Urinalysis Research Articles

Usefulness of urinary biomarker-based risk score and multiparametric MRI for clinically significant prostate cancer detection in biopsy-naïve patients.

This study aimed to investigate the accuracy of multiparametric magnetic resonance imaging (mpMRI), genetic urinary test (GUT), and prostate cancer prevention trial risk calculator version 2.0 (PCPTRC2) for the clinically significant prostate cancer (csPCa) diagnostic in biopsy-naïve patients. In a single center study between 2021 and 2024 participants underwent prostate mpMRI, GUT, and ultrasound (US) guided biopsy. The csPCa risk was calculated using PCPTRC2. After conducting a digital rectal examination (DRE), a GUT was performed. It incorporated the RNA levels of prostate cancer antigen 3 (PCA3) and transmembrane serine protease 2 (TMPRSS2) gene and ETS-related gene (ERG) fusion genes (T: E), along with the patient's age and PSA density. The McNemar test compared detection rates between modalities. 208 (mean age 62.9 years +/- 8.2) men were included prospectively. A positive GUT score was found in 67.8% and PIRADS ≥3 in 81.7% of all cases. The combination of GUT with mpMRI showed significantly higher sensitivity (99.1%) than GUT and mpMRI alone, 84.4% and 93.8%, respectively (p ≤ 0.05). Similarly, very high sensitivity (99.0%) was achieved by combining mpMRI with PCPTCR2. Nevertheless, mpMRI plus GUT combination exceeded mpMRI plus PCPTCR2 by allowing to save a higher fraction of unnecessary biopsies, 25% and 2.4%, respectively. GUT and mpMRI combination would allow saving a substantial fraction of unnecessary biopsies with minimal risk of missing csPCa cases.

Focal dermal hypoplasia: a probable underrecognized low bone mass disorder secondary to aberrant Wnt signaling.

A 29-year-old Spanish Caucasian man, without relevant family history, was attended in our unit due to an undiagnosed skeletal dysplasia associated with low bone mass and several fragility fractures throughout his childhood and adolescence. DXA exams throughout his life showed very low BMD values; currently, his spinal and femoral neck T-scores were - 4.3 and - 3.5, respectively. Blood and urinary tests were normal. Other relevant features included right hand and foot syndactyly, aplasia cutis, right hemibody hypoplasia, vertebral malformations, abnormal-looking humerii, and Asperger's syndrome among others. Whole exome sequencing retrieved a highly probable pathogenic variant in the PORCN gene p.(Arg296Pro) in mosaicism. PORCN mutations cause focal dermal hypoplasia (FDH), an X-linked ultra-rare ecto-mesodermal disorder characterized by several of the findings the patient presented. However, low BMD has not been classically associated with the disease. Noteworthy, PORCN is key for canonical Wnt signaling. Literature scrutiny has yielded other cases of FDH with skeletal fragility during childhood. In addition, preclinical studies with PORCN inhibitors, currently under development as an antitumoral therapy, have shown rapid detrimental effects on bone mass. Collectively, these findings indicate that FDH is probably an underrecognized monogenic cause of low bone mass due to defective Wnt signaling.

Evaluation of the recombinant protein Sh-TSP-2 for the serological diagnosis of imported urogenital schistosomiasis and comparison with commercially available tests.

Different agencies have emphasized the need to evaluate current serological methods for screening patients with suspected urogenital schistosomiasis. However, there is still a lack of evidence regarding the most appropriate methods for this purpose. Here we assessed the diagnostic efficacy of a newly developed serological technique that utilizes the recombinant protein Sh-TSP-2, applied to the urine and serum of migrants suspected of having urogenital schistosomiasis. The sensitivity, specificity, positive and negative predictive values of an in-house enzyme-linked immunosorbent assay (ELISA) using the recombinant protein Sh-TSP-2 were analysed and compared with other commercial serological methods. Due to the limitations of microscopy as a perfect reference method, a latent class analysis (LCA) and composite reference standard (CRS) approach was used to determine the sensitivity and specificity of each test. According to the LCA model, the commercial tests NovaLisa® and immunochromatography test (ICT) immunoglobulin G–immunoglobulin M (IgG–IgM) presented the highest sensitivity (100%), whereas the Sh-TSP-2 serum ELISA test had 79.2%. The Sh-TSP-2 urine and serum ELISA tests had the highest specificities among the serological methods (87.5 and 75%, respectively). CRS modelling showed that the ICT IgG–IgM, NovaLisa® and Sh-TSP-2 serum tests led in sensitivity at 97.1, 88.6 and 71.4%, respectively, with all tests except that the ICT IgG–IgM test having a specificity >90%. Sh-TSP-2 has been validated as a screening tool for patients suspected of having urogenital schistosomiasis. Although commercial serological tests have shown higher sensitivities, Sh-TSP-2 could be valuable for confirming results from tests with lower specificity. Nevertheless, further studies with larger patient cohorts are necessary to fully verify its potential.

Public knowledge, attitudes, and practices regarding antibiotics use and resistance in Montenegro.

A drug consumption monitoring revealed that Montenegro is one of the major consumers of antimicrobial drugs in Europe. The aim of this study is to obtain the first data on the knowledge, attitudes, and practices of the general population in Montenegro regarding antibiotics use. This cross-sectional study was designed according to the methodology of Eurobarometer survey on antimicrobial resistance, created by the European Commission. The standardized questionnaire was conducted in Podgorica, in October-November 2022. A total of 532 participants completed the questionnaire. More than a half of responders (60.9%) have received antibiotics within the last 12 months and among them 33.4% was missing a medical prescription, nor the antibiotic was administered by a medical practitioner. The rest of the responders mostly had some antibiotics left over from a previous course (13.0%), had taken it from a pharmacy (11.4%), or elsewhere without a prescription. The most frequent reasons for antimicrobial therapy were "cold" (22.5%), "sore throat" (21.0%), "cough" (19.4%), and "COVID-19" (coronavirus disease 2019) (17.9%). Throat swab, blood test, urine test, or other test that could identify the cause of the illness preceded antimicrobial therapy in 46.3% participants. Only one-half of the participants were convinced that antibiotics are ineffective in viral infection treatment. This study is the first report on public knowledge, attitudes and practices regarding antibiotics use and resistance in Montenegro and it highlights the need for the knowledge improvement among general population, better regulations for antibiotics procurement and a campaign regarding appropriate antibiotics use among youth.

The role of Iowa gambling task performance in response to citalopram treatment for cocaine use disorder

ABSTRACT Background: Cocaine use disorder (CUD) is associated with executive functioning impairments linked to serotonergic function. Previous studies reported efficacy with the selective serotonin reuptake inhibitor citalopram in reducing cocaine use. Objectives: The current study explored moderation and mediation of citalopram effects on cocaine use by performance across executive function domains. Methods: We conducted a secondary analysis of a double-blind, placebo-controlled, randomized Bayesian adaptive trial investigating citalopram efficacy in CUD treatment-seeking adults. At baseline and mid-treatment, participants completed assessments of decision-making (Iowa Gambling Task; IGT), attention, response inhibition, and cognitive flexibility. Outcomes were longest duration of abstinence (LDA; count of consecutive cocaine-negative urine tests) and Treatment Effectiveness Score (TES; count of cocaine-negative urine tests from study midpoint to endpoint). Bayesian models estimated independent moderation and mediation effects of cognitive ability on the association between treatment (citalopram 40 mg vs. placebo) and LDA/TES. Results: Of the four assessments, only the IGT demonstrated concurrent moderation and mediation in the sample (N = 80; 82% males). Treatment effects on LDA (IRR = 1.02) and TES (IRR = 1.03) were strongest in participants with higher baseline IGT scores, which indicate less risky decision-making (posterior probabilities >93%). Models supported a positive indirect effect of treatment on TES (IRR = 1.12, posterior probability = 81.6%), with 52.3% of the total effect mediated by changes in IGT scores from baseline to mid-treatment. Conclusion: We found evidence for IGT as a moderator and mediator of citalopram’s effects on cocaine use. Decision-making ability may play a role in predicting who responds to citalopram and how.

No Injury Observed in Kidneys Treated with Burst Wave Lithotripsy in Therapeutically Anticoagulated Pigs.

Introduction: Current American Urological Association guidelines recommend that patients with acute obstructive kidney stone requiring continuous anticoagulation/antiplatelet therapy should not be treated by shockwave lithotripsy or percutaneous nephrolithotomy because of the risk of catastrophic renal hemorrhage possible with those techniques. Currently, ureteroscopy is the only recommended surgical treatment. We evaluated if burst wave lithotripsy (BWL) could be used in these cases by treating pigs with BWL while undergoing anticoagulation therapy. Materials and Methods: Six pigs (31-37 kg) were given 200 units/kg porcine heparin, and then the right kidney of each animal was treated with a dose of BWL (18,000 ultrasound pulses at 10 Hz, 20 cycles/pulse, peak positive pressure of 12 MPa) known to fracture kidney stones. The contralateral kidney served as a control. Therapeutic anticoagulation was confirmed by evaluating activated partial thromboplastin time (aPTT). Microhematuria was checked by urine test strips. Kidneys were subsequently evaluated for hemorrhagic injury via MRI. Results: aPTT was significantly elevated (>100 seconds) throughout the entire treatment period (p = <0.001) indicating therapeutic anticoagulation. Gross hematuria was not observed in any of the pigs. After BWL, microhematuria averaged 145.8 red blood cells (RBC)/μL in the BWL-treated kidney and 48 RBC/μL in the control kidneys, and there was no statistically significant difference noted in microhematuria rates between the two groups (p = 0.16). Hemorrhagic injury measured only 0.10 ± 0.02% of the tissue in the BWL-treated kidneys and 0.12 ± 0.04% in the control side, with a paired difference of -0.03 ± 0.05%, showing no significant difference (p = 0.58). Conclusions: A typical clinical dose of BWL causes no hemorrhagic injury to the kidney even during therapeutic anticoagulation therapy. This result suggests that BWL should be safe to use in patients with stone undergoing anticoagulation/antiplatelet therapy.

Continuous high-soy protein soymilk intake affects ordinary walking speed in the Japanese pre-frail and frail elderly: a randomized controlled trial.

To investigate whether continuous intervention using soymilk containing high soy protein improves physical frailty, a randomized controlled trial was conducted among the Japanese pre-frail and frail elderly. Japanese pre-frail and frail elderly participants (n = 73) were randomly assigned to the high-soy protein and control groups, who then ingested soymilk containing 14.5g/200ml and 3.2g/200ml of soy protein, respectively. Before and after the 12-week intervention, walking speed, skeletal muscle mass, grip strength, and the revised Japanese CHS questionnaire regarding fatigue and physical activity were examined to evaluate the impact of each soymilk on physical frailty and compare the variation between the two groups. Physical activity (monitored using a pedometer), dietary intake (determined by questionnaire), and estimated protein intake (determined by casual urine testing) were also recorded before and after the intervention. For the final analysis of the entire cohort (n = 70), there were no significant differences in the endpoints between the two groups. In the subgroup analysis, among participants with a walking speed of at least 1m/s (n = 35, P = 0.012) and at least 5,000 steps/day before intervention (n = 27, P = 0.0083), the variation in walking speed after the 12-week intervention was significantly higher in the high-soy protein group than in the control group. Estimated protein intake was also significantly higher in the high-soy protein group than in the control group after the intervention. Regarding physical activity and dietary intake, no significant differences were observed between the groups before or after the intervention. The continuous 12-week intervention of high soy protein increased the walking speed among the Japanese pre-frail and frail elderly participants who had an ordinarily high walking speed and high step counts. UMIN Clinical Trials Registry, UMIN000044999. Registered July 29, 2021; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000051409 .

Prospective validation study of a combined urine and plasma test for predicting high-grade prostate cancer in biopsy naïve men.

Early and accurate diagnosis of prostate cancer (PC) is crucial for effective treatment. Diagnosing clinically insignificant cancers can lead to overdiagnosis and overtreatment, highlighting the importance of accurately selecting patients for further evaluation based on improved risk prediction tools. Novel biomarkers offer promise for enhancing this diagnostic process. In this study, we aimed to externally validate a previously developed urine and plasma biomarker test in a biopsy-naïve population. Urine and blood samples were prospectively collected from 362 biopsy-naïve men with suspected PC before they underwent transrectal prostate biopsies. The expression levels of a 10-gene mRNA panel were quantified using reverse transcription/quantitative polymerase chain reaction of both urine and plasma. These gene expression levels, combined with clinical features and plasma prostate-specific antigen (PSA) levels, were used to predict the presence of International Society of Urological Pathology grade group ≥ 2 PC. Complete data were available for 314 patients. The sensitivity and specificity of the biomarker test were 87% (95% CI: 79-93%) and 42% (95% CI: 36-49%), respectively. The area under the curve was 0.76 (95% CI: 0.7-0.82) for the biomarker test probability and 0.65 (95% CI: 0.59-0.72) for PSA (p = 0.02). The test's negative predictive value was 89% (CI: 81-94%). This study did not replicate the previously reported high accuracy of the biomarker test, highlighting the need for further refinement and robust external validation to ensure reliable performance across diverse patient populations.

Efficacy of the Roy Adaptation Model with smartphone training in reducing urinary tract infection in pediatric clean intermittent catheterization: a prospective study

PurposeStudy aimed to compare incidence of urinary tract infection (UTI), type of bacteria grown, development of antibiotic resistance over 2 years in children whose caregivers underwent training based on the Roy Adaptation Model with an android phone application for patients clean intermittent catheterization (RAMACIC) versus those whose caregivers received routine training in hospital.MethodThis study was conducted as a descriptive, prospective study with 40 patients and caregivers between October 2021 and 2023 as a continuation of a previously conducted randomized controlled experimental study by the researchers. Data were collected the “Participant Form,” and “Urine Test Form” analyzed with the SPSS 22 package. Descriptive data were determined by number (n), percentage (%), mean, and standard deviation. The frequency of UTI between the two groups was determined by the Chi-square test, and the effect size of the data was determined by Cramer’s V value of the Chi-square test.ResultsA significant reduction in UTI incidence among children of RAMACIC-trained caregivers during the first, second, third, and fourth 6-month periods compared with those under routine CIC training was observed (p < 0.05). It was determined that E. coli was the most frequently grown bacteria in both groups, with a higher rate in the group receiving routine training in the hospital, and antibiotic resistance was higher in the group receiving routine training in the hospital compared with RAMACIC.ConclusionRAMACIC, when administered to caregivers, effectively lowers the long-term risk of UTI development in patients undergoing CIC, also effective in reducing the antibiotic resistance that developed in patients.

Evaluation of pre-analytical factors impacting urine test strip and chemistry results.

Careful consideration of the pre-analytical process for urine examination is essential to avoid errors and support accurate results and decision-making. Our objective was to assess the impact of various pre-analytical factors on urine test strip and quantitative chemistry results, including stability, tube type, fill volume, and centrifugation. Residual random urine specimens were identified. Stability of 10 urine test strips and 13 quantitative chemistry parameters were assessed at eight time points (2, 4, 6, 8, 24, 48, 72, and 96 h) at room temperature (RT) and 2-8 °C (n=10-20 samples). The effect of additional pre-analytical variables was assessed, including using preservative tubes for urine chemistry as well as preservative tube underfilling and centrifugation on urine test strip results (n=10 samples). Seven of the ten urine tests strips evaluated met the minimal agreement criteria for stability (Cohen's kappa>0.70) across all conditions. A Cohen's kappa value of<0.70 was observed for pH (48 h), glucose (72 h), and protein (96 h) at RT. All 13 urine chemistry analytes remained stable at defined time points and conditions. Underfilling preservative tubes for urine test strips and centrifugation demonstrated no significant effect. The impact of using preservative tubes for urine chemistry was negligible with the exception of sodium and osmolality. These findings highlight the pre-analytical factors that impact urine specimen evaluation and may be useful in informing clinical laboratory practices. Acceptable stability window for urine test strips should be considered in the context of the proportion of pathological samples evaluated.

Prediction of urinary tract infection using machine learning methods: a study for finding the most-informative variables

BackgroundUrinary tract infection (UTI) is a frequent health-threatening condition. Early reliable diagnosis of UTI helps to prevent misuse or overuse of antibiotics and hence prevent antibiotic resistance. The gold standard for UTI diagnosis is urine culture which is a time-consuming and also an error prone method. In this regard, complementary methods are demanded. In the recent decade, machine learning strategies that employ mathematical models on a dataset to extract the most informative hidden information are the center of interest for prediction and diagnosis purposes.MethodIn this study, machine learning approaches were used for finding the important variables for a reliable prediction of UTI. Several types of machines including classical and deep learning models were used for this purpose.ResultsEighteen selected features from urine test, blood test, and demographic data were found as the most informative features. Factors extracted from urine such as WBC, nitrite, leukocyte, clarity, color, blood, bilirubin, urobilinogen, and factors extracted from blood test like mean platelet volume, lymphocyte, glucose, red blood cell distribution width, and potassium, and demographic data such as age, gender and previous use of antibiotics were the determinative factors for UTI prediction. An ensemble combination of XGBoost, decision tree, and light gradient boosting machines with a voting scheme obtained the highest accuracy for UTI prediction (AUC: 88.53 (0.25), accuracy: 85.64 (0.20)%), according to the selected features. Furthermore, the results showed the importance of gender and age for UTI prediction. ConclusionThis study highlighted the potential of machine learning strategies for UTI prediction.

Longitudinal Changes in Pitch-Related Acoustic Characteristics of the Voice Throughout the Menstrual Cycle: Observational Study.

Identifying subtle changes in the menstrual cycle is crucial for effective fertility tracking and understanding reproductive health. The aim of the study is to explore how fundamental frequency features vary between menstrual phases using daily voice recordings. This study analyzed smartphone-collected voice recordings from 16 naturally cycling female participants, collected every day for 1 full menstrual cycle. Fundamental frequency features (mean, SD, 5th percentile, and 95th percentile) were extracted from each voice recording. Ovulation was estimated using luteinizing hormone urine tests taken every morning. The analysis included comparisons of these features between the follicular and luteal phases and the application of changepoint detection algorithms to assess changes and pinpoint the day in which the shifts in vocal pitch occur. The fundamental frequency SD was 9.0% (SD 2.9%) lower in the luteal phase compared to the follicular phase (95% CI 3.4%-14.7%; P=.002), and the 5th percentile of the fundamental frequency was 8.8% (SD 3.6%) higher (95% CI 1.7%-16.0%; P=.01). No significant differences were found between phases in mean fundamental frequency or the 95th percentile of the fundamental frequency (P=.65 and P=.07). Changepoint detection, applied separately to each feature, identified the point in time when vocal frequency behaviors shifted. For the fundamental frequency SD and 5th percentile, 81% (n=13) of participants exhibited shifts within the fertile window (P=.03). In comparison, only 63% (n=10; P=.24) and 50% (n=8; P=.50) of participants had shifts in the fertile window for the mean and 95th percentile of the fundamental frequency, respectively. These findings indicate that subtle variations in vocal pitch may reflect changes associated with the menstrual cycle, suggesting the potential for developing a noninvasive and convenient method for monitoring reproductive health. Changepoint detection may provide a promising avenue for future work in longitudinal fertility analysis.

Efficacy and safety of Jianpi Qinghua granules for non-erosive reflux disease with spleen deficiency and damp-heat syndrome: a multicenter, randomized, double-blind, placebo-controlled clinical trial.

Non-erosive reflux disease (NERD), the most frequent phenotype of gastroesophageal reflux disease, presents without visible esophageal mucosal damage but significantly impacts patients' quality of life. Current treatments like proton pump inhibitors show limited efficacy for many NERD patients, necessitating alternative approaches. Jianpi Qinghua (JQ) granules, a traditional Chinese medicine, have shown promise in treating NERD by targeting symptoms of spleen deficiency and damp-heat syndrome. This study aims to evaluate the efficacy and safety of JQ granules in treating patients with NERD characterized by spleen deficiency and damp-heat syndrome. A multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted with a total of 78 NERD patients randomly assigned to receive either JQ granules or placebo for 4 weeks, followed by a 4-week follow-up period. Seventy-eight NERD patients with spleen deficiency and damp-heat syndrome were recruited and randomly assigned to receive either JQ granules (n = 39) or placebo (n = 39). The trial included a 1-week lead-in, followed by a 4-week double-blind treatment, and a 4-week follow-up. Primary endpoints were the improvement rates of reflux and heartburn symptoms and VAS score changes. Secondary endpoints included atypical symptom scores, total TCM syndrome scores, GERD Health-Related Quality-of-Life (HRQL), and self-rated depression and anxiety scales. Safety assessments involved routine blood, urine, and liver and kidney function tests. After 4 weeks, the improvement rate for reflux or heartburn symptoms was 79.49% in the JQ group vs. 58.97% in the placebo group (P < 0.05). VAS scores showed significant reductions in both groups but without notable inter-group differences. Total TCM syndrome scores significantly decreased in both groups, with the JQ group showing greater improvement trends. The JQ group had higher rates of effective TCM syndrome improvement and better GERD-HRQL scores. Both groups saw significant reductions in self-rated depression and anxiety scores, with trends favoring JQ granules. Safety assessments were comparable between groups. JQ granules significantly outperform placebo in treating NERD symptoms and display long-term effectiveness. They effectively address spleen deficiency and damp-heat syndrome, improving patients' social functioning, and have a favorable safety profile. https://clinicaltrials.gov/study/NCT04324138?term=NCT04324138&rank=1, identifier: NCT04324138.

Degree of housing damage caused by the Great East Japan Earthquake and all-cause mortality in the community-based cohort study of the Tohoku Medical Megabank Project

BackgroundNatural disasters may have negative health effects on survivors. However, long-term observations on this are lacking. Therefore, this study investigated the association between the degree of housing damage caused by...

Triboelectric Nanogenerator-Based Self-Powered Urinary Protein Detection Utilizing Triboelectric Material with Colorimetric Function.

Chronic kidney disease (CKD) has a high incidence rate, and if not detected and treated in a timely manner, it poses a risk of progressing to renal failure and even uremia. Performing home monitoring of urinary protein, which is a recognized indicator of CKD, is considered an effective means of achieving early warning for CKD. Although the existing urinary protein test strips for home self-testing are cost-effective and simple, they suffer from drawbacks such as susceptibility to contamination and lack of quantitative detection capability. Consequently, they are unable to fulfill the urgent requirement of long-term continuous monitoring. Here, we develop a sensing material that exhibits both colorimetric response for qualitative detection and triboelectric sensitivity for quantitative detection of urinary proteins. Meanwhile, in order to ensure the convenience and accuracy of testing in a home setting, a multichannel portable device that can provide stable mechanical energy input and simultaneously monitor environmental factor has been successfully developed. By utilization of the aforementioned sensing material and device, naked-eye rapid qualitative detection and self-powered quantitative detection of urinary proteins have been achieved. Therefore, this material and device show great potential in the field of home-based urinary protein detection for early warning of CKD.

Influence of Menstrual Phase and Symptoms on Sleep Before and After Matches for Professional Footballers.

This study investigated the association of menstrual cycle phase and symptoms with objective and subjective sleep measures from professional footballers before and after matches. Twenty-three non-hormonal contraceptive-using professional footballers (from four clubs) were monitored for up to four menstrual cycles during a domestic league season. Menstrual phases (menstruation, mid-late follicular, luteal) were determined using calendar counting and urinary hormone tests (luteinizing hormone and pregnandiol-3-glucuronide). Players rated the severity of 18 symptoms on the evenings of matches and the following two evenings. Individual daily summed menstrual symptom severity (MSS) scores were calculated. Subjective sleep quality was rated the morning of matches and the following two mornings. Objective sleep (bedtime, waketime, total sleep time [TST], sleep onset latency, wake after sleep onset, sleep efficiency) obtained from actigraphy was measured the night prior to (MN-1), of (MN), and following (MN+1) matches. Linear mixed models were performed for each sleep measure to examine the effects of menstrual phase and symptoms. Bedtime was significantly later for MN (p < 0.001), waketime was significantly earlier for MN+1 (p < 0.001), and TST was significantly longer for MN-1 (p < 0.001). Menstrual phase did not have a significant effect on any sleep variable (p > 0.05). Increased MSS score was associated with increased TST (p = 0.03) and increased waketime (p = 0.03). Increased lower back pain severity and mood changes/anxiety severity were associated with increased waketime (p = 0.048) and TST (p = 0.009), respectively. Overall, bedtime and waketime were affected by the night related to matches, with increased TST the night before a match. Menstrual phase was not related to any objective or subjective sleep variables, whilst increasing menstrual symptom severity was related to later waketime and longer TST.

Evaluation of the applicability of urine lateral flow immunochromatography tests for the detection of cocaine in plasma samples

IntroductionQualitative analysis of cocaine in urine is a common practice in emergency settings. However, positive results from urine screening tests do not necessarily indicate recent exposure. In this context, plasma is considered a more appropriate option due to its shorter detection window and better correlation with symptomatology. Therefore, the availability of rapid tests for this biological matrix is extremely relevant in the clinical and emergency context. MethodsA lateral flow immunochromatography test designed for analyzing cocaine in urine was evaluated for use with plasma samples. A total of 412 samples from suspected cases of intoxication were processed and tested. Concurrently, the samples were analyzed for cocaine and its metabolites, benzoylecgonine and ecgonine methyl ester, using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Reliability parameters, including sensitivity, specificity, positive predictive value, negative predictive value, and efficiency, were calculated considering different cutoff values. ResultsApproximately 8.3 % of the samples tested positive in the immunoassay, while 10.2 % had a concentration greater than 5 ng/mL for at least one analyte in the LC-MS/MS analysis. Using benzoylecgonine as the target analyte with a cutoff of 40 ng/mL yielded the best reliability results, with 96.3 % sensitivity and 97.9 % specificity. Cocaine did not show satisfactory results, whereas ecgonine methyl ester, despite having 92.9 % sensitivity and 94.7 % specificity at its best cutoff (20 ng/mL), had a positive predictive value of only 38.2 %. ConclusionsThe study evaluated the suitability of using rapid urine tests for cocaine detection in plasma, offering a simple and quick drug screening method that is particularly useful in toxicological emergencies.

Gaps and Similarities in Research Use LOINC Codes Utilized in Korean University Hospitals: Towards Semantic Interoperability for Patient Care.

The accuracy of Logical Observation Identifiers Names and Codes (LOINC) mappings is reportedly low, and the LOINC codes used for research purposes in Korea have not been validated for accuracy or usability. Our study aimed to evaluate the discrepancies and similarities in interoperability using existing LOINC mappings in actual patient care settings. We collected data on local test codes and their corresponding LOINC mappings from seven university hospitals. Our analysis focused on laboratory tests that are frequently requested, excluding clinical microbiology and molecular tests. Codes from nationwide proficiency tests served as intermediary benchmarks for comparison. A research team, comprising clinical pathologists and terminology experts, utilized the LOINC manual to reach a consensus on determining the most suitable LOINC codes. A total of 235 LOINC codes were designated as optimal codes for 162 frequent tests. Among these, 51 test items, including 34 urine tests, required multiple optimal LOINC codes, primarily due to unnoted properties such as whether the test was quantitative or qualitative, or differences in measurement units. We analyzed 962 LOINC codes linked to 162 tests across seven institutions, discovering that 792 (82.3%) of these codes were consistent. Inconsistencies were most common in the analyte component (38 inconsistencies, 33.3%), followed by the method (33 inconsistencies, 28.9%), and properties (13 inconsistencies, 11.4%). This study reveals a significant inconsistency rate of over 15% in LOINC mappings utilized for research purposes in university hospitals, underlining the necessity for expert verification to enhance interoperability in real patient care.

Seasonality and age-related propensity of cats to occur bacterial urocystitis

Diseases of the urinary system are relevant for cats regardless of how they are kept. During the year, cats' bodies are prone to infectious diseases, but the degree of manifestation in different periods is different. Bacterial urocystitis in cats is caused by several factors, which include a decrease in the protective functions of the immune system, improper diet and housing conditions, complications of non-infectious pathologies, and subclinical bacteriuria. The seasonality of bacterial urocystitis, mainly when relapses characterize the disease, is essential for early detection and timely prevention. A calculated approach to determining the most susceptible age groups of cats and the seasonality of infectious urocystitis determines the patterns of the spread of this disease. Mathematical approaches to modeling the early increase in the frequency of bacterial urocystitis in cats will make it possible to limit the uncontrolled use of antibiotics. Retrospective analysis of microbiological urine test data of 34 cats diagnosed with bacterial urocystitis during 12 months from June 2023 to May 2024 in the conditions of the Zoolabix veterinary laboratory in Lviv. The results showed that 55.9 % of disease cases occur in autumn. It was established that the number of patients increased gradually starting in September. The highest level of incidence occurs in November and is 29.4 % of all cases, while in spring, it is only 5.9 %, which is 9.5 times less than the number of patients in the autumn period. Urethral and bladder infections in cats were diagnosed sporadically during the spring months. The analysis showed that among cats of different ages, the frequency of bacterial urocystitis increases in animals of geriatric age (44.1 %), while young animals get sick the least often (23.5 %).

Prevalence of Urinary Tract Infection among Patients Underwent Elective Total Knee Arthroplasty

Objectives: Urinary tract infections (UTIs) are one of the most common infections that can lead to a devastating complicated total knee arthroplasty (TKA). The main objective of this research was to investigate the prevalence of UTIs among patients who underwent elective TKA and to look for scientific correlation between co-morbidities, gender, and post-operative care. Our review provides an insight into the local characteristics among our population. Methods: This is a retrospective chart review at a tertiary care hospital in Riyadh, Saudi Arabia. All patients from April 2006 to April 2018 undergoing TKA were included. We excluded patients with age less than 45 years, end-stage renal disease, and patients with history of oncological disease. Results: A total of 311 had TKA. 217 patients (69.8%) were females. The most prevalent comorbidity was Hypertension (68.5%) followed by Diabetes (51.8%). The rate of positive preoperative urinalysis and urine culture was (9.6%, 5.1%) respectively. Postoperatively, 8% of patients had a positive urinalysis and 6.1% had a positive urine culture. Age &gt; 65, BPH in males, &gt;33 BMI were statistically significant correlation with positive preoperative and postoperative urine tests. Conclusion: This study shows considerably high rates of UTI among TKA patients. It provides important correlations between the diagnosis UTIs and patients characteristics who underwent TKA.