Urine Screening Research Articles

Likelihood of Positive Urine Screens of THC-COOH After Daily Use of Full-Spectrum Hemp Extracts Varies as a Function of Screening Criterion Used.

The authors recruited nineteen daily users of retail oral hemp-derived CBD products (≤0.3% Δ9-tetrahydrocannbinol; THC) and collected urine samples that were screened for 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH), a metabolite of THC. Urine samples were aliquoted into two samples-one that was subjected to immunoassay (IA) testing and the other shipped to a third-party laboratory for confirmation testing. Findings showed that the daily use of oral hemp-derived CBD extracts consistently resulted in positive urine IA screening results for THC-COOH at the 20 ng/mL detection criterion; however, positive results at the 50 ng/mL criterion were rare. Confirmation testing of each sample using LC-MS/MS analysis showed a positivity rate of 42% (range 37-178 ng/mL) at the >15 ng/mL criterion, which was intermediate to the two IA screening tests, suggesting that the IA 20 ng/mL and 50 ng/mL tests used are subject to high rates of false positive and negative results, respectively. Therefore, efforts should be made to increase public awareness regarding the risk of positive drug test results following oral hemp-derived CBD product use.

A novel portable Raman scattering platform for antibiotic screening in pig urine.

Public health and food safety are gaining attention globally. Consumer health can be protected from chemical residues in meat by early detection or screening for antibiotic residues before selling the meat commercially. However, conventional practices are normally applied after slaughtering, which leads to massive business losses. This study aimed to use portable surface-enhanced Raman spectroscopy (SERS) equipped with multivariate curve resolution-alternation least squares (MCR-ALS) to determine the concentrations of enrofloxacin, oxytetracycline, and neomycin concentrations. This approach can overcome the problems of business loss, costs, and time-consumption, and limit of detection (LOD). Aqueous solutions of three standard antibiotics (enrofloxacin, oxytetracycline, and neomycin) with different concentrations were prepared, and the LOD for each antibiotic solution was determined using SERS. Extracted pig urine was spiked with enrofloxacin at concentrations of 10, 20, 50, 100, and 10,000 ppm. These solutions were investigated using SERS and MCR-ALS analysis. Urine samples from pigs at 1 and 7 days after enrofloxacin administration were collected and investigated using SERS and MCR-ALS to differentiate the urinary enrofloxacin concentrations. The LOD of enrofloxacin, oxytetracycline, and neomycin in aqueous solutions were 0.5, 2.0, and 100 ppm, respectively. Analysis of enrofloxacin spiking in pig urine samples demonstrated the different concentrations of enrofloxacin at 10, 20, 50, 100, and 10,000 ppm. The LOD of spiking enrofloxacin was 10 ppm, which was 10 times lower than the regulated value. This technique was validated for the first time using urine collected on days 1 and 7 after enrofloxacin administration. The results revealed a higher concentration of enrofloxacin on day 7 than on day 1 due to consecutive administrations. The observed concentration of enrofloxacin was closely correlated with its circulation time and metabolism in pigs. A combination of SERS sensing platform and MCR-ALS is a promising technique for on-farming screening. This platform can increase the efficiency of antibiotic detection in pig urine at lower costs and time. Expansion and fine adjustments of the Raman dataset may be required for individual farms to achieve higher sensitivity.

Co-Circulation of West Nile, Usutu, and Tick-Borne Encephalitis Viruses in the Same Area: A Great Challenge for Diagnostic and Blood and Organ Safety.

Viral infections caused by viruses from the family Flaviviridae such as Zika (ZIKV), Dengue (DENV), yellow fever (YFV), tick-borne encephalitis (TBEV), West Nile (WNV), and Usutu (USUV) are some of the most challenging diseases for recognition in clinical diagnostics and epidemiological tracking thanks to their short viremia, non-specific symptoms, and high cross-reactivity observed in laboratory techniques. In Central Europe, the most relevant endemic flaviviruses are mosquito-borne WNV and USUV, and tick-borne TBEV. All three viruses have been recognised to be responsible for human neuroinvasive diseases. Moreover, they are interrupting the blood and transplantation safety processes, when the great efforts made to save a patient's life could be defeated by acquired infection from donors. Due to the trend of changing distribution and abundance of flaviviruses and their vectors influenced by global change, the co-circulation of WNV, USUV, and TBEV can be observed in the same area. In this perspective, we discuss the problems of flavivirus diagnostics and epidemiology monitoring in Slovakia as a model area of Central Europe, where co-circulation of WNV, USUV, and TBEV in the same zone has been recently detected. This new situation presents multiple challenges not only for diagnostics or surveillance but particularly also for blood and organ safety. We conclude that the current routinely used laboratory diagnostics and donor screening applied by the European Union (EU) regulations are out of date and the novel methods which have become available in recent years, e.g., next-gene sequencing or urine screening should be implemented immediately.

Urine Biomarkers in the Management of Adult Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review.

Neurogenic lower urinary tract dysfunction requires lifelong surveillance and management for the perseveration of patients' quality of life and the prevention of significant morbidity and mortality. Urine biomarkers are an attractive noninvasive method of surveillance for these patients. The aim of this systematic review is to search for and critically appraise studies that investigate the clinical usefulness of urine biomarkers in the management of neurogenic lower urinary tract dysfunction (NLUTD) in adults. This review was conducted according to PRISMA and MOOSE guidelines. Search strategy included PubMed, CENTRAL, and Scopus (until October 2022). Studies investigating potential urine biomarkers for the management of adults with NLUTD were included. Fifteen studies fulfilled the criteria. To date, a variety of different urine molecules have been investigated for the diagnosis and management of neurogenic overactive bladder and detrusor overactivity (nerve growth factor, brain-derived neurotrophic factor, prostaglandin E2, prostaglandin F2α, transformation growth factor β-1, tissue inhibitor metalloproteinase-2, matrix metalloproteinase-2, substance P, microRNA), diagnosis of vesicoureteral reflux (exosomal vitronectin), urinary tract infection (neutrophil gelatinase-associated lipocalin, interleukin 6) and bladder cancer screening (cytology, BTA stat, survivin) in neurological patients. Further studies are needed to specify the utility of each molecule in the management algorithm of adult NLUTD.

Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates.

The U.S. opioid epidemic has been characterized by increases in opioid misuse, overdose deaths, and neonatal opioid withdrawal syndrome. Research suggests that marijuana legalization has contributed to decreased use of opiates, although many studies had methodological weaknesses and failed to address the pregnant population. Implementation of medical cannabis laws has the potential to reduce maternal opioid use and, therefore, neonatal exposure to the drugs. This study aimed to examine the association between Oklahoma's implementation of state medical marijuana laws and the neonatal exposure to opioids. Electronic medical records at two sites (Oklahoma City and Lawton) were searched for results of cord, urine, and meconium screens to detect amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, opiates, phencyclidine, and tetrahydrocannabinol (THC). Two study periods were compared: 19 months before Oklahoma's medical marijuana law took effect and 19 months after legalization began. A total of 16,804 babies were born alive at the two sites during the study period. The rate of positive THC tests per 1,000 liveborn infants significantly increased from 16.2 per 1,000 during the prelaw period to 22.2 per 1,000 during the postlaw period (p = 0.004). Neonatal opioid exposure incidence showed a nonsignificant decrease from 7.6 positive tests per 1,000 liveborn infants to 6.8 per 1,000 from prelaw to postlaw period (p = 0.542). The number of positive tests for THC and concomitant use of opioids doubled from the prelaw period (n = 4) to postlaw (n = 9), but there were too few cases for statistical significance. Infants at the more rural site had significantly higher rates for amphetamines, benzodiazepines, and THC, with a trend toward higher rates for opiates. Marijuana legalization was related to significant increases in positive test rates for THC, but no significant change/association was noted for neonatal exposure to opioids. · Prior studies have not examined neonatal exposure to opioids following marijuana legalization.. · Oklahoma's new law led to higher neonatal marijuana exposure.. · Legalization of medical marijuana did not change Oklahoma's neonatal opioid positivity rate..

Causas no genéticas de hipertirosinemia que deben considerarse al interpretar un hallazgo de tirosina elevada en orina

In several countries newborns are screened for tyrosinemia type 1 using tyrosine as a primary marker . In some situations elevated tyrosine levels in blood are discovered due to elevated tyrosine in a metabolic urine screening. In Peru, some pediatric patients suspected of having a genetic condition (inborn error of metabolism) undergo a metabolic urine screening that includes - among other things - qualitative detection of tyrosine. However, when there are elevated levels of tyrosine in urine this does not always mean that the patient has a genetic condition. Most often hypertyrosinemia has a non-genetic origin. Therefore, it is important to review the non-genetic causes of hypertyrosinemia and thus avoid potential misinterpretations of this finding. The genetic entities associated with increased levels of tyrosine are those that generate an enzymatic deficiency in the degradation of tyrosine, within which tyrosinemias type I, II or III are included (2,3). However, elevated tyrosine levels in the blood usually have a nongenetic cause. The most common non-genetic cause of increased tyrosine levels in the blood is transient tyrosinemia of the newborn. This is due to immaturity of enzymes involved in tyrosine degradation– such as 4-hydroxyphenylpyruvate dioxygenase– such as 4-hydroxyphenylpyruvate dioxygenase.

Risk factors for relapse among methamphetamine users receiving a joint legal–medical treatment program as a diversion intervention: A one-year follow-up study

BackgroundMethamphetamine (METH) is a Schedule II illicit drug in Taiwan. A 12-month legal–medical joint intervention program has been developed for first-time METH offenders during deferred prosecution. Risk factors associated with METH relapse use among these individuals were unknown. MethodsWe enrolled a total of 449 METH offenders referred by the Taipei District Prosecutor's Office to Taipei City Psychiatric Center. The study defines relapse as having any positive urine toxicology result or self-report of METH use during 12-month treatment. We compared demographic and clinical variables between a relapse group and nonrelapse group and used a Cox proportional hazards model to determine variables associated with time to relapse. ResultsOf all participants, 37.8 % relapsed to use METH and 23.2 % were noncompleters in the one-year follow-up. Compared to the nonrelapse group, the relapse group had lower educational attainment, more severe psychological symptoms, longer duration of METH use, higher odds of polysubstance use, higher craving severity, and higher odds of positive baseline urine. The Cox analysis revealed individuals with positive urine results and higher craving severity at baseline were at higher risks of METH relapse (hazard ratio [95 % CI]: 3.85 [2.61–5.68] and 1.71 [1.19–2.46], respectively, p < 0.001). Baseline positive urine results and high craving could also predict a shorter length of time to relapse than their respective counterparts. ConclusionsPositive urine screening for METH at baseline and high craving severity are two indicators of an increased risk of drug relapse. Tailored treatment plans incorporating these findings to prevent relapse are warranted in our joint intervention program.

Gelsemium Intoxication in a child detected using targeted and untargeted urinary toxicological screening

Gelsemium intoxication remain rarely reported especially in a pediatric population. The phytochemical composition of Gelsemium indicates that numerous toxic indole or oxindole alkaloids are found in different tissues of the plant. In this study, we reported the case of a three-year-old boy intoxicated to Gelsemium specie. He was admitted for lower limb stiffness which has been spontaneously resolved in 48 hours. A toxicological screening based on a targeted and an untargeted approach using liquid chromatography hyphenated to high resolution tandem mass spectrometry has been performed on urine sample of the child. It allowed to identify gelsemine, as well as gelsedine and its hydroxylated metabolites, which are toxic alkaloids encountered in Gelsemium specie. Furthermore, gelsemine was quantified in the urine sample at a concentration of 40 ng/mL. Even if Gelsemium poisoning remain a rare cause of intoxication, inclusion of specific alkaloids in targeted screening may be relevant to identify such an intoxication. Furthermore, untargeted screening may be regarded as a complementary approach to investigate additional chemicals related to a dedicated intoxication, useful to support the diagnosis.

Urinary profiles of methoxyphenamine and its metabolite after inhalation of methoxyphenamine smoke in humans: aiming to distinguish between active and passive exposure

PurposeMethamphetamine (METH) is commonly abused through smoking. However, the lack of evidence regarding differences in urinary METH excretion after its active and passive inhalation has resulted in complications where the accused claims passive exposure. This study aimed to determine the differences in urinary excretion after active and passive inhalation of the drug, using methoxyphenamine (MPA) as a model for METH.MethodsBody temperature and locomotor activity were measured in mice as indicators of central nervous system toxicity. Six healthy adult male subjects were exposed to passive or active inhalation of MPA smoke in a small room, and urine samples were taken. MPA concentrations were measured using liquid chromatography–tandem mass spectrometry (LC–MS/MS).ResultsThere were no signs of toxicity in mice exposed to MPA smoke, ensuring the safety of the clinical study. Urinary MPA concentrations were significantly lower with passive inhalation compared with those of active inhalation. The maximum urinary MPA concentration in passive inhalation was 13.4 ng/mL, which was 1/60 of active inhalation with 800 ng/mL. The urinary excretion in passive inhalation until 24 h was 8.21 μg, which was 1/76 of active inhalation with 625 μg.ConclusionsSince METH and MPA are expected to be excreted similarly, urinary METH concentrations in passively exposed persons are expected to be lower than the cutoff value of the screening kit. If the urine screening test is positive, the suspect should be considered a METH user.Trial registration number: jRCTs031210604, registration date: Feb. 9, 2022.

Exploring potential moderators of depressive symptoms and treatment outcomes among patients with opioid use disorder

BackgroundDepressive symptoms are common in patients seeking medication treatment for opioid use disorder (MOUD treatment) and decrease quality of life but have been inconsistently related to opioid treatment outcomes. Here, we explore whether depressive symptoms may only be related to adverse treatment outcomes among individuals reporting high opioid use-related coping motives (i.e., use of opioids to change affective states) and high trait impulsivity, two common treatment targets. MethodsPatients seeking MOUD treatment (N = 118) completed several questionnaires within two weeks of their treatment intake. Treatment outcomes (opioid-positive urine screens and days retained in treatment) were extracted from treatment records. Moderation analyses controlling for demographic characteristics and main effects were conducted to explore interaction effects between depressive symptoms and two distinct moderators. ResultsDepressive symptoms were only related to opioid use during early treatment among patients reporting high opioid use-related coping motives (B = 2.67, p =.004) and patients reporting high trait impulsivity (B = 2.01, p =.039). Further, depressive symptoms were only inversely related to days retained among individuals with high opioid use-related coping motives (B = -10.12, p =.003). ConclusionsIndividuals presenting to treatment with opioid-related coping motives and/or impulsivity in the context of depressive symptoms may confer unique risk for adverse treatment outcomes. Clinicians may wish to consider these additive risk factors when developing their treatment plan.

Smanjenje potrebe za ponavljanjem testiranja na nedozvoljene supstance u urinu u okviru sive zone uz pomoć merne nesigurnosti

Background: On an initial urine screening test for illegal substances, if the concentration of a substance is at or above the determined legislative threshold, it is reported as positive. Repeating testing with the same sample to verify it before reporting is a common practice in clinical laboratories. This study aimed to determine whether measurement uncertainty (MU) results can be used to detect a grey zone to reduce repeat testing. Methods: A retrospective study was conducted using data from the laboratory information system between January 1, 2020, and July 1, 2022. Samples studied twice within one hour before reporting for the same urine sample were analyzed. The MU values for urinary amphetamine, cannabinoid, cocaine, and opioid parameters were calculated using ADVIA Chemistry reagents on a Siemens ADVIA 1800 chemical analyzer. The grey zone was defined as the cut-off value ± MU. Results: Urine samples, 319 amphetamine, 198 cannabinoid, 112 cocaine, and 125 opiate tests were repeated from 31.839 patients (16-65 years). Ten amphetamine, 12 can - nabinoid and 2 cocaine test results changed from positive to negative or negative to positive on retesting, all within the grey zone level defined by the MU value. Mean biases bet - ween the repeated test results were -7.64 (95% CI: -13.71 to -1.57) ng/mL for the amphetamine and 1.16 (95% CI: 0.31 to 2.01) ng/mL for the cannabinoid results. Conclusion: Repeating only values within the grey area for each illicit substance may be useful to reduce unnecessary duplicate measurements.

Holistic Approach to Ecstasy-induced Atrial Fibrillation in a Young Patient: A Case Report

Stimulants abuse is a global issue. Acute myocardial infarction, heart failure, and arrhythmia have all been linked to stimulants misuse and its synthetic variants but are rather uncommon. Herein, we present a case of a young patient presented with atrial fibrillation that did not respond to digoxin therapy. A suspicion of drug toxicity was later confirmed with a bedside urine screening. Following administration of benzodiazepines, the patient's clinical condition gradually improved, and he was eventually discharged with a prescription of lifelong warfarin. Therefore, patients with a low-to-intermediate risk of coronary artery disease presenting with atypical symptoms may benefit from a full substance use history and urine drug screening to ensure prompt institution of appropriate treatment.

Factorial design applied to LC-ESI-QTOF mass spectrometer parameters for untargeted metabolomics.

Investigations of untargeted metabolomics are based on high-quality data acquisition usually from multiplatform systems that include high-resolution mass spectrometry equipment. The comprehensive set of results is used as data entry for bioinformatics and machine learning sciences to access reliable metabolic and biochemical information for clinical, forensic, environmental, and endless applications. In this context, design of experiments is a powerful tool for optimizing data acquisition procedures, using a multivariate approach, which enables the maximization of a high-quality amount of information with reduced number of tests. In this study, we applied a 33 Box-Behnken factorial design with central point triplicate for optimizing the ionization of an HPLC-ESI-QTOF method used for screening urine samples. Nozzle voltage (V), fragmentor voltage (V) and nebulizer pressure (psig) were the factors selected for variation. The response surface methodology was applied in the molecular features extracted at each level, resulting in a statistical model that helps evaluating the synergic interaction between these factors. Together with the qualitative analysis of the resulting total ion chromatograms, we came across a reproducible (6.14% RSD) and highly efficient method for untargeted metabolomics of human urine samples. The proposed method can be useful for applications in several urine-based metabolomics-driven studies, as the factorial design can be applied in the development of any analytical protocol considering different LC-MS setups.

Rapid analysis of urine using mass spectrometry with atmospheric pressure laser plasma ionization

Atmospheric pressure laser plasma ionization (APLPI) technique was studied in application to the problem of rapid determination of physiologically active substances in urine. The objectives of this study included investigation by APLPI method of urine samples obtained from treated patients; determination of analytical characteristics of the method; comparative studies of APLPI and HPLC-MS/MS methods in terms of signal-to-noise ratio and evaluation of the possibility of screening urine samples without sample preparation by APLPI method. The instrumental implementation of the method is based on the use of a high-resolution mass analyzer "Orbitrap", in which the standard ion source was replaced by the in-lab developed APLPI source, combined with thermal desorption sample introduction. Urine samples, in which physiologically active substances, in particular barbiturates, carbаmazepine, thiapride, sulpiride, psilocin, amphetamine, tramadol, diphenhydramine, and others were preliminarily detected by HPLC-MS/MS, were investigated. The APLPI method was found to be capable of detecting all these analytes. The duration of the analysis of one sample does not exceed one minute. Using the "dilution in matrix" method calibration curves for a number of compounds were constructed and the analytical characteristics of the method determined. The calibration curves are linear in the range of three orders of magnitude. The mean value of the relative standard deviation of the ion signal in this range was 24%. The limits of detection found for the determination of diphenhydramine, lidocaine and phenobarbital in urine extracts were 0.7 ng/ml, 0.5 ng/ml and 10 ng/ml, respectively. Comparative studies showed that APLPI and HPLC-MS/MS methods were characterized by close values of signal-to-noise ratios. The advantages of the APLPI method are in the rapidity, retrospective analysis, and small sample volume. The limitation of the method is the necessity of desorption of the determined compounds into the gas phase. The possibility of using the APLPI method for screening physiologically active substances in urine without sample preparation has been demonstrated.

Construction of noninvasive prognostic model of bladder cancer patients based on urine proteomics and screening of natural compounds.

Bladder cancer (BCa) has a high incidence and recurrence rate worldwide. So far, there is no noninvasive detection of BCa therapy and prognosis based on urine multi-omics. Therefore, it is necessary to explore noninvasive predictive models and novel treatment modalities for BCa. First, we performed protein analysis of urine from five BCa patients and five healthy individuals using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Combining multi-omics data to mine particular and sensitive molecules to predict BCa prognosis. Second, urine proteomics data were combined with TCGA transcriptome data to select differential genes that were specifically highly expressed in urine and tissues. Further, the Lasso equation was used to screen specific molecules to construct a noninvasive prediction model of BCa. Finally, natural compounds of specific molecules were selected by combined network pharmacology and molecular docking to complete molecular structure docking. A noninvasive predictive model was constructed using PSMB5, P4HB, S100A16, GET3, CNP, TFRC, DCXR, and MPZL1, specific molecules screened by multi-omics, and clinical features, which had good predictive value at 1, 3, and 5years of prediction. High expression of these target genes suggests a poor prognosis in patients with BCa, and they were mainly involved in cell adhesion molecules and the IGF pathway. In addition, the corresponding drugs and natural compounds were selected by network pharmacology, and the molecular structure 7NHT of PSMB5 was found to be well docked to Ellagic acid, a natural compound in Hetaoren that we found. The 3D structure 6I7S of P4HB was able to bind to Stigmasterol in Shanzha stably, and the structure 6WRV of TFRC as an iron transport carrier was also able to bind to Stigmasterol in Shanzha stably. The structures 1WOJ, 3D3W, and 6IGW of CNP, DCXR, and MPZL1 can also play an important role in combination with the natural compounds (S)-Stylopine, Kryptoxanthin, and Sitosterol in Maqianzi, Yumixu, and Laoguancao. The noninvasive prediction model based on urinomics had excellent potential in predicting the prognosis of patients with BCa. The multi-omics screening of specific molecules combined with pharmacology and compound molecular docking can promote the research and development of novel drugs.

159. Antibiotic and diagnostic stewardship surrounding pre-operative testing in patients undergoing cardiac surgery

Abstract Background Despite national guidelines from the US Preventative Services Task Force and the Infectious Diseases Society of America that recommend against screening for asymptomatic bacteriuria (ASB, defined as &amp;gt; 105 CFU of an organism) in most circumstances, pre-operative screening urine culture (UCx) continues. Detection and treatment of ASB leads to antibiotic exposure and risk of antibiotic-associated adverse events like drug reactions, Clostridioides difficile infection (CDI), and colonization by drug-resistant organisms. We describe the implementation of eliminating pre-operative screening for ASB in patients undergoing cardiac surgery. Figure 1Pre-operative checklist for cardiac surgery prior to intervention Methods This was a pre-post study of practice change involving removing ASB screening as part of the pre-cardiac surgery checklist (Figure 1). The pre-intervention period was 08/18/21 – 11/17/21, the post intervention period was 12/1/21 – 3/1/22. We identified all patients who underwent a cardiac arterial bypass graft procedure with or without vein harvesting. We reviewed pre-operative UCx, test indication, antibiotic administration pre-operatively due to culture growth, and post-operative CDI and CAUTI within 30 days post procedure identified through routine infection prevention and control surveillance. Results Pre-intervention, 117/128 (91.4%) patients undergoing cardiac surgery had a UCx collected. Of the UCx, 100% were ordered as part of the pre-operative checklist and not for symptoms. Five patients pre-intervention had ASB detected. Four patients received antibiotics to treat ASB. A fifth patient received antibiotics for bacteriuria which did not meet ASB count threshold. Post-intervention, 15/123 had a UCx (12.3%). Of these, 12/15 were ordered as part of the pre-operative checklist (80%), and the remaining three had symptoms documented. Post-intervention, one patient had ASB detected and did not receive antibiotics. Pre- and post-intervention there were 2 cases of CDI (2/128, 1.6% and 2/123, 1.6%, respectively). There were no CAUTIs either pre- or post-intervention. Conclusion Standard pre-operative UCx is known to be a low-value test and is not recommended by national guidelines. In this single-center diagnostic stewardship intervention, screening was reduced by 87.2%. There was no change in infectious outcomes. Disclosures All Authors: No reported disclosures.

Hydroxy levamisole and its phase II conjugates as potential indicators of levamisole doping in thoroughbred horses.

According to previous research, aminorex is the major metabolite of levamisole; however, in the screening of levamisole-positive racehorse urine and plasma samples, aminorex could only be detected in trace amounts or not at all. In forensic laboratories, hydroxy levamisole and its phase II conjugates make it easier to confirm levamisole misuse and to differentiate between the abuse of levamisole and aminorex. This study aimed to identify the major levamisole metabolites that can be detected along with the parent drug. The study describes levamisole and its metabolites in thoroughbred horses following oral administration and in vitro with equine liver microsomes. The plausible structures of the detected metabolites were postulated using liquid chromatography combined with high-resolution mass spectrometry. Under the experimental conditions 26 metabolites (17 phase I, 2 phase II, and 7 conjugates of phase I metabolites) were detected (M1-M26). The major phase I metabolites identified were formed by hydroxylation. In phase II, the glucuronic acid conjugates of levamisole and hydroxy levamisole were detected as the major metabolites. In plasma, the parent drug and major metabolites are detectable for up to eight days, while in urine, they are detectable for up to twenty days. Levamisole levels rapidly increased at 45 min following administration, then declined gradually until detectable levels were reached approximately 8days after administration, according to a pharmacokinetics study. A prolonged elimination profile and relatively high concentration of hydroxy metabolites suggest that the detection of hydroxy metabolites is imperative for investigating levamisole doping in horses.

Preliminary Findings on Urinary Incontinence Screening Among Childbearing Women Attending Maternal and Child Health Clinic in Kuantan

Introduction: Urinary incontinence is common among childbearing women that affect quality of life and the screening should be performed as early as possible to prevent further complication in later life. Thus, this study was conducted to assess the level of knowledge and practice of UI screening and its associated factors among childbearing women. Methods: A cross-sectional study using convenience sampling method was carried out among 113 childbearing women attending selected Maternal and Child Health Clinic in Kuantan. A self-administered questionnaire was distributed to participants from February 2020 to April 2020. A structured validated Malay version questions towards urinary incontinence screening were used consisting of 20 items on knowledge, 11 items on attitude and 12 items on practices. Results: The response rate for this study was 71% and 93.8% of participants were Malay. Majority of childbearing women, 92%, showed lack of knowledge on urinary incontinence and 91.1% of them never do the screening. Only 39.8% of childbearing women have positive attitude towards the urinary incontinence screening. One Way Anova test shows no association between education level and knowledge (p=0.074) and no association between parity and severity (p=0.843). However, Independent t-test shows a statistical difference between severity of urinary incontinence and screening practice (p=0.036). Conclusion: The knowledge, attitude and practice of urinary incontinence screening need to be enhanced among childbearing women. Health education and awareness campaign should be done regularly to encourage childbearing women to do the screening and discuss the consequence of urinary incontinence in future with health care providers.

The Epidemiology, Associated Factors and Bacterial Profile of Asymptomatic Bacteriuria in Pregnant Women: A Retrospective Chart Review Study in Saudi Arabia.

Asymptomatic bacteriuria (ASB) is the presence of significant amounts of bacteria within the urinary tract in the absence of urinary tract infection (UTI) symptoms, resulting in negative neonatal and pregnancy consequences. This study determined the prevalence, bacteriology patterns, and associated factors with ASB among pregnant women in both primary and hospital levels of care in the Eastern Province of Saudi Arabia. This retrospective chart review study included pregnant women between 18 and 50 years who performed the screening urine culture test during their first antenatal visit between 2017 and 2021, without UTI symptoms. The collected data involved the demographic, medical, and obstetric characteristics, and urine culture results. T-tests and chi-squared tests were used for bivariate associations followed by binary logistic regression models. ASB was positive among 03.42% of the 6471 pregnant women included in the study. Logistic regression revealed that the risk of positive ASB increased in pregnant women in the first and second trimesters (OR = 2.04, 95% CI = 1.41-2.93 and OR= 1.50, 95% CI = 1.03-2.19, respectively), as well as pregnant women with a history of previous UTI (OR = 2.98, 95% CI = 2.14-4.15). The predominant organism isolates were E. coli, followed by GBS, Klebsiella pneumoniae, and Enterococcus faecalis. With limited data on ASB among pregnant women in Saudi Arabia, findings from the current study could help decision-makers in the country assess the epidemiological characteristics of the condition. Further study is recommended to investigate the susceptibility patterns of commonly prescribed antibiotics with different uropathogens to guide the clinicians who deal with these cases. Additionally, a large national study across the other regions in the kingdom is suggested to calculate the prevalence of ASB in Saudi Arabia.

Tissue S100/calgranulin expression and blood neutrophil-to-lymphocyte ratio (NLR) in dogs with lower urinary tract urothelial carcinoma

BackgroundUrothelial carcinoma (UC) is the most common neoplasm of the canine lower urinary tract, affecting approximately 2% of dogs. Elderly female patients of certain breeds are predisposed, and clinical signs of UC can easily be confused with urinary tract infection or urolithiasis. Diagnosis and treatment are challenging given the lack of disease-specific markers and treatments. The S100A8/A9 complex and S100A12 protein are Ca2+-binding proteins expressed by cells of the innate immune system and have shown promise as urinary screening markers for UC. The neutrophil-to-lymphocyte ratio (NLR) can also aid in distinguishing certain neoplastic from inflammatory conditions. Our study aimed to evaluate the tissue expression of S100/calgranulins and the blood NLR in dogs with UC. Urinary bladder and/or urethral tissue samples from dogs with UC (n = 10), non-neoplastic inflammatory lesions (NNUTD; n = 6), and no histologic changes (n = 11) were evaluated using immunohistochemistry. Blood NLRs were analyzed in dogs with UC (n = 22) or NNUTD (n = 26).ResultsTissue S100A12-positive cell counts were significantly higher in dogs with lower urinary tract disease than healthy controls (P = 0.0267 for UC, P = 0.0049 for NNUTD), with no significant difference between UC and NNUTD patients. Tissue S100A8/A9-positivity appeared to be higher with NNUTD than UC, but this difference did not reach statistical significance. The S100A8/A9+-to-S100A12+ ratio was significantly decreased in neoplastic and inflamed lower urinary tract tissue compared to histologically normal specimens (P = 0.0062 for UC, P = 0.0030 for NNUTD). NLRs were significantly higher in dogs with UC than in dogs with NNUTD, and a cut-off NLR of ≤ 2.83 distinguished UC from NNUTD with 41% sensitivity and 100% specificity. Higher NLRs were also associated with a poor overall survival time (P = 0.0417).ConclusionsThese results confirm that the S100/calgranulins play a role in the immune response to inflammatory and neoplastic lower urinary tract diseases in dogs, but the tissue expression of these proteins appears to differ from their concentrations reported in urine samples. Further investigations of the S100/calgranulin pathways in UC and their potential as diagnostic or prognostic tools and potential therapeutic targets are warranted. The NLR as a routinely available marker might be a useful surrogate to distinguish UC from inflammatory conditions.