Urine Collection Research Articles

Temperature and time after urine collection affect the detection of phenethylamine, a substance prohibited in sports.

2-Phenylethylamine (phenethylamine) and its derivatives are stimulant drugs, which are prohibited in sports because of their potential performance-enhancing properties. If phenethylamine is detected in an athlete's urine, the athlete may be subjected to serious sanctions, such as disqualification for both domestic and international competitions. Given the serious consequences athletes face for phenethylamine detection, great care should be taken to avoid false positive tests. In forensic medicine, it is widely known that phenethylamine is produced by putrefactive bacteria in autopsy urine samples; it is possible that this process could also occur in an athlete's urine sample without proper storage. In this study, human urine samples were stored at -20, 4, or 22°C for 14 days, and phenethylamine in the samples was quantitatively analyzed using ultra-high-performance liquid chromatography-tandem mass spectrometry. No phenethylamine was detected in urine samples stored at -20°C throughout 14-day period. Nevertheless, phenethylamine was detected after 6days in these samples stored at 4°C and after only 1day in samples stored at 22°C. Additionally, the concentration of phenethylamine in these samples increased each day after detection. These results suggest that urine samples should be stored immediately at -20°C after collection when testing athletes for phenethylamine, especially if the sample must be stored for extended period before testing.

Prevalence, Peculiarities and Patterns of Urogenital Schistosomiasis and Hematuria in Owena Reservoir Area, Ondo East Local Government Area, Ondo State, Nigeria

Background: Schistosomiasis, Leprosy, Leishmaniasis, Malaria, Trypanosomiasis and Filariasis are the six major tropical diseases, specially targeted for control by the Special Program for Research and Training on Tropical Diseases of the United Nations Development Programme (UNDP), World Bank and World Health Organization. Out of the above six diseases, schistosomiasis is the second most important tropical diseases, second only to malaria. The distribution of schistosomiasis cuts across 76 countries in Africa, Latin America and Asia. Schistosoma hematobium endemicity cuts across 54 countries. Aim: To study the prevalence, peculiarities and patterns of urogenital schistosomiasis and hematuria in Owena Reservoir Area for an effective, affordable and sustainable schistosomiasis control in the area. Materials and methods: Owena Reservoir Area consists of Owena, Kajola and Baiken communities. A school-based cross-sectional technique was used for urine collection and quantification of Schistosoma hematobium eggs which involved 624 pupils in March 2014 and 591 pupils in April 2015. Risk factors, socio-demographic variables were collected using questionnaires. Urine samples were examined for Schistosoma hematobium eggs using sedimentation by gravity cum centrifugation. The urine samples obtained from the pupils were divided into two separate 30ml universal sterling plastic bottles with conical bottom. The first of the two 30ml universal sterling plastic bottles were examined for Schistosoma hematobium eggs using sedimentation by gravity cum centrifugation. The second of the two 30ml universal sterling plastic bottles were assessed for gross hematuria through visual observation of bloody urine while non-bloody samples were examined for micro-hematuria using one strip of commercially prepared chemical reagent strips COMBUR-9 prepared and marketed by Acun Laboratory USA which was dipped into each urine sample and the color change was matched with standard by the side of the container of the reagent strips. Results: Out of the 624 pupils examined in March 2014, 256 (41.0%) were positive for Schistosoma hematobium eggs in urine, while in April 2015, 381 (64.5%) out of 591 were positive. Prevalence of hematuria in the three communities shows that in Owena community the age group 21 – 30 had the highest prevalence (49.2%); in Kajola, the age group 5-10 had the highest prevalence (46.2%); while in Baiken community, the age group 5-10 had the highest prevalence (55.5%) – with 95% Confidence Interval in all cases. Conclusion: Macrohematuria was identified as a sensitive and specific diagnostic technique for identifying people infected with Schistosoma hematobium in the three communities. This parameter may be recommended as a cost saving diagnostic approach during future control efforts, with reference to the April 2015 peculiarities and patterns of infection shown by this study.

Time-course effects of different fiber-rich ingredients on energy values, microbiota composition and SCFA profile in growing pigs.

This study was to investigate time-course effects of different types of dietary fiber on the energy values, fecal microbiota and short-chain fatty acid (SCFA) concentration in growing pigs. A total of 24 barrows (initial body weight, 19.8±0.5kg) were assigned to 4 dietary treatments based on body weight (BW) in a completely randomized design, including a basal diet (CON) and 3 fiber-rich diets replacing corn, soybean meal and soybean oil in the CON diet with 20% sugar beet pulp (SBP), defatted rice bran (DFRB) or soybean hull (SBH), respectively. Fresh feces were sampled on d 7, 14 and 21, followed by 5d total feces and urine collections. The results showed that there were no differences in DE and ME between any of the fiber ingredients on d 7, 14 or 21. However, fiber inclusion decreased the DE and ME of the diet (P<0.05) regardless of the time effect. Principal coordinate analysis (PCoA) revealed distinctly different microbial communities on the DFRB diet and SBH diet across different times (P<0.05) and the fecal microbiota of the 4 diet groups demonstrated notably distinct clusters at each time point (P<0.05). With adaptation time increased from 7 to 21d, cellulose-degrading bacteria and SCFA-producing bacteria (e.g., Ruminococcaceae _UCG-014, Rikenellaceae _RC9_gut_group and Bifidobacterium) increased in the fiber inclusion diets, and pathogenic genera (e.g., Streptococcus and Selenomonas) were increased in the basal diet (P<0.05). Furthermore, the gut microbiota of growing pigs adapted more easily and quickly to the SBP diet compared to the DFRB diet, as reflected by the concentration of propionate, butyrate, isovalerate and total SCFA which increased with time for growing pigs fed the DFRB diet (P<0.05). Collectively, our results indicated at least 7d adaptation was required to evaluate the energy values of fiber-rich ingredients, as the hindgut microbiota of growing pigs may need more time to adapt to a high fiber diet, especially for insoluble dietary fiber.

Nitrogen and energy losses and methane emissions from beef cattle fed diets with gradual replacement of maize silage and concentrate with grass silage and corn-cob mix.

Diets based on large proportions of grassland-based feed are uncommon in forage-based intensive beef production, thus contradicting governmental or commercial strategies to promote the use of grassland-based feed in ruminant production systems. Compared with typical maize silage/concentrate diets, grassland-based diets are associated with impaired nitrogen (N) and energy utilisation because of the comparably lower energy and higher CP content of these feeds. However, quantitative studies concerning the effects of increased dietary proportions of grassland-derived feeds on N and energy losses and utilisation and on methane emissions are missing and the compensation potential of using a limited proportion of an energy-rich forage is unknown. Therefore, we tested five diets with varying types and proportions of forage and concentrate. Three diets consisted of grass silage, maize silage, and concentrate in ratios of, g/kg DM, 100:600:300 (G100; control), 300:500:200 (G300), and 500:300:200 (G500), respectively. Two diets were composed of grass silage, corn-cob mix (CCM), and concentrate in ratios of, g/kg DM, 500:300:200 (G500CCM), and 750:150:100 (G750CCM), respectively. A high-protein concentrate (270g CP/kg DM) was fed to G100, whereas a low-protein concentrate (140g CP/kg DM) was used in the remaining diets. Diets were fed throughout the entire fattening period to groups of six Limousin-crossbred bulls each. When weighing 246±18kg, each animal underwent a 7-day total daily faeces and urine collection, which was followed by measuring methane emissions in respiration chambers for 48h. Total DM intake was similar across all diets, whereas the N intake varied (P<0.05). Urinary N loss (g/day) was the highest for G750CCM (28.2) and G100 (26.6) and lowest for G500CCM (15.2) and G300 (16.9) (P<0.001). Energy utilisation was comparable among all groups. Metabolisable energy intake decreased numerically only with increasing proportions of grass silage in the diet. Substituting maize silage with CCM counteracted the loss in metabolisable energy intake. Absolute methane emissions were not different across the groups, but methane emission intensity (mg/g body protein retention) varied (P<0.05), being numerically lower for G100 (349) and G500CCM (401) compared with the other groups (488 on average). In conclusion, the results show that the grass silage proportion in beef cattle diets can be substantially increased when strategically combined with energy-dense forages, such as CCM. This also limits the need for concentrate and additional protein sources; in addition, the associated urinary N emissions, which are potentially noxious to the environment, are avoided.

Detections of organophosphate and pyrethroid insecticide metabolites in urine and sweat obtained from women during infrared sauna and exercise: A pilot crossover study.

Synthetic pesticides such as organophosphates and pyrethroids are commonly used worldwide yet the metabolic and long-term human health effects of these environmental exposures are unclear. Urinary detections of metabolites involving both classes of insecticides have been documented in various global populations. However, reports documenting similar detections in human sweat are sparse. In this study, the concentrations of four insecticide metabolites were measured using liquid chromatography coupled with tandem mass spectrometry in repeated sweat and urine collections (n=85) from 10 women undergoing three interventions (control, infrared sauna and indoor bicycling) within a single-blinded randomised crossover trial. The Friedman test with post-hoc two-way analysis of variance, the related-samples Wilcoxon signed rank test and the Spearman's rank-order correlation test were used to analyse the results. Organophosphate metabolites were detected in 84.6% (22/26) and pyrethroids in 26.9% (7/26) of the collected sweat samples (pooled per individual, per intervention). Urinary concentrations of three of the four metabolites marginally increased after infrared sauna bathing: 3,5,6-trichloro-2-pyridinol (z=2.395, p=0.017); 3-phenoxybenzoic acid (z=2.599, p=0.009); and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (z=2.090, p=0.037). Urinary 3-phenoxybenzoic acid also increased after exercise (z=2.073, p=0.038) and demonstrated the most temporal variability (days to weeks) of any of the urinary metabolites. Definitive sweat/urine correlations were not demonstrated. These results indicate metabolites from organophosphate and pyrethroid pesticides can be detected in human sweat and this raises intriguing questions about perspiration and its role in the metabolism and excretion of synthetic pesticides.

Simplified urinary steroid profiling by LC-MS as diagnostic tool for malignancy in adrenocortical tumors

ObjectivesPreoperative identification of malignant adrenal tumors is challenging. 24-h urinary steroid profiling by LC-MS/MS and machine learning has demonstrated high diagnostic power, but the unavailability of bioinformatic models for public use has limited its routine application. We here aimed to increase usability with a novel classification model for the differentiation of adrenocortical adenoma (ACA) and adrenocortical carcinoma (ACC). MethodsEleven steroids (5-pregnenetriol, dehydroepiandrosterone, cortisone, cortisol, α-cortolone, tetrahydro-11-deoxycortisol, etiocholanolone, pregnenolone, pregnanetriol, pregnanediol, and 5-pregnenediol) were quantified by LC-MS/MS in 24-h urine samples from 352 patients with adrenal tumor (281 ACA, 71 ACC). Random forest modelling and decision tree algorithms were applied in training (n = 188) and test sets (n = 80) and independently validated in 84 patients with paired 24-h and spot urine. ResultsAfter examining different models, a decision tree using excretions of only 5-pregnenetriol and tetrahydro-11-deoxycortisol classified three groups with low, intermediate, and high risk for malignancy. 148/217 ACA were classified as being at low, 67 intermediate, and 2 high risk of malignancy. Conversely, none of the ACC demonstrated a low-risk profile leading to a negative predictive value of 100% for malignancy. In the independent validation cohort, the negative predictive value was again 100% in both 24-h urine and spot urine with a positive predictive value of 87.5% and 86.7%, respectively. ConclusionsThis simplified LC-MS/MS-based classification model using 24-h-urine provided excellent results for exclusion of ACC and can help to avoid unnecessary surgeries. Analysis of spot urine led to similarly satisfactory results suggesting that cumbersome 24-h urine collection might be dispensable after future validation.

First trimester 3D ultrasound placental volume at 11th to 13th weeks gestational age for predicting preeclampsia

Background: After the 20th week of pregnancy, preeclampsia is diagnosed when a woman develops new-onset hypertension (systolic blood pressure 140 mm Hg or higher, or diastolic blood pressure 90 mm Hg or higher) and proteinuria (300 mg or more in a 24-hour urine collection, or 1+ on dipstick testing). The aim of this work was to determine the sensitivity of placental volume (PV) in the first trimester at 11th week to 13th week+6 days in predicting preeclampsia. Methods: This prospective observational study was carried out on 250 women with any gravidity, singleton pregnancy between 11th to 13th week of gestation based on the last menstrual period or first-trimester ultrasound. All patients were subjected to laboratory investigations (CBC, Renal function tests, Random blood sugar and tests to detect proteinuria.) and imaging. Results: The sensitivity and specificity of PV in differentiating between preeclampsia and normotensive were 60.0%; 60.0% respectively. There was high significant difference in between preeclmpesia and normotensive cases regarding to PV. Conclusions: The PV was lower in cases with preeclampsia as compared to nonpreeclamptic women with highly significant statistical difference and that means 3D PV measurement at 11th to 13th week of pregnancy could increase the predictive accuracy for pre-eclampsia.

Editorial Commentary.

No AccessUrology PracticeHealth Policy1 Mar 2023Editorial CommentaryThis article comments on the following:Potential for Urolithiasis-related Research Using the Novel Medicare-Litholink Database Julio G. Davalos Julio G. DavalosJulio G. Davalos * E-mail Address: [email protected] Chesapeake Urology Associates, Glen Burnie, Maryland More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000378.02AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Commentary." Urology Practice, 10(2), p. 153 Reference 1. . Prevalence of 24-hour urine collection in high risk stone formers. J Urol. 2014; 191(2):376-380. Link, Google Scholar © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesUrology Practice25 Jan 2023Potential for Urolithiasis-related Research Using the Novel Medicare-Litholink Database Volume 10Issue 2March 2023Page: 153-153 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Julio G. Davalos Chesapeake Urology Associates, Glen Burnie, Maryland * E-mail Address: [email protected] More articles by this author Expand All Advertisement PDF downloadLoading ...

Reducing sulfide and methane production in gravity sewer sediments through urine separation, collection and intermittent dosing

Sulfide and methane production are a major concern in sewer management. Many solutions with the use of chemicals have been proposed yet incurring huge costs. Here, this study reports an alternative solution to reduce sulfide and methane production in sewer sediments. This is achieved through integration of urine source separation, rapid storage, and intermittent in situ re-dosing into a sewer. Based on a reasonable capacity of urine collection, an intermittent dosing strategy (i.e. 40 min per day) was designed and then experimentally tested using two laboratory sewer sediment reactors. The long-term operation showed that the proposed urine dosing in the experimental reactor effectively reduced sulfidogenic and methanogenic activities by 54% and 83%, compared to those in the control reactor. In-sediment chemical and microbial analyses revealed that the short-term exposure to urine wastewater was effective in suppressing sulfate-reducing bacteria and methanogenic archaea, particularly within a surface active zone of sediments (0–0.5 cm) likely attributed to the biocidal effect of urine free ammonia. Economic and environmental assessments indicated that the proposed urine approach can save 91% in total costs, 80% in energy consumption and 96% in greenhouse gas emissions compared to the conventional use of chemicals (including ferric salt, nitrate, sodium hydroxide, and magnesium hydroxide). These results collectively demonstrated a practical solution without chemical input to improve sewer management.

Abstract MP44: Cardiovascular and Behavioral Correlates of Restless Leg Syndrome in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: Restless Legs Syndrome (RLS) is a neurological condition characterized by uncomfortable sensations in the legs at rest that leads to sleep disruption and impaired quality of life. Correlates of RLS in prior studies are inconsistent but include many correlates of cardiovascular disease (CVD) risk factors. The objective of our study is to describe the burden and correlates of RLS in an epidemiological study of middle-aged adults. Methods: Participants in the CARDIA study completed the Cambridge-Hopkins RLS questionnaire between 2020-2022. Sociodemographic characteristics, cigarette smoking, physical activity, alcohol intake, depressive symptoms, parity and menopausal status were determined based on self-report. Waist circumference, body mass index (BMI) and blood pressure were measured using standard procedures. Serum glucose and creatinine were measured in fasting samples. A spot urine collection was used to determine urinary albumin and creatinine. Hypertension and diabetes were determined based on current clinical guidelines. We carried out univariate and multivariable logistic regression modeling to identify correlates associated with RLS. Results: In 2337 CARDA participants (44% Black and 60% female) with a mean age of 55.2 years old (SD=3.6), 120 (5.5%) participants (white women=78, black women=12, white men=26 and black men=4) endorsed symptoms of RLS. White participants and females were significantly more likely to endorse having RLS (Table). Health behaviors assessed in our study were not associated with RLS; however, the presence of diabetes and markers of adverse kidney function (i.e., serum creatinine, ACR) were associated with a higher odds of RLS and these associations persisted in a multivariable model. Conclusion: Metabolic disorders that lead to microvascular and peripheral nerve damage were associated with RLS in this sample. Future research should investigate whether RLS and peripheral neuropathy are overlapping conditions.

The Urinary Excretion of Magnesium as an Effective Magnesium Deficiency State Indicator: A Controlled Intervention Trial.

With the western influence in our diets, food consumption has changed, and our magnesium (Mg) intake is no longer optimal. Serum Mg (S-Mg) level is currently used as an indicator of Mg deficiency and is strictly regulated via compensatory mechanisms. It is believed that a 24-h urine collection can be used to evaluate potential Mg deficiency. This study aimed to assess whether Mg deficiency state as found in urine Mg (U-Mg) excretion and improving such deficiency with a diet that meets the Recommended Dietary Allowances (RDAs) of Mg for 15 d. Healthy Japanese women were recruited for Study 1 (n=22) and Study 2 (n=10). Study 1 was 1-d balance test, where fasting blood and 24-h urine samples were collected. Study 2 was 15-d diet load test, where fasting blood (days 1, 7, and 15) and 24-h urine (odd days) were collected. All test meals were made certain to have met the RDA for Mg for women in their 20s. In Studies 1 and 2, S-Mg was within the normal range. In Study 1, U-Mg excretion was 67.7±17.0 mg/d, with a large dispersion. In Study 2, U-Mg excretion on days 7 and 15 was significantly higher than on day 1, but have no significant differences in U-Mg excretion between days 7-15. U-Mg excretion can be a valuable indicator to evaluate Mg state. In young women, improvements in Mg deficient state were observed after 7-15 d of taking meals that met the RDAs of Mg.

The effect of micro-particle curcumin on chronic kidney disease progression: the MPAC-CKD randomized clinical trial.

Curcumin is a commonly used herbal supplement with anti-inflammatory and anti-fibrotic properties. Animal studies and small human trials suggest that curcumin reduces albuminuria in patients with chronic kidney disease (CKD). Micro-particle curcumin is a new, more bioavailable formulation of curcumin. To determine whether micro-particle curcumin versus placebo slows the progression of albuminuric CKD we conducted a randomized, double-blind, placebo-controlled trial with 6-month follow-up. We included adults with albuminuria [a random urine albumin-to-creatinine ratio >30mg/mmol (265mg/g) or a 24-h urine collection with more than 300mg of protein] and an estimated glomerular filtration rate (eGFR) between 15 and 60mL/min/1.73 m2 within the 3months before randomization. We randomly allocated participants 1:1 to receive micro-particle curcumin capsules (90mg/day) or matching placebo for 6months. After randomization, the co-primary outcomes were the changes in albuminuria and the eGFR. We enrolled 533 participants, but 4/265 participants in the curcumin group and 15/268 in the placebo group withdrew consent or became ineligible. The 6-month change in albuminuria did not differ significantly between the curcumin and placebo groups [geometric mean ratio 0.94, 97.5% confidence interval (CI) 0.82 to 1.08, P=.32]. Similarly, the 6-month change in eGFR did not differ between groups (mean between-group difference -0.22mL/min/1.73m2, 97.5% CI-1.38 to 0.95, P=.68). Ninety milligrams of micro-particle curcumin daily did not slow the progression of albuminuric CKD over 6months. ClinicalTrials.gov Identifier: NCT02369549.

Validation of a Thai semiquantitative food frequency questionnaire (semi-FFQ) for people at risk of metabolic syndrome

BackgroundFood frequency questionnaires (FFQ) are a useful dietary assessment tool to determine relationships between diet and non-communicable diseases (NCDs). Our purpose was to validate a semiquantitative FFQ (semi-FFQ) for Thais at risk of metabolic syndrome (MS).MethodsThe researchers identified 345 men and women aged 30–65 years who were eligible for the study. Ninety-four participants were finally enrolled (54 in a “urine-collection not-required” group and 40 in a “urine collection” group). They were asked to maintain a 4-day food record for 4 weeks and partook in a semi-FFQ interview during week 4. Urine samples and biochemical results related to MS were collected. Validation results were associated with three primary nutrients for MS (sugar, fat, and sodium) and biochemical results (blood glucose, lipid profiles, blood pressure, and 24-h urine sodium).ResultsThe biomarker level of each key MS nutrient significantly increased commensurate with rises in semi-FFQ estimated intakes. Correlation coefficients (r) were as follows: fasting blood glucose, r = 0.221 (fruits) and r = 0.229 (desserts); triglycerides, r = 0.112 (a la carte-dishes); low-density lipoprotein cholesterol, r = 0.205 (rice-with-topping dishes); systolic blood pressure, r = 0.272 (snacks) and r = 0.190 (a la carte dishes). Fasting blood glucose was a significant biomarker associated with the development of metabolic syndrome (OR 1.42, 95% CI 1.12–1.81). We also found that fat (OR 1.28, 95% CI 1.09–1.89), sodium (OR 1.98, 95% CI 1.05–1.95) and energy (OR 1.09, 95% CI 1.01–1.17) from an a la carte meal were significantly associated with the development of metabolic syndrome.ConclusionsThai food has a unique characteristic since it often pairs various ingredients and seasoning in one menu. This semi-FFQ is a tool that offers relatively valid ranking for intake of energy, nutrients, single foods, and mixed dishes based on Thai menus associated with a risk for developing metabolic syndrome and NCDs. Using this tool could help identify unhealthy dietary patterns and help develop recommendations for people at risk with the goal of preventing NCDs.

Polymerized human cord hemoglobin assisted with ascorbic acid as a red blood cell substitute alleviating oxidative stress for blood transfusion.

Introduction: Blood transfusion is widely used in clinical settings, where considerable efforts have been devoted to develop red blood cell substitutes to overcome blood shortage and safety concerns. Among the several kinds of artificial oxygen carriers, hemoglobin-based oxygen carriers are promising due to their inherent good oxygen-binding and -loading properties. However, difficulties in prone to oxidation, production of oxidative stress, and injury in organs limited their clinical utility. In this work, we report a red blood cell substitute composed of polymerized human cord hemoglobin (PolyCHb) assisted with ascorbic acid (AA) that alleviates oxidative stress for blood transfusion. Methods: In this study, the in vitro impacts of AA on the PolyCHb were evaluated by testing the circular dichroism, methemoglobin (MetHb) contents and oxygen binding affinity before and after the addition of AA. In the in vivo study, guinea pigs were subjected to a 50% exchange transfusion with PolyCHb and AA co-administration, followed by the collection of blood, urine, and kidney samples. The hemoglobin contents of the urine samples were analyzed, and histopathologic changes, lipid peroxidation, DNA peroxidation, and heme catabolic markers in the kidneys were evaluated. Results: After treating with AA, there was no effect on the secondary structure and oxygen binding affinity of the PolyCHb, while the MetHb content was kept at 55%, which was much lower than that without AA treating. Moreover, the reduction of PolyCHbFe3+ was significantly promoted, and the content of MetHb could be reduced from 100% to 51% within 3h. In vivo study results showed that PolyCHb assisted with AA inhibited the formation of hemoglobinuria, upgraded the total antioxidant capacity and downgraded the superoxide dismutase activity of kidney tissue, and lowered the expression of biomarkers for oxidative stress, e.g., malondialdehyde (ET vs ET+AA: 4.03±0.26μmol/mg vs 1.83±0.16μmol/mg), 4-hydroxy-2-nonenal (ET vs ET+AA: 0.98±0.07 vs 0.57±0.04), 8-hydroxy 2 deoxyguanosine(ET vs ET+AA: 14.81±1.58ng/ml vs 10.91±1.36ng/ml), heme oxygenase 1 (ET vs ET+AA: 1.51±0.08 vs 1.18±0.05) and ferritin (ET vs ET+AA: 1.75±0.09 vs 1.32±0.04). The kidney histopathology results also demonstrated that kidney tissue damage was effectively alleviated. Conclusion: In conclusion, these comprehensive results provide evidence for the potential role of AA in controlling oxidative stress and organ injury in the kidneys induced by PolyCHb, and suggest that PolyCHb assisted with AA has promising application for blood transfusion.

Determinants of renal papillary appearance in kidney stone formers: An in-depth examination

The aim of this study is to investi-gate the association between the urinary metabolic milieu and kidney stone recurrence with a validated papillary evaluation score (PPLA). We prospectively enrolled 30 stone for-mers who underwent retrograde intrarenal surgery procedures. Visual inspection of the accessible renal papillae was performed to calculate PPLA score, based on the characterization of ductal plugging, surface pitting, loss of papillary contour and Randall's plaque extension. Stone compositions, 24h urine collections and kidney stone events during follow-up were collected. Relative supersaturation ratios (RSS) for calcium oxalate (CaOx), brushite and uric acid were calculated using EQUIL-2. PPLA score > 3 was defined as high. Median follow-up period was 11 months (5, 34). PPLA score was inversely correlated with BMI (OR 0.59, 95% CI 0.38, 0.91, p = 0.018), type 2 diabetes (OR 0.04, 95% CI 0.003, 0.58, p = 0.018) and history of recurrent kidney stones (OR 0.17, 95%CI 0.04, 0.75, p = 0.019). The associations between PPLA score, diabetes and BMI were not confirmed after excluding patients with uric acid stones. Higher PPLA score was associated with lower odds of new kidney stone events during follow-up (OR 0.15, 95% CI 0.02, 1.00, p = 0.05). No other significant correla-tions were found. Our results confirm the lack of efficacy of PPLA score in phenotyping patients affected by kidney stone disease or in predicting the risk of stone recurrence. Larger, long-term studies need to be performed to clarify the role of PPLA on the risk of stone recurrence.

Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury

In recent years, cases of liver damage caused by ashwagandha herbal supplements have been reported from different parts of the world (Japan, Iceland, India, and the USA). Here, we describe the clinical phenotype of suspected ashwagandha-induced liver injury and the potential causative mechanism. The patient was admitted to the hospital because of jaundice. In the interview, it was reported that he had been taking ashwagandha for a year. Laboratory results showed an increase in total bilirubin, alanine transaminase (ALT), aspartate transaminase (AST), (gamma-glutamyl transpherase (GGT), alkaline phosphatase (ALP), total cholesterol, triglycerides, and ferritin. Based on clinical symptoms and additional tests, the patient was diagnosed with acute hepatitis and referred to a facility with a higher reference rate to exclude drug-induced liver injury. An R-value was assessed, indicative of hepatocellular injury. The result of the 24 h urine collection exceeded the upper limit of normal for copper excretion in urine twice. The clinical condition improved after intensive pharmacological treatment and four plasmapheresis treatments. This case is another showing the hepatotoxic potential of ashwagandha to cause cholestatic liver damage mixed with severe jaundice. In view of several documented cases of liver damage caused by ashwagandha and the unknown metabolic molecular mechanisms of substances contained in it, attention should be paid to patients reporting the use of these products in the past and presenting symptoms of liver damage.

The impact of the interaction between dietary total phosphorus level and efficacy of phytase on the performance of growing-finishing pigs

Two experiments were conducted to investigate the interaction between dietary total phosphorus (P) level and phytase on the performance of growing-finishing pigs. In experiment 1, a total of 96 growing pigs [Duroc × Landrace × Yorkshire (barrows, initial body weight (BW) = 39.1 ± 0.5 kg), 8 pigs per treatment] were used in a 5-d total fecal and urine collection study to determine the apparent total tract digestible (ATTD) P release value of phytase in 2 dietary standardized total tract digestible (STTD) P levels (1.49 vs 2.87 g/kg of STTD P) with 0, 250, 500, 750, 1000, and 1250 FTU/kg of phytase. The results indicated that there was an interaction between P level and phytase in the determination of coefficient of apparent total tract digestibility of P (P < 0.01). The determined P release curves were STTD P = −1.4 phytase2 × 10−6 + 20.8305 phytase × 10−3 + 6.88392 × 10−2, R² = 0.9766 [1] in low-P diets, and STTD P = −1.2 phytase2 × 10−6 + 20.2754 phytase × 10−3 + 1.86325 × 10−2, R² = 0.9965 [2] in high-P diets. In experiment 2, a total of 1344 growing pigs [Duroc × Landrace × Yorkshire (initial BW = 69.4 ± 0.6 kg), 28 pigs per pen] were used in a 35-d growth performance study. The study had 4 dietary treatments which included low-P (1.0 g/kg of STTD P) diet group, high-P (1.9 g/kg of STTD P) diet group, low-P diet + 1100 FTU/kg phytase group, and high-P diet + 250 FTU/kg phytase group. The two treatments with phytase were formulated to the same STTD P level using the P release value of phytase determined by equation [1] from Experiment 1. The results showed that the treatment with 1100 FTU/kg phytase had greater gain to feed ratio compared to the treatment with 250 FTU/kg phytase, 1.0 g/kg total STTD P group and 1.9 g/kg total STTD P group (P < 0.05). In conclusion, the determination of P release of phytase may be impacted by the total P level in the diet. The P release value determined in low-P diets may not be accurate for the diet formulation when dietary total P level is greater.

Determination and prediction of digestible energy, metabolizable energy, and standardized ileal digestibility of amino acids in barley for growing pig

Two experiments were performed to determine the digestible energy (DE), metabolizable energy (ME) and standardized ileal digestibility coefficients (SIDC) of amino acids (AA) in barley for pigs, and to develop prediction equations for the DE, ME and SIDC of AA based on its chemical composition. In Exp. 1, twenty-two castrated male pigs (29.5 ± 1.3 kg) were allotted to a replicated 11 × 3 incomplete Latin square design, including 11 diets and 3 consecutive periods. A corn-soybean meal basal diet and 10 test diets containing 400 g/kg of each barley at the expense of corn and soybean meal were prepared, and all diets had a constant ratio of corn to soybean meal. Each period includes 7 d of adaption and 5 d of total feces and urine collection. The DE and ME contents were measured by the total collection method. In Exp. 2, twenty-two ileal-cannulated pigs (30.5 ± 2.1 kg) were used in a duplicated 11 × 3 incomplete Latin square design with 11 diets and three 7-day periods. Titanium dioxide (3 g/kg) was added to all diets as indicator and ieal digesta were collected on d 6 and 7 of each period. Barley was the sole nitrogen source in 10 barley diets and a nitrogen-free diet was used for the endogenous nitrogen losses. The results showed great variations in ether extract (EE), calcium (Ca), ash, acid detergent fiber (ADF) and crude fiber (CF) among samples of barley. On an air-dry basis, the DE and ME in barley for pigs were 12.26 (11.29–13.58) MJ/kg and 11.87 (10.95–13.15) MJ/kg, respectively. The optimal prediction equations for DE and ME were: DE (MJ/kg) = −23.594 + 0.358 crude protein (CP) + 0.043 EE (R2 =0.95) and ME (MJ/kg) = 0.338 + DE - 0.014 ADF (R2 =0.99), respectively. The SIDC of lysine (Lys), methionine (Met), threonine (Thr), and tryptophan (Trp) in barley were 0.767 (0.731–0.809) g/kg, 0.825 (0.803–0.872) g/kg, 0.809 (0.793–0.822) g/kg, and 0.794 (0.760–0.858) g/kg, respectively. The best-fit prediction equations for SIDC of Lys, Met, Thr and Trp in barley fed to pigs were: SIDC Lys = 0.721 + 0.002 EE (R2 =0.79), SIDC Met = 1.045–0.00041 total starch (R2 =0.69), SIDC Thr = 0.739 + 0.001 ADF (R2 =0.69) and SIDC Trp = 1.468–0.006 CP - 0.001 neutral detergent fiber (R2 =0.99), respectively. The study confirms the large variations in chemical composition of different sources of barley, which contributes to the differences of DE, ME and SIDC of AA in barley fed to pigs and the fiber fraction can be used as key predictors.

Urine CA125 and HE4 for the Detection of Ovarian Cancer in Symptomatic Women.

The symptoms of ovarian cancer are vague, and current risk assessment tools such as serum CA125 and transvaginal ultrasound scan fail to reliably detect the disease early. This study aimed to evaluate urine CA125 and HE4 as diagnostic biomarkers for ovarian cancer in symptomatic women. Paired urine and serum samples were collected from women undergoing treatment for ovarian cancer (cases) or investigations for gynaecological symptoms (controls). Biomarkers were measured using an automated chemiluminescent enzyme immunoassay analyser. Standard diagnostic accuracy metrics were calculated. In total, 114 women were included, of whom 17 (15%) were diagnosed with an epithelial ovarian malignancy. Levels of urine CA125 and HE4 were significantly elevated in women with ovarian cancer compared to controls [CA125: 8.5 U/mL (IQR: 2.4-19.5) vs. 2.3 U/mL (IQR: 1.0-6.4), p = 0.01. HE4: 12.0 nmol/L (IQR: 10.3-23.1) vs. 6.7 nmol/L (IQR: 3.4-13.6), p = 0.006]. Urine CA125 and HE4 detected ovarian cancer with an AUC of 0.69 (95% CI: 0.55-0.82) and 0.71 (95% CI: 0.69-0.82), respectively (p = 0.73). A combination of urine CA125 and HE4 at optimal thresholds had a sensitivity of 82.4% (95% CI: 56.6-96.2) and was comparable to the sensitivity of serum CA125 [88.2% (95% CI: 63.6-98.5)]. Larger studies are required to confirm our findings, standardise urine collection, and evaluate optimal biomarker thresholds. Urine CA125 and HE4 may be useful non-invasive diagnostic tools to triage women for formal ovarian cancer investigations.

Impact of urinary calcium excretion on kidney, bone, and cardiovascular systems in patients with bone biopsy proven osteoporosis: a longitudinal long-term follow-up study.

Hypercalciuria is common in patients with osteoporosis. However, the long-term effect of urinary calcium excretion (UCaE) on patients' health is not well-examined. The current study aims to assess the impact of UCaE on kidney, bone, and cardiovascular outcomes in patients with bone biopsy proven osteoporosis. Longitudinal study of all patients with osteoporosis who underwent bone biopsy and 24-h urine collection between 2008 and 2015 in the University of Kentucky. DXA scans, serum markers, kidney function, and cardiovascular events were recorded until last clinic visit in 2021. Exclusion criteria were secondary osteoporosis or conditions that might substantially impact UCaE. The significant results in univariate analysis were confirmed in multi-variable regression models involving clinically important covariates that might impact patients' outcomes. Study included 230 patients with mean follow-up of 7.2 ± 2.9 years. The mean age was 61 years, and the mean eGFR at baseline was 85 ± 19 ml/min/1.73 m2. Low bone turnover (LBT) was present in 57% and high bone turnover (HBT) in 43% of patients. Hypercalciuria was found in one-third of patients with no difference between LTB and HTB. UCaE correlated positively with eGFR but did not affect the rate of eGFR decline over time. Higher UCaE predicted kidney stones development. We observed U-shaped effect of UCaE on bone health. Hypercalciuria predicted loss of BMD at all sites, but also hypocalciuria was associated with higher loss in total hip BMD. Upper limb fractures were the most observed fractures, and their incidence was higher in patients with hyper- or hypo-calciuria. Lower UCaE independently predicted development of major adverse cardiac events (MACE) and cardiovascular disease (CVD). UCaE correlated with eGFR but it did not affect the change of eGFR over time. Patients with normal UCaE had lower incidence of upper limb fractures and less reduction in BMD. Low UCaE predicted MACE and CVD.