted to 37 (95% confidence interval 15.0–38.50) %, p 0.001), versus in the control group 9.55 (95% confidence interval 7.67–15.0) % (p 0.001) according to the FRAX questionnaire for the Russian Federation. In the group of patients with osteoporosis, the Charlson index values were 5.1 (95% confidence interval 4.7–5.6) points. As a result of the correlation analysis, a reliable positive relationship was revealed between low bone mineral density L1–L4 and hip with bone metabolism: alkaline phosphatase, C-terminal telopeptide of type 1 collagen, vitamin D, osteocalcin, urinary deoxypyridinoline. We found a negative relationship between bone mineral density and the Charlson index, absolute ten-year risk of hip fracture and the duration of early menopause, and the level of hypertension. To assess the dependence of QRISK3-2018 on osteoporosis risk factors in the group of patients with osteoporosis, multiple linear regression was performed. This model was characterized by a statistically significant correlation between the factors and the dependent variable of high tightness. The coefficient of determination was 0.608, indicating a 60.8% contribution of the factors taken into account in the model to the variance of QRISK3-2018. CONCLUSIONS: In women with postmenopausal osteoporosis, comorbid pathology is more common, aggravating the course of the disease. Knowledge of the prevalence of concomitant pathology and joint risk factors will make it possible to simultaneously form groups at increased risk of development, which will ensure prevention of both diseases with the same non-medical means and drugs.

Adherence to antihypertensive medications in Omani patients: a comparison of drug biochemical analysis and the Morisky Medication Adherence Scale

Background: Medication nonadherence is a major risk factor for suboptimal or failed hypertension pharmacologic therapy. Objective: To determine the nonadherence rate to antihypertensive medications using high-performance liquid chromatography–tandem mass spectrometry (LC–MS/MS) and the self-reported Morisky Medication Adherence Scale (MMAS). Methods: This study used a prospective cross-sectional cohort design. Patients with hypertension aged ≥18 years and prescribed at least one antihypertensive medication were recruited from an outpatient hypertensive clinic at a tertiary healthcare institution in Oman. Adherence was assessed using LC–MS/MS urine analysis and the MMAS. Results: In total, 162 patients completed the MMAS questionnaire and provided urine samples for LC–MS/MS analysis. The overall mean age of the cohort was 55 ± 13 years, and 57% of the patients were men. The mean systolic and diastolic blood pressures were 146 ± 18 mmHg and 79 ± 10 mmHg, respectively. Using the MMAS method, 65% of the patients reported nonadherence. However, LC–MS/MS analysis revealed that only 27% of the patients were nonadherent. The adherent group by LC–MS/MS had significantly lower systolic (P = 0.026) and diastolic blood pressures (P < 0.001) than the nonadherent group, whereas no differences were observed using the MMAS method. There was weak or no agreement between the MMAS and LC–MS/MS results (P = 0.142). Conclusion: Almost one-fourth of our patients with hypertension were nonadherent to their medications. There was a weak concordance between the MMAS and LC–MS/MS methods in detecting medication nonadherence. Further research into noninvasive convenient adherence scales or methods and their correlations with LC–MS/MS analysis is warranted.

Brewer’s spent grain as a potential sorbent for toxicology methods: application to antidepressant analysis in urine

Brewer’s spent grain as a potential sorbent for toxicology methods: application to antidepressant analysis in urine

Advances in molecular imaging of kidney diseases.

Background Diagnosing and monitoring kidney diseases traditionally rely on blood and urine analyses and invasive procedures such as kidney biopsies, the latter offering limited possibilities for longitudinal monitoring and a comprehensive understanding of disease dynamics. Current non-invasive methods lack specificity in capturing intrarenal molecular processes, hindering patient stratification and patient monitoring in clinical practice and clinical trials. Summary Molecular imaging enables non-invasive and quantitative assessment of physiological and pathological molecular processes. By using specific molecular probes and imaging technologies, e.g., magnetic resonance imaging (MRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), or ultrasound (US), molecular imaging allows the detection and longitudinal monitoring of disease activity with spatial and temporal resolution of different kidney diseases and disease-specific pathways. Several approaches have already shown promising results in kidneys and exploratory clinical studies, and validation is needed before implementation in clinical practice. Key messages Molecular imaging offers a non-invasive assessment of intrarenal molecular processes, overcoming the limitations of current diagnostic methods. It has the potential to serve as companion diagnostics, not only in clinical trials, aiding in patient stratification and treatment response assessment. By guiding therapeutic interventions, molecular imaging might contribute to the development of targeted therapies for kidney diseases.

Prevalence and associated factors of acute kidney injury in Ethiopia, systematic review and meta-analysis.

Acute kidney injury, characterized by a sudden decline in glomerular filtration rate, presents a significant global health challenge, with its high prevalence exacerbated by hypertension and limited healthcare access. This systematic review and meta-analysis examined 19 studies encompassing 11,955 participants to assess acute kidney injury prevalence and associated factors in hospitalized patients inEthiopia. The overall pooled prevalence of acute kidney injury was found to be 3.20% (95% CI 2.91-3.48), with considerable heterogeneity (I2 = 99.3%; p < 0.001). Subgroup analyses identified elevated rates ofacute kidney injury in studies conducted post-2020 (31.656%, 95% CI 24.465-38.848), particularly in the Oromia region (41.622%, 95% CI 11.873-71.372), and smaller study sample (< 400) (44.524%, 95% CI 30.117-58.932). Hypertension, congestive heart failure, sepsis, chronic kidney diseases, and nephrotoxicity emerged as significant risk factors. Regular monitoring of renal function through blood and urine analyses is crucial for early detection and management of acute kidney injury, particularly in high-risk groups. Addressing healthcare disparities and reducing nephrotoxic medication use are essential strategies to mitigate acute kidney injury incidence and improve kidney health outcomes worldwide.

Regional and ethnic factors of obesity and diabetes mellitus in women of re-productive age in the Pribaikal region

Introduction. Overweight is currently one of the leading global medical problems. Overweight and obesity contribute significantly to the development of diseases such as diabetes, cardiovascular disorder and can also cause premature death. Obesity has a negative impact on reproductive function; almost a quarter of women of childbearing age are overweight and about a third of them are obese.Aim. To study the characteristics of carbohydrate metabolism, hormonal indicators, and clinical-metabolic profiles, as well as to assess the potential risk of developing diabetes mellitus in women of fertile age with overweight and obesity residing in the Baikal region.Materials and methods. The study involved 60 overweight and obese women of reproductive age in the Pribaikalye region, including 33 women of Russian nationality (group 1) and 27 women of Buryat nationality (group 2). Anthropo-metric, sociodemographic and behavioural criteria were analysed, as well as questionnaires using the FINDRISC Scale. General clinical analyses of blood and urine were performed, lipid profile parameters, glucose, insulin, creatinine, transaminases, estradiol, thyroid hormone, leptin levels in blood plasma were studied. In addition, an oral glucose tolerance test was performed and the insulin resistance index (HOMA-IR) was calculated.Results. In the group of Buryat women with lower body weight as compared to Russians, higher levels of leptin, HOMA- IR index, and larger waist circumference are observed. In Buryat women, low physical activity makes a significant contribution to the development of overweight and obesity, while for Russian women, excessive caloric intake is more important. In accordance with the results of the FINDRISC scale survey, the greatest contribution to the potential development of diabetes mellitus in the Russian group is body mass index (weight), and in the Buryat group, in addition to these indicators, waist circumference and reduced physical activity.Conclusions. The results of the study will be of great help in the development of pro-grammes for the prevention of diabetes and obesity, taking into account regional and ethnic differences among the population.

P43 Unmasking posterior reversible encephalopathy syndrome: a hidden threat in juvenile lupus

Abstract Introduction Posterior reversible encephalopathy syndrome (PRES) is a neurological condition identifiable through clinical presentation and magnetic resonance imaging (MRI). While PRES has been rarely documented in children as a complication of juvenile lupus, it remains a potentially reversible condition. However, it can be complicated by vasculopathy, infarction, or haemorrhage. The pathogenesis of PRES is still unclear. In juvenile lupus, the risk factors for PRES are multifaceted and interact with each other, including vasculitis, lupus nephritis, chronic kidney disease (CKD) leading to renal-origin hypertension, and iatrogenic hypertension caused by several hypertension-inducing drugs commonly used as first-line treatments for lupus. Case description A 14-year-old girl diagnosed with lupus presented with persistent fatigue, lower limb oedema, and abdominal symptoms (vomiting and diarrhoea). She experienced two episodes of PRES, three months apart. Active SLE was confirmed through clinical and laboratory findings, including positive autoimmune and serologic results for ENA antibody screen, high levels of anti-double-stranded DNA (&amp;gt;400), and low complements C3 (0.15 g/L) and C4 (&amp;lt;0.03 g/L). Urine analysis revealed 2+ RBCs, 3+ proteins, and an estimated glomerular filtration rate (eGFR) of ∼21 ml/min/1.73 m² with a plasma creatinine of 226 micromol/L. Renal biopsy identified lupus nephritis class IV and chronic kidney disease (CKD) changes, leading to a diagnosis of CKD stage 4. Initial treatment included a course of pulse methylprednisolone (1 g daily for 3 days) alongside rituximab and MMF for remission induction followed by high-dose oral prednisone (2 mg/kg/d). Her blood pressure started to increase following the first methylprednisolone pulse. In addition, two weeks later, severe fluid overload necessitated dialysis. Despite dialysis and the use of four antihypertensive agents (lisinopril, amlodipine, atenolol, doxazosin), her blood pressure fluctuated and remained uncontrolled. A week later, she experienced focal seizures. While a CT brain scan showed no abnormalities, an MRI revealed multifocal areas of bilateral cerebral hemispheric cortico-subcortical signal and diffusion alteration, indicating evolving PRES. A steroid weaning plan was implemented, and IV cyclophosphamide was initiated according to the National Institutes of Health protocol. Eight weeks later, she had another PRES episode, presenting with seizures confirmed by MRI findings. On both occasions, hypertensive encephalopathy was promptly recognized, and she was transferred to the PICU. Fortunately, her symptoms completely resolved within 12 hours of anticonvulsant and antihypertensive therapies. Discussion Common triggers of PRES include autoimmune conditions such as systemic lupus erythematosus (SLE), hypertensive encephalopathy, and drug toxicities (mainly cytotoxic and immunosuppressive drugs), all of which interact in lupus patients. However, it remains unclear how each factor contributes to the development of PRES. Additionally, the exact pathophysiological mechanism behind PRES is still debated. The two most widely accepted hypotheses involve: firstly, increased arterial blood pressure overwhelming cerebral autoregulatory mechanisms, leading to vascular leakage and vasogenic oedema. Secondly, endothelial dysfunction, where endothelial damage caused by circulating toxins enhances the release of vasoactive and immunogenic agents, altering vascular permeability. Our patient’s development of PRES is multifactorial, with lupus nephritis being a primary cause, aggravated by chronic kidney disease, leading to salt and water retention, which was further exacerbated by prednisolone. Other drugs, such as rituximab and cyclophosphamide, might have also been implicated in causing hypertension. PRES following rituximab infusion has been documented, with onset ranging from immediately after infusion to up to four weeks later. Proposed mechanisms include compromised blood-brain barrier integrity and immune dysregulation. Intravenous cyclophosphamide has also been identified as a potential trigger for PRES in patients with and without SLE, though the exact reason for this remains unclear. The dual role of these drugs in potentially precipitating life-threatening risks like PRES while being therapeutic agents presents a confusing dilemma. Much remains to be learned to enable the prevention and prompt response to PRES. Key learning points • Juvenile lupus with PRES is an uncommon neurological manifestation influenced by multiple factors. • Risk factors for PRES in juvenile lupus include lupus nephritis, CKD secondary to lupus, and iatrogenic hypertension including steroids, rituximab, and cyclophosphamide. These factors commonly exist and interplay together. • The pathogenesis of PRES in lupus, including the role of drugs, remains unclear. • Patients with lupus should be closely monitored, particularly their blood pressure. • Early diagnosis and prompt treatment of PRES can reverse radiologic and neurologic findings, leading to a favourable prognosis.

Extraction and evaluation for anti-diabetic effects of some Indian plant extracts

Diabetes is a metabolic disease associated with changes in the structure and function of several biological systems. The main cause of tissue injury is persistent hyperglycaemia. The past 20 years have seen increased expansion of the harmful effects of persistent hyperglycaemia, even if peripheral neuropathy and small and large vascular disease can also be used to explain diabetes-related organ failure. Liophyllum decastes, Butea monosperma, and Opuntia dillenil fruit extracts were shown to pass phytochemical testing. The study findings of Butea Monosperma, Opuntia dillenil, and Liophyllum decastes distilled (150 mg/kg) and (300 mg/kg) on STZ-tempted DM rats were paired with Glibenclamide. The glucometer method, serum and urine analysis, as well as factors including body weight, food consumption, glucose levels, and biochemical analysis, were used to determine the blood sugar rankings. Liophyllum decastes fungus fruit, Opuntia dillenil Planned fruit, and distilled Butea monosperma leaves all have anti-diabetic properties for diabetics.

Design and analysis of flexible antenna sensor for non-invasive detection of pregnancy in bovine

This research article presents a monopole antenna-based sensor for detecting cow pregnancy through urine analysis. The proposed flexible antenna sensor is printed on denim fabric with a permittivity of 1.7 and a loss tangent of 0.002. The flexible antenna resonates at 2.4 GHz and the gain of the proposed antenna sensor is 2.016 dBi, with a corresponding efficiency of 96.8%. The antenna's dimensions are 30 × 44 × 1 mm3. The substrate region behind the inner area of the radiator ring acts as a sensing area. This substrate can absorb liquids through the sensing area, causing the dielectric properties of the substrate to change according to the dielectric constant of the fluid under test. Urea concentration in pregnant cow urine is 11.06 mg/dL and 1.39 mg/dL in non-pregnant cow urine. The proposed antenna sensor uses microwave signals to detect pregnancy in cows. The deviation in resonance frequency and quality factor are used as key parameters for detecting cow pregnancy.

The diagnostic value of cytokines in chronic glomerulonephritis in children

In modern clinical practice of pediatricians, the problem of timely adequate treatment of chronic glomerulonephritis (CGN) in children is of particular relevance, due to both the high prevalence of the disease and the severity of its course, the complexity of therapy and the ambiguity of the prognosis. Lesions of the urinary system in children are not only common, but also tend to grow, and often at an early age. Deterioration of the environmental background, toxic and allergic effects of drugs lead to damage primarily to the kidneys, which are the eliminating organ. The aim of the study was to study urocytokines to assess the immune response in children with HCG, depending on the association with cytomegalovirus infection. The study included 100 children aged 4-7 years, permanently residing in the Bukhara region of the Republic of Uzbekistan. At the time of the study, the patients were undergoing routine treatment in the Department of Pediatric Nephrology of the Bukhara Regional Children’s Multidisciplinary Medical Center. All children underwent general clinical (general blood test with leukoformula, general urine analysis, biochemical blood test with determination of urea, creatinine and cystatin C, immunological (TNFα, IL-18, MCP-1, IgM and IgG antibodies to cytomegalovirus infection (CMVI) in blood serum, IL-1β and IL-17A in urine) examination methods. Thus, it was found that the concentration of cystatin C in the blood serum was inversely proportional to the glomerular filtration rate in the kidneys – with a decrease in kidney function in sick children, a twofold increase was noted, that is, the accumulation of cystatin C in the blood. An increase in the concentration of IL-18 in serum and IL-1β in urine relative to the control group in CGN was an indicator of the severity of an autoimmune reaction, and a relatively low concentration of cytokines in both blood and urine in CGN with CMVI indicated suppression of the specific antiviral immunity of CMVI. It was found that an increase in serum MCP-1 by 1.4 times in group 1 and 2.9 times in group 2 of CGN with CMVI is an indicator of viral kidney damage. A significantly high concentration of IL-17A in urine in CGN with CMVI indicated local cytokine production in the kidneys and acted as an indicator of the prognosis of the outcome of CGN.

Self-control study of multi-omics in identification of microenvironment characteristics in urine of uric acid stone

AbstractThe aim of this study is to perform proteomic and metabolomic analyses in bilateral renal pelvis urine of patients with unilateral uric acid kidney stones to identify the specific urinary environment associated with uric acid stone formation. Using cystoscopy-guided insertion of ureteral catheters, bilateral renal pelvis urine samples are collected. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is employed to identify differentially expressed proteins and metabolites in the urine environment. Differentially expressed proteins and metabolites are further analyzed for their biological functions and potential metabolic pathways through Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. In the urine from the stone-affected side, eight differential proteins were significantly upregulated, and six metabolites were dysregulated. The uric acid stone urinary environment showed an excess of α-ketoisovaleric acid and 3-methyl-2-oxovaleric acid, which may contribute to the acidification of the urine. Functional and pathway analyses indicate that the dysregulated metabolites are mainly associated with insulin resistance and branched chain amino acid metabolism.

Administration Route Differentiation of Altrenogest via the Metabolomic LC-HRMS Analysis of Equine Urine

Altrenogest, also known as allyltrenbolone, is a synthetic form of progesterone used therapeutically to suppress unwanted symptoms of estrus in female horses. Altrenogest affects the system by decreasing levels of endogenous gonadotrophin and luteinizing and follicle-stimulating hormones, which in turn decreases estrogen and mimics the increase of progesterone production. This results in more manageable mares for training and competition alongside male horses while improving the workplace safety of riders and handlers. However, when altrenogest is administered, prohibited steroid impurities such as trendione, trenbolone, and epitrenbolone can be detected. It has been assumed that greater concentrations of these steroid impurities are present in injectable preparations and, therefore, pose a greater risk of causing anabolic effects when administered. For this reason, and due to the necessity of this therapeutic substance for the safety of thoroughbred racing participants, a metabolomic approach investigating the differentiation of two main administration routes was conducted. Liquid chromatography high-resolution mass spectrometry analysis of equine urine samples found five sulfated compounds, estrone sulfate, testosterone sulfate, 2-methoxyestradiol sulfate, pregnenolone sulfate, and cortisol sulfate, with the potential to differentiate between oral and intramuscularly administered altrenogest using a random forest classification model. The best model results, comparing two horses’ administration normalized peak area datasets, gave an AUC score of 0.965 with a confidence level of 95% (between 0.931 and 0.995). Identifications of these compounds were confirmed with assistance from the Shimadzu Insight Explore Assign feature, together with MS/MS spectrum and retention time matching of purchased and synthesized reference standards. This study proposes a new potential application for metabolomic multi-tool workflows and machine learning models in a forensic toxicological context.

Estimating Uncertainty in Actinide Intake Due to Unknown Time of Exposure

Bioassay of radiation workers handling actinides in powder form is carried out annually under routine monitoring program. In case of routine monitoring, as the day of intake is unknown, it is assumed that intake has occurred at the midpoint of monitoring interval. However, an uncertainty is introduced in intake estimation due to this assumption. In the present work, uncertainties were evaluated due to unknown time of intake of Type M and S compounds of Pu and U for annual and biennial monitoring interval. Lung and excreta monitoring methods were considered for uncertainty estimation along with the spread of ±1 month or ±2 months in measurements, at the end of monitoring interval. Annual lung monitoring is found to be the most robust and accurate method for assessment of intake of Type S compounds of Pu, Am and U when time of intake is unknown and Pu is detected using 241Am as a tracer. For Type M compounds, uncertainty was found to be higher than 3 for biennial monitoring interval. Uncertainty is found to be less than 3 for Type S compounds of Pu and U and also for Type M compounds of Pu for both, annual and biennial monitoring intervals using urine analysis. It is higher than 3 for Type M compounds of U for both the monitoring intervals. It is greater than 3 for both Type M and S compounds of Pu and U for both the monitoring intervals using fecal analysis.

Epidemiological Aspects of Renal Disorders in Dogs at South-Saurastra Region of Gujarat- A Prospective Study

Background: Kidney plays a major role in eliminating metabolic wastes from body, in maintaining acid-base balance and production of hormones. Due to their anatomic and physiologic features, kidneys are most susceptible to toxicity and ischemia. No study has been carried out to assess the renal disorders in dog in this region. Hence, the epidemiological study was carried out to record renal disorders in dogs at Junagadh. Methods: The assessment of the incidence of renal disorders in dogs was performed in the hospital cases presented at Veterinary Clinical Complex, COVSAH, KU from September 2022 to August 2023. A total of 2850 caseloads of dogs with different ailments were screened, out of which 170 dogs were diagnosed as renal disorders based on clinical presentation, hematology, serum biochemistry, urine analysis and nephrosonography. Result: The overall incidence of renal disorders in dogs was 5.96%. The higher occurrence of renal disorders was noted in age group of 6-8 years (9.62%) and males (6.61%). The dog breeds that were found higher incidence were Labrador retriever (9.68%) followed by German shepherd (7.24%). Month and Season wise higher incidence was recorded in the month of October (10%) of monsoon (7.61%) season. The highest recorded incidence of renal disorder was nephritis and renal failure (AKI/CKD) (each 35.88%).

Road to automated urinalysis analyzer: Validation of Sysmex UN-3000 to supplant manual urinalysis

Abstract Introduction/Objective Traditionally, urinalysis encompasses the chemical analysis of urine by dipstick and manual microscopy for formed elements. High specimen volume and varying subjectivity among individuals performing microscopic analysis make the practice both imprecise and inefficient. Implementation of Sysmex UN- Series™Automated Urinalysis (Sysmex Corporation, Kobe, Japan) fulfilled our need for automation, addressing both issues at hand. Automated urinalysis offers a solution for laboratories to meet the growing demand for faster result turn around times(TAT) with ever increasing specimen volumes. We expect greater sensitivity and reproducibility in terms of comparison to manual microscopy, as well as quicker TAT with the change in methodology. Methods/Case Report Using both unpreserved and preserved urine tubes, a macroscopic comparative study between Clinitek Advantus(manual) and Clinitek Novus (automated) methods was carried out on 141 urines with greater than 60 abnormal patients. Similarly, a microscopic study between the laboratory’s manual microscopy procedure and the Sysmex UF-5000 was carried out on 112 urines with greater than 60 abnormal patients. RBCs, WBCs, Epithelial cells were evaluated under high power field(40X); casts and crystals were evaluated under lower power field(10X). The Reference Range Interval for both chemical and microscopic was verified using 44 normal patient specimens. The quantified values are converted to high and low power field (hpf/lpf), analogous to the current system in the laboratory. Results (if a Case Study enter NA) Most parameters had &amp;gt;90% agreement between manual and automated method. Parameters falling below 90% were checked to see if discrepancies fell within 1 degree. Automated system is more sensitive than manual and our average TAT for urinalysis dropped 50%. Conclusion The automated urinalysis technology enabled us to focus only on samples requiring intervention based on pathological criteria, resulting in reduced overall TAT and workload burden, and improved consistency in reporting across specimens.

Automatic kidney stone identification: an adaptive feature-weighted LSTM model based on urine and blood routine analysis.

Kidney stones are the most common urinary system diseases, and early identification is of great significance. The purpose of this study was to use routine urine and blood detection indices to build a deep learning (DL) model to identify the presence of kidney stones in the early stage. A retrospective analysis was conducted on patients with kidney stones who were treated at West China Hospital of Sichuan University from January 2020 to June 2023. A total of 1130 individuals presenting with kidney stones and 1230 healthy subjects were enrolled. The first blood and urine laboratory data of participants at our hospital were collected, and the data were divided into a training dataset (80%) and a verification dataset (20%). Additionally, a long short-term memory (LSTM)-based adaptive feature weighting model was trained for the early identification of kidney stones, and the results were compared with those of other models. The performance of the model was evaluated by the area under the subject working characteristic curve (AUC). The important predictive factors are determined by ranking the characteristic importance of the predictive factors. A total of 17 variables were screened; among the top 4 characteristics according to the weight coefficient in this model, urine WBC, urine occult blood, qualitative urinary protein, and microcyte percentage had high predictive value for kidney stones in patients. The accuracy of the kidney stone (KS-LSTM) learning model was 89.5%, and the AUC was 0.95. Compared with other models, it has better performance. The results show that the KS-LSTM model based on routine urine and blood tests can accurately identify the presence of kidney stones. And provide valuable assistance for clinicians to identify kidney stones in the early stage.

Novel Biomarkers for Early Detection of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality globally. Most patients present with late diagnosis, leading to poor prognosis. This narrative review explores novel biomarkers for early HCC detection. We conducted a comprehensive literature review analyzing protein, circulating nucleic acid, metabolite, and quantitative proteomics-based biomarkers, evaluating the advantages and limitations of each approach. While established markers like alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin, and AFP-L3 remain relevant, promising candidates include circulating tumor DNA, microRNAs, long noncoding RNAs, extracellular vesicle, and metabolomic biomarkers. Multi-biomarker panels like the GALAD score, Oncoguard, and Helio liver test show promise for improved diagnostic accuracy. Non-invasive approaches like urine and gut microbiome analysis are also emerging possibilities. Integrating these novel biomarkers with current screening protocols holds significant potential for earlier HCC detection and improved patient outcomes. Future research should explore multi-biomarker panels, omics technologies, and artificial intelligence to further enhance early HCC diagnosis and management.