The risk prediction value of paraquat poisoning dose, urine protein and myocardial enzymes / 中华劳动卫生职业病杂志

Objective: To explore the value of paraquat (PQ) intake, urine protein and myocardial enzyme indexes in judging the prognosis of patients with acute PQ poisoning. Methods: From September to December 2021, all 201 patients with acute PQ poisoning admitted to Guangzhou Twelfth People's Hospital from January 2010 to December 2019 were selected as the research objects. Based on follow-up results 60 days after poisoning, the research objects were divided into survival group (n=78) and death group (n=123) . The differences in information about poisoning, treatment plan, PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase between the two groups of patients were compared and analyzed. Logistic regression and Cox regression were used to analyze the correlation between poisoning outcome and PQ intake, urine protein and myocardial enzymes. ROC curve and principal component analysis were used to explore high-efficiency indicators for predicting the outcome of acute PQ poisoning. Results: The PQ intake[50 (20, 100) ml], urine protein (total rank 15570.50) , creatine kinase[ (336.36±261.96) U/L], creatine kinase isoenzyme[ (43.91±43.74) U/L], lactate dehydrogenase [ (346.01±196.50) U/L], α-hydroxybutyrate dehydrogenase content[ (271.23±11.92) U/L] of patients in the death group were all higher than the survival group[15 (10, 20) ml, 4730.50, (187.78±178.06) U/L, (18.88±15.50) U/L, (190.92±60.50) U/L, (152.60±48.34) U/L, respectively] (P<0.05) . The outcome of acute PQ poisoning was positively correlated with PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase (P<0.05) . Multivariate logistic regression and multivariate Cox regression analysis showed that creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase and α-hydroxybutyrate dehydrogenase was positively correlated with the prognosis of patients with acute PQ poisoning (P<0.05) . ROC curve analysis and principal component analysis showed that the combined indexes of PQ intake, urine protein and myocardial enzymes had the highest efficacy and weight in judging the prognosis of patients (AUC=0.91, weight coefficient=0.19, sensitivity=0.76, specificity=0.89) . When the combined score was ≥4, the probability of accurately predicting the death of patients was as high as 91% (positive predictive value=0.91) . Conclusion: PQ intake, urine protein combined with creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase has high value in predicting the prognosis of patients with acute PQ poisoning.

Desempenho de diferentes marcas de tiras reagentes relativo à densidade e à análise química da urina de cães e gatos / Performance of different brands of reagent strips for density and chemical analysis of dog and cat urine

Objetivou-se verificar a compatibilidade entre diferentes marcas de tiras reagentes para urinálise, tanto de uso veterinário, como de uso humano, e confrontar os parâmetros semiquantitativos desse instrumento com métodos quantitativos. Para isso, foram analisadas 77 amostras frescas de urina de cães e gatos e testados 04 modelos de tiras reagentes. Quanto à densidade urinária, houve correlação razoável entre os métodos quantitativo e semiquantitativo naquelas amostras com pH ácido, mas não naquelas com pH neutro ou alcalino. Quanto à concentração proteica, houve similaridade de 53,3% a 83,3% entre as marcas testadas e quando comparadas com a análise fotométrica houve uma correlação razoável (rs = 0,69752 a 0,75074). Em ponto de corte de 15mg/dL de proteína, a sensibilidade da tira reagente foi 82,5% e 100% para urina canina e felina, respectivamente. No tocante à hematúria, houve divergência razoável entre a sedimentoscopia e as diferentes marcas de tiras reativas. Quanto à piúria, há uma baixa sensibilidade das tiras em relação às amostras caninas com muitos resultados falso-negativos (33% a 75%), enquanto em amostras felinas a sensibilidade foi de 100%. Assim, independente da marca, as tiras reagentes devem servir apenas como teste rápido de triagem, sendo mais apropriado o uso de métodos quantitativos na avaliação clínica do paciente a partir da urinálise.

The aim was to verify the compatibility between different brands of urinary dipsticks, for both human and veterinary use, and to compare the semiquantitative parameters of this instrument with quantitative methods. For this, 77 fresh samples of urine from dogs and cats were analyzed e and 04 models of reagent strips were tested. Regarding urinary density, a reasonable correlation was observed between the quantitative and semiquantitative methods in those samples with acidic pH, which did not occur in those with neutral or alkaline pH. Regarding the protein concentration, there was similarity from 53.3% to 83.3% between the brands and in the comparative analysis between the control strip and the photometric analysis, there was a reasonable correlation (rs = 0.69752 to 0.75074). In cut-off point of 15mg/dL protein, the sensitivity of the reagent strip was 82.5% and 100% for canine and feline urine, respectively. Regarding hematuria, there was a reasonable divergence of results between sedimentation and tested dipsticks. As for pyuria, there is a low sensitivity of the strips in relation to canine samples with many false negative results (33% to 75%), while in feline samples the sensitivity was 100%. Thus, regardless of the brands, the reagent strips should serve only as a rapid screening test, while the use of quantitative methods in the clinical evaluation of the patient from urinalysis is more appropriate.

Urolithiasis and sleeve gastrectomy: a prospective assessment of urinary biochemical variables / Urolitíase e gastrectomia vertical: uma avaliação prospectiva das variáveis bioquímicas urinárias

ABSTRACT Introduction: to evaluate urinary biochemical alterations related to urolithogenesis processes after sleeve gastrectomy (SG). Materials and methods : prospective study with 32 individuals without previous diagnosis of urolithiasis who underwent SG. A 24-h urine test was collected seven days prior to surgery and at 6-month follow-up. The studied variables were urine volume, urinary pH, oxalate, calcium, citrate, and magnesium and calcium oxalate super saturation (CaOx SS). Results: patients were mainly women (81.2%), with mean age of 40.6 years. Mean pre- and postoperative BMI were 47.1 ± 8.3 Kg/m2 and 35.5 ± 6.1 Kg/m2, respectively (p<0.001). Urine volume was significantly lower at the postoperative evaluation in absolute values (2,242.50 ± 798.26 mL x 1,240.94 ± 352.39 mL, p<0.001) and adjusted to body weight (18.58 ± 6.92 mL/kg x 13.92 ± 4.65 mL/kg, p<0.001). CaOx SS increased significantly after SG (0.11 ± 0.10 x 0.24 ± 0.18, p<0.001). Moreover, uric acid levels were significantly lower at the postoperative evaluation (482.34 ± 195.80 mg x 434.75 ± 158.38 mg, p=0.027). Urinary pH, oxalate, calcium, citrate, and magnesium did not present significant variations between the pre- and postoperative periods. Conclusion: SG may lead to important alterations in the urinary profile. However, it occurs in a much milder way than that of RYGB.

RESUMO Introdução: avaliar as alterações bioquímicas urinárias relacionadas aos processos de litíase urinária após gastrectomia vertical (GV). Método: estudo prospectivo, com 32 indivíduos submetidos a GV, sem diagnóstico prévio de urolitíase. Foi coletada urina de 24 horas, sete dias antes da operação e no retorno de 6 meses. As variáveis estudadas foram volume de urina, pH urinário, oxalato, cálcio, citrato e super saturação de oxalato e cálcio (SS CaOx). Resultados: os pacientes foram em sua maioria mulheres (81,2%), com idade média de 40,6 anos. O IMC médio pré e pós-operatório foi 47,1 ± 8,3 Kg/m2 e 35,5 ± 6,1 Kg/m2, respectivamente (p<0,001). O volume de urina foi significativamente baixo na avaliação pós-operatória em valores absolutos (2.242,50 ± 798,26 mL versus 1.240,94 ± 352,39 mL, p<0,001) e ajustado ao peso corporal (18,58 ± 6,92 mL/kg versus 13,92 ± 4,65 mL/kg, p<0,001). A SS CaOx aumentou significativamente após a GV (0,11 ± 0,10 versus 0,24 ± 0,18, p<0,001). Além disso, os níveis de ácido úrico apresentaram-se significativamente baixos na avaliação pós-operatória (482,34 ± 195,80 mg versus 434,75 ± 158,38 mg, p=0,027). PH urinário, oxalato, cálcio, citrato e magnésio não apresentaram variações significativas entre os períodos pré e pós-operatório. Conclusão: a GV pode levar a alterações importantes no perfil urinário. Entretanto, essas ocorrem de forma muito mais leve que na derivação gástrica em Y de Roux.

Diálisis peritoneal en un neonato con enfermedad de la orina con olor a jarabe de arce. A propósito de un caso / Peritoneal dialysis in a neonate with maple syrup urine disease. A case report

La enfermedad de jarabe de arce es una entidad autosómica recesiva producida por un error congénito en el metabolismo de tres aminoácidos esenciales de cadena ramificada: valina, leucina e isoleucina. La forma neonatal de esta enfermedad se manifiesta por un cuadro de compromiso neurológico grave y progresivo, asociado a un olor peculiar de la orina, consecuencia de la eliminación del exceso de estos aminoácidos. Este olor a azúcar quemada remeda a la melaza obtenida de los arces, lo que da nombre a esta enfermedad. El mejor método para eliminar estos tóxicos es la hemodiafiltración, pero, en los centros en los que esta práctica no es posible, la diálisis peritoneal constituye una alternativa.Se presenta a un recién nacido con leucinosis, con compromiso grave del sistema nervioso central, en quien la diálisis peritoneal fue de utilidad para superar la descompensación metabólica.

Maple syrup disease is an autosomal recessive entity caused by a congenital error in the metabolism of three essential branched-chain amino acids: valine, leucine and isoleucine. The neonatal form of this disease is expressed by a severe and progressive neurological compromise, associated with a peculiar smell of urine, a consequence of the elimination of the excess of these amino acids. This smell of burnt sugar mimics the molasses obtained from maples, which gives its name to this disease. The best method to eliminate these toxins is hemodiafiltration, but in centers where this practice is not possible, peritoneal dialysis is an alternative.We present a newborn with leukinosis with severe central nervous system involvement in whom peritoneal dialysis was useful to overcome metabolic decompensation.

Valores de referencia de analitos en orina en la edad pediatrica / Reference values of analytes in urine in the pediatric age / Valores de referência de analitos na urina na idade pediátrica

La deteccion de trastornos metabolicos minerales puede explicar diversas anomalias fisiologicas que exigen para su interpretacion la comparacion con valores de referencia validados. El objetivo de este trabajo fue la determinacion de valores de referencia en la poblacion infantil uruguaya, de los analitos sodio, potasio, calcio, magnesio, fosforo y urato relacionados con la creatinina en muestras de la segunda miccion de la manana en 470 escolares (240 ninas y 230 ninos) con edades comprendidas entre 7 y 12 anos. Las medianas obtenidas fueron: Na/Crea: 139 mmol/g, K/Crea: 78 mmol/g, Ca/Crea: 77 mg/g, Mg/Crea: 71 mg/g, P/Crea: 500 mg/g, Ur/Crea: 554 mg/g, Crea: 117 mg/dL. A excepcion de los cocientes Na/Crea y K/Crea se encontro una disminucion de la excrecion de estos analitos con la edad, independientemente del sexo. Los valores obtenidos resultaron ser analogos a los de otras poblaciones con tipo de alimentacion similar.

The detection of mineral metabolic disorders can explain several pathologies which require the comparison with reference values for their interpretation. The aim of this study was to determine the reference values of 470 Uruguayan school children with ages between 7 and 12 for sodium, potassium, calcium, magnesium, phosporous and urate and their relationship with creatinine in urine samples of the second urination of the morning. The median obtained were: Na/Crea: 139 mmol/g, K/Crea: 78 mmol/g, Ca/Crea: 77 mg/g, Mg/Crea: 71 mg/g, P/Crea: 500 mg/g, Ur/Crea: 554 mg/g, Crea: 117 mg/dL. A diminishment of excretion with the age was found, regardless the sex, except for Na/Crea and K/Crea. The values obtained were similar to those of others populations with a similar diet.

A detecção de distúrbios metabólicos minerais pode explicar várias anomalias fisiológicas, que exigem a comparação com valores de referência validados para serem interpretados. O objetivo deste estudo foi determinar valores de referência na população infantil uruguaia, dos analitos sódio, potássio, cálcio, magnésio, fósforo e urato relacionados com a creatinina em amostras da segunda micção da manhã em 470 alunos (240 meninas e 230 meninos) com idades entre 7 e 12 anos. As medianas obtidas foram: Na/Crea: 139 mmol/g, K/Crea: 78 mmol/g, Ca/Crea: 77 mg/g, Mg/Crea: 71 mg/g, P/Crea: 500 mg/g, Ur/Crea: 554 mg/g, Crea: 117 mg/dL. Com exceção dos quocientes Na/Crea e K/Crea, foi encontrada uma diminuição na excreção destes analitos com a idade independentemente do sexo. Os valores obtidos foram análogos aos de outras populações com um tipo similar de dieta.

Renal changes and acute kidney injury in covid-19: a systematic review

SUMMARY OBJECTIVE We aimed to present a review of renal changes in patients with COVID-19. METHODS We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.

RESUMO OBJETIVO Apresentar uma revisão sobre as alterações renais nos pacientes com COVID-19. MÉTODOS Foi realizada uma revisão sistemática de literatura para buscar estudos referentes a pacientes com alterações renais clínicas, laboratoriais e anatomopatológicas durante a infecção por SARS-CoV-2. A busca foi realizada nas bases de dados eletrônicos PubMed, Scopus e Embase, com as palavras-chaves: "COVID-19", "coronavirus", "Sars-CoV-2", "kidney injury" e "kidney disease", para identificar artigos originais publicados na literatura até 07 de maio de 2020. Quinze estudos trouxeram alterações renais clínicas e laboratoriais dos pacientes com COVID-19, e três abordaram análises anatomopatológicas. DISCUSSÃO A Lesão renal aguda (LRA) foi um achado relevante nos pacientes com COVID-19. Houve também alterações significativas nos exames laboratoriais que indicam lesão renal, como o nível de creatinina e ureia séricas, proteinúria e hematúria. As alterações laboratoriais e a LRA foram importantes nos pacientes que desenvolveram o quadro grave da doença. Há considerável prevalência de LRA nos grupos de pacientes que vieram a óbito. Na análise histopatológica de pacientes com SARS-CoV-2 foram encontrados achados renais sugestivos que o vírus poderia ter efeitos diretos sobre o rim. CONCLUSÃO A COVID-19 é uma doença que, apesar de acometer principalmente os pulmões, também acomete os rins. Aumento das escórias nitrogenadas, hematúria, proteinúria e LRA foram achados frequentes em pacientes com quadros graves da COVID-19. Esses achados foram relacionados a maior mortalidade. É necessária a realização de mais estudos com enfoque nas alterações renais e suas implicações no quadro clínico causadas pelo novo coronavírus.

Prevalence of voluntary dehydration according to urine osmolarity in elementary school students in the metropolitan region of São Paulo, Brazil

OBJECTIVES: To evaluate the prevalence of voluntary dehydration based on urine osmolarity in elementary school students from two public educational institutions in the metropolitan region of São Paulo and evaluate whether there is a relationship between voluntary dehydration and nutritional status or socioeconomic status. METHODS: Analytical cross-sectional study with students from two public schools in the city of Osasco. The determination of urine osmolarity was performed using the freezing method of the Advanced® Osmometer Model 3W2. Urine osmolarity greater than 800 mOsm/kg H2O was considered voluntary dehydration. During data collection, the weights and heights of the students, environmental temperatures and air humidity levels were obtained. RESULTS: A total of 475 students aged six to 12 years were evaluated, of whom 188 were male. Voluntary dehydration occurred in 63.2% of the students and was more frequent in males than in females. The prevalence of voluntary dehydration was more frequent in males aged six to nine years than in females. However, no statistically significant difference was observed between males and females aged 10 to 12 years. No association was found between voluntary dehydration and nutritional status or socioeconomic status. CONCLUSION: The prevalence of voluntary dehydration was high in elementary school students and was more frequent in males. No association was found between voluntary dehydration and nutritional or socioeconomic status.

Comparación de concentración y excreción de flúor, con y sin fortificación de flúor en sal, costa rica 2005 / Comparison of fluoride concentration and excretion in fortified and non-fortified salt use. Costa Rica 2005

Resumen Objetivo: Determinar la concentración y excreción de flúor en orina de 24 horas en 4 grupos de edad y la exposición de flúor en uñas, sin y con fluoruración de la sal, después de un periodo de interrupción de siete meses. Cartago 2004-2005. Metodología: Muestra no probabilística y secuencial de 127 individuos distribuidos en cuatro grupos poblacionales (4-6, 10-12, 15-17 y 35-60 años de edad). El análisis de flúor en orina, agua y sal se realizó con el electrodo específico. El análisis de flúor en uñas se realizó mediante el análisis de difusión facilitada con hexametildisiloxano (HMDS). Se calculó la concentración de flúor en orina, uñas, agua y sal, así como la excreción de flúor en orina. Resultados: En el periodo sin sal fluorurada (fase 1), 90,5% de muestras de sal tenían menos de 15,8 mgF/kg (promedio 22,7 mgF/kg) y el agua un promedio de 0,25 mgF/l; en el periodo con sal fluorurada (fase 2) el promedio de flúor en sal fue de 143,5 mgF/kg, siempre con la concentración de agua de 0,25 mgF/l. La excreción urinaria de 24 horas y la concentración de flúor con 7 meses sin sal fluorurada en ambos casos fue menor en la fase I en los cuatro grupos de edad. Con sal fluorurada (fase II) la excreción aumentó en 80% en promedio, en todos los grupos de edad. Por el contrario, la concentración de flúor en uñas, fue más elevada durante la fase 1, sin diferencias significativas entre grupos ni entre fases. Conclusión: La interrupción de la fluoruración de la sal en Costa Rica permitió medir la presencia de éste elemento en la población centinela (control), confirmando que el organismo mantiene el flúor aún por 7 meses después de dejar de ingerir flúor independiente de la edad. La medición de la concentración de flúor en uñas podría constituirse en un método de medición de éste elemento para complementar el estudio de flúor en el organismo humano.

Abstract Objective: To determine the concentration and excretion of fluoride in urine of 24 hours in 4 age groups and fluoride exposure in nails, without and with fluoridation of the salt, after a period of interruption of seven months. Cartago 2004-2005. Methodology: Non-probabilistic and sequential sample of 127 individuals distributed in four population groups (4-6, 10-12, 15-17 and 35-60 years of age). The analysis of fluorine in urine, water and salt was performed with the specific electrode. Nail fluoride analysis was performed by diffusion analysis provided with hexamethyldisiloxane (HMDS). The concentration of fluoride in urine, nails, water and salt, as well as the excretion of fluoride in urine was calculated. Results: In the period without fluoridated salt (phase 1), 90.5% of salt samples had less than 15.8 mgF / kg (average 22.7 mgF / kg) and water averaged 0.25 mgF / L; In the period with fluorided salt (phase 2) the average fluoride in salt was 143.5 mgF / kg, always with the water concentration of 0.25 mgF / l. The 24-hour urinary excretion and fluoride concentration at 7 months without fluoridated salt in both cases was lower in phase I in all four age groups. With fluoridated salt (phase II) excretion increased by 80% on average in all age groups. In contrast, the fluoride concentration in nails was higher during phase 1, without significant differences between groups or between phases. Conclusion: The interruption of fluoridation of salt in Costa Rica allowed the measurement of the presence of this element in the sentinel population (control), confirming that the organism maintains the fluoride still for 7 months after stopping ingesting fluorine independent of age. The measurement of the concentration of fluoride in nails could constitute a method of measuring this element to complement the study of fluorine in the human organism.

Urinary sodium excretion in a young to middle-aged adult urban population: a pilot study in Ecuador / Excreción de sodio urinario en una población urbana de adultos jóvenes y de mediana edad: un estudio piloto en Ecuador

ABSTRACT Objective High sodium consumption is associated with cardiovascular disease (CVD). CVD is the leading cause of mortality in Ecuador, which may be caused in part by unhealthy eating habits. Currently, there are no data on the consumption of sodium using 24-hr urine samples. The aims of the study were to provide preliminary data of sodium intake in an urban population sample consisting of adults between 25 and 64 years old, and to explore the feasibility to conduct a population-level sodium intake determination by using 24-hr urine samples. Methods A cross-sectional study was conducted in a sample of 129 adults living in an urban setting. 24-hr urinary samples were collected and the WHO STEPS instrument was used to collect the socio-demographic and clinical characteristics of participants. A reference value of 2.0 g/day was used to differentiate between normal and high sodium intake groups. Results Participants' median age was 39 years, 91% of them identified themselves as belonging to the mestizo race, and 60% were female. The average sodium intake was 2 655(±1 185) mg/d (range: 1 725 to 3 404), which is equivalent to a salt intake of 6.8 g/d (range: 4.4 to 8.7). Sodium intake was significantly higher in males than in females: 3 175(±1 202) mg/d vs. 2 304(±1 042) mg/d, respectively, (p<.01). Conclusions Sodium consumption in two-thirds of the participants was higher than the WHO recommended level. These results should help to support the execution of a national sodium intake survey that, in turn, would provide information to guide and plan public health strategies seeking to decrease cardiovascular diseases occurrence rates in Ecuador.(AU)

RESUMEN Objetivo Un exceso de sodio dietético se asocia con enfermedades cardiovasculares (ECV). Las ECV son la principal causa de mortalidad en el Ecuador, tal vez por patrones dietéticos no saludables en su población. Al momento no existe información del consumo de sodio usando orina de 24-hr. Los objetivos del estudio fueron proveer información preliminar de la ingesta de sodio en una muestra urbana de adultos de 25-64 años, y explorar la factibilidad de realizar un estudio a nivel nacional. Métodos Estudio de corte-transversal de 129 adultos residentes en un entorno urbano. Se recolectó muestras urinarias de 24-hr y se recolectaron características socio-demográficas y clínicas usando los cuestionarios STEPS de la OMS. Un valor de referencia de 2.0 g/día fue utilizado para discriminar entre consumidores normales y altos de sodio. Resultados La mediana de edad de la población estudiada fue de 39 años, 91% se autodefinió de raza mestiza, y 60% fueron femeninas. La ingesta promedio de sodio fue de 2 655(±1 185) mg/d (rango: 1 725 to 3 404), que es equivalente a una ingesta de sal de 6.8 g/d (rango: 4.4 to 8.7). La ingesta masculina fue significativamente mayor que el de las mujeres 3 175(±1 202) mg/d vs. 2 304(±1 042) mg/d, respectivamente, (p<.01). Conclusiones Dos tercios de la población estudiada consume sodio mayor al recomendado por la OMS. Estos resultados apoyan la ejecución de un estudio nacional que guíe la planificación en salud pública e informe estrategias para mejorar la salud cardiovascular en el Ecuador.(AU)

Determination of the reference interval for the activity of NAcetyl-ß-D-glucosaminidase (NAG) in urine of healthy dogs / Determinação de intervalo de referência para a atividade da NAcetyl-ß-D-glucosaminidase (NAG) na urina de cães sadios

The diagnosis of acute kidney injury by evaluating the activity of urinary enzymes is an important tool especially for its precocity in relation to methods of assessment of renal function considered late as the installation of injury precedes the function change. This study was performed to determine the reference interval for urinary NAG activity (N-Acetyl-β-D-glucosaminidase) in urine of healthy dogs of different breeds, ages and sexes. It was utilized an automated method for the determination of NAG activity standardized for dog urine samples. Through statistical analysis it was observed that NAG is positively correlated with the age of the animal and urine specific gravity but is not interfered by sex or weight. Based on the determination of urinary activity and after correcting the values for a 1,025 urine specific gravity was obtained an reference interval of X '= 3.62U/L±0.66U/L.(AU)

O diagnóstico da injúria renal aguda pela avaliação da atividade de enzimas urinárias é uma importante ferramenta para o médico veterinário, especialmente por sua precocidade em relação aos métodos de avaliação da função renal, considerados tardios, visto que a instalação da injúria precede a alteração da função. Neste estudo foi realizada a determinação do intervalo de referência médio para a atividade urinária de NAG (N-Acetyl- β-D-Glucosaminidase), em urinas de cães hígidos, de diferentes raças, sexos e faixas etárias. Para isso, trabalhou-se com um método automatizado para determinação da atividade de NAG, padronizado para amostras de urina de cães. Por meio de análise estatística, observou-se que a NAG apresenta correlação positiva com a idade do animal e com a densidade urinária, mas não sofre interferência quanto ao sexo ou peso. Com base na determinação da atividade urinária e após corrigir os valores para uma densidade de 1,025, obteve-se um intervalo de referência médio de X´ = 3,62U/L±0,66U/L.(AU)

Alteraciones urinarias en niños con primera infección urinaria e infección urinaria recurrente / Urinary disorders in children with first urinary infection and recurrent urinary tract infection

Introducción: las infecciones del tracto urinario son un problema frecuente en la población pediátrica. La infección del tracto urinario recurrente tiene mayor riesgo de cicatrices renales y daño glomerular. Objetivo: describir la frecuencia de hematuria, presencia de proteínas en orina, elevación en tensión arterial y hallazgos ecográficos en pacientes pediátricos desde 1 mes hasta 14 años de edad, con diagnóstico de infección del tracto urinario. Métodos: estudio descriptivo transversal, realizado entre octubre de 2014 y febrero de 2016, en pacientes que asistieron al servicio de urgencias pediátricas del Hospital de San José, con diagnóstico de infección del tracto urinario. Resultados: se diagnosticaron 125 pacientes con infección del tracto urinario, la mediana de edad fue de 2,75 años, más frecuente en mujeres (75,2 por ciento) y la mayoría recibió tratamiento intrahospitalario (58,4 por ciento). Se observó que en el grupo de infección del tracto urinario recurrente fue más frecuente el hallazgo de hematuria, que en la infección del tracto urinario primer episodio (21,9 vs. 11,8 por ciento), al igual que las malformaciones renales (32,0 vs. 14,5 %). En la tensión arterial no se observaron grandes diferencias entre los grupos, con una frecuencia de tensión arterial elevada en hospitalizados de 19,6 por ciento para primer episodio, y 18,2 por ciento en recurrentes. La presencia anormal de proteínas en orina fue de 35,4 por ciento en el grupo de infección del tracto urinario primer episodio. Conclusiones: son frecuentes la presencia de hematuria, malformaciones renales y elevación de la tensión arterial en pacientes con infección del tracto urinario. Se encuentra una frecuencia inusual de pacientes con elevación de la presión arterial y proteínas en orina, probablemente por falsos positivos. Se debe insistir en seguimiento ambulatorio del uroanálisis y la tensión arterial, para garantizar que esta se normalice o para detectar daños permanentes(AU)

Introduction: urinary tract infections are a frequent problem in the pediatric population. Recurrent urinary tract infection has a higher risk of kidney scars and glomerular damage. Objective: to describe frequency of hematuria, presence of proteins in urine, increase of blood pressure, and ultrasound findings in pediatric patients from 1 month to 14 years old with a diagnosis of urinary tract infection. Methods: cross-sectional descriptive study conducted from October 2014 to February 2016, in patients who attended the pediatric emergency´s service of the Hospital of San José with a diagnosis of urinary tract infection. Results: 125 patients with urinary tract infection were diagnosed, the median age was 2.75 years, it was more frequent in women (75.2 percent) and the majority of them received intrahospital treatment (58.4 percent). It was observed that in the recurrent urinary tract infection group the finding of hematuria was more frequent, than in the group of urinary tract infection as a first episode (21.9 vs. 11.8 percent), as well as the renal malformations (32,0 vs. 14.5percent). In blood pressure, there were no large differences among the groups, with a rate of high blood pressure frequency in hospitalized patients of 19.6 percent for first episode, and 18.2 percent in recurrent patients. The abnormal presence of proteins in urine was of 35.4 percent in the group of urinary tract infection first episode(AU) Conclusions: the presence of hematuria, renal malformations and increase of blood pressure in patients with urinary tract infection are frequent. There is an unusual frequency of patients with high blood pressure and proteins in the urine, probably due to false positives. It must be addressed the ambulatory monitoring of urinalysis and blood pressure to ensure that it normalizes or to detect permanent damage

Excreção fracionada urinária de sódio, potássio e cloreto em cordeiros suplementados com cloreto de amônio para prevenção de urolitíase / Urinary fractional excretion of sodium, potassium and chloride in lambs supplemented with ammonium chloride to prevent urolithiasis

A urolitíase é uma doença importante de cordeiros confinados. A acidificação da urina, pela ingestão de cloreto de amônio, é o método preventivo mais frequentemente empregado. Devido à falta de informação específica em ovinos, este estudo foi realizado para avaliar as alterações que ocorrem nos eletrólitos urinários de cordeiros, que receberam cloreto de amônio na dieta. Foram utilizados 100 cordeiros, com 3 meses de idade, que foram mantidos em confinamento durante 56 dias, e distribuídos em 3 grupos: G1 (n=40) que receberam 400mg/kg de peso vivo (PV) de cloreto de amônio/dia, durante 21 dias; G2 (n=40) que receberam 400mg/kg de PV de cloreto de amônio/dia durante 42 dias; e G3 (n=20) que não receberam cloreto de amônio. Os cordeiros foram examinados e as amostras de sangue e urina foram colhidas a cada 7 dias: 0 (antes do início da ingestão de cloreto de amônio), 7, 14, 21, 28, 35, e 42 dias. As concentrações séricas e urinárias de sódio (Na+), potássio (K+), cloreto (Cl-), e de creatinina foram mensuradas em todos os momentos de colheita. A excreção fracionada urinária (EFu) de eletrólitos e a diferença de íons fortes (SID) na urina [(Na+ + K+) - Cl] foram calculadas. A EFu de Na+, K+ e Cl- não variou ao longo do tempo em G3, provando que a dieta de confinamento, por si só, não influenciou a excreção urinária destes eletrólitos. A ingestão de cloreto de amônio, pelo grupo G1 e G2, influenciou a EFu sobre o tempo de confinamento. A SID urinária foi mais precisa do que a EFu de Cl- para demonstrar que a concentração de Cl- aumentou na urina, o que destacou a relevância desta variável.(AU)

Urolithiasis is an important disease of lambs confined. The urine acidification, by ammonium chloride intake, is the preventive method most frequently employed. Due to the lack of specific information in sheep, this study was performed to evaluate the electrolyte changes that occur in the urine of lambs receiving ammonium chloride in the diet. One hundred male lambs, 3 months old, were kept in a feedlot during 56 days, and distributed in 3 groups: G1 (n=40) receiving 400mg/kg BW of ammonium chloride/day during 21 days; G2 (n=40) receiving 400mg/kg BW of ammonium chloride/day during 42 days; and G3 (n=20) that did not receive ammonium chloride. The lambs were examined and blood and urine samples were collected every 7 days: 0 (the beginning of ammonium chloride intake), 7, 14, 21, 28, 35, and 42 days. Serum and urine sodium (Na+), potassium (K+), chloride (Cl-), and creatinine concentrations were measured. The urinary fractional excretion (FE) of electrolytes and the urine strong ion difference [(Na+ + K+) - Cl-] were calculated. FEs of Na+, K+, and Cl- did not vary over time in G3, proving that the feedlot diet, by itself, did not influence the urinary excretion of these electrolytes. The ingestion of ammonium chloride, instead, influenced FEs over the time of feedlot. The urinary SID was more accurate than the FE of Cl- to demonstrate that the concentration of Cl- increased in the urine. It highlights the relevance of this variable.(AU)

Fractional excretion of electrolytes and paradoxical aciduria in dairy cows with left displaced abomasum / Excreção fracionada de eletrólitos em acidúria paradoxal em vacas leiteiras com deslocamento de abomaso à esquerda

The fractional excretion of electrolytes is used to assess renal function and interpret electrolyte and acid-base imbalances. Left displaced abomasum is a common disorder in dairy cows, which causes hypokalemic, hypochloremic metabolic alkalosis. There is limited information on fractional excretion of electrolytes in cows with displaced abomasum. This study aimed to measure the fractional excretion of sodium, potassium, and chloride and paradoxical aciduria in dairy cows with displaced abomasum. Blood and urine samples were collected from 30 dairy cows before and 24, 48, and 72 h after surgery. The cows were divided into two groups (G1: laparoscopy and G2: laparotomy) with 15 cows each. The concentrations of chloride, sodium, potassium, and creatinine were measured in serum and urine. Urinary pH and packed cell volume were measured. Fractional excretion of sodium, potassium, and chloride and urinary strong ion difference [SID]urine were calculated using published formulas. Cows in both groups showed hypokalemic, metabolic alkalosis before surgery; however, hypochloremia was observed only in G2. Potassium concentration significantly increased 24, 48, and 72 h after surgery in G1 and 48 and 72 h after surgery in G2. There were no significant changes in fractional excretion of sodium, chloride, and potassium and urinary pH and [SID]urine between treatments and time points. Paradoxical aciduria was observed before and 24 h following surgery in G1. Fractional excretion and urinary SID are valuable tools to understand hypochloremic, hypokalemic alkalosis in dairy cows with displaced abomasum, as well as paradoxical aciduria and return of abomasal flux.(AU)

A excreção fracionada de eletrólitos é calculada para verificar a função renal e auxiliar na interpretação de distúrbios eletrolíticos e ácido-base. O deslocamento de abomaso à esquerda é frequente em vacas leiteiras, ocasionado alcalose hipoclorêmica e hipocalêmica. Há pouca informação na literatura sobre excreção fracionada de eletrólitos em vacas com deslocamento de abomaso. Este estudo objetivou mensurar a excreção fracionada de sódio, potássio e cloro e a acidúria paradoxal em vacas leiteiras com deslocamento abomasal. Amostras sanguíneas e urinárias foram coletadas de 30 vacas antes e 24, 48 e 72 horas após operação. As vacas foram divididas em dois grupos (G1: laparoscopia e G2: laparotomia) com 15 animais cada. As concentrações de cloro, sódio, potássio e creatinina foram dosadas no soro e urina. Mensurou-se pH urinário e o hematócrito. A excreção fracionada e diferença de íons fortes urinário [SID]urina foram calculados utilizando fórmulas publicadas. Vacas de ambos os grupos apresentaram alcalose hipocalêmica antes da operação. Não houve alterações significativas na excreção fracionada de sódio, potássio e cloro, no pH urinário e na [SID]urina entre os tratamentos e momentos. Acidúria paradoxal foi observada no G1 antes e 24h após operação. A excreção fracionada e [SID]urina são ferramentas importantes para interpretar a alcalose hipoclorêmica e hipocalêmica em vacas leiteiras com deslocamento de abomaso, como também a acidúria paradoxal e o retorno do fluxo abomasal.(AU)

Study on Urinary Metabolic Profile in Rats with Deep Venous Thrombosis Based on Pattern Recognition / 法医学杂志

OBJECTIVES@#To study the urinary metabolic profile in rats with deep venous thrombosis （DVT） based on metabolomics and to screen out small molecular biomarkers for the diagnosis and forensic identification of DVT.@*METHODS@#Inferior vena cava of rats was ligated to construct DVT models. The rats were randomly divided into three groups： DVT, sham, and control groups, 10 in each group. The urine of DVT and sham rats was collected during 24 hours in the metabolic cage at 48 hours after operating, meanwhile, 24 hours urine was collected in control group. The metabolic profile was analyzed by nuclear magnetic resonance. SIMCA-P 14.1 software was used for pattern recognition. The variable importance in projection （VIP） value from orthogonal PLS-DA （OPLS-DA） model combined with Mann-Whitney U test were used to search the different metabolites in the urine.@*RESULTS@#The metabolic profiles of urine from DVT, sham, and control groups had significant differences. The DVT, sham, and control groups could be distinguished by the partial least squares method-discriminant analysis （PLS-DA） model. Compared with the urine of the rats in control groups, the levels of leucine, glutamine, creatine, creatinine and sucrose in the urine of DVT rats were up-regulated, and the levels of 3-hydroxybutyrate, lactate, acetone, α-oxoglutarate, citrate and hippurate were down-regulated.@*CONCLUSIONS@#The different metabolites in the urine of DVT rats are expected to become its candidate biomarkers. The results can provide a research basis for the diagnosis, treatment and forensic identification of DVT.

Investigação do refluxo vésico-ureteral por abordagens metabolômicas alvo e global em urina utilizando como plataformas analíticas CE-MS, CESI-MS, RPLC-MS e HILIC-MS / Investigation of vesicoureteral reflux by target and untargeted metabolomic approaches in urine using CE-MS, CESI-MS, RPLC-MS and HILIC-MS as analytical platforms

O refluxo vésico-ureteral (RVU) é uma das condições urológicas comumente diagnosticada entre crianças. Altos graus dessa condição podem causar cicatrização renal, insuficiência renal e hipertensão arterial. A uretrocistografia miccional é o método mais comumente utilizado para o diagnóstico, no entanto, esse procedimento envolve sedação, cateterismo vesical e expõe a criança a uma quantidade significativa de radiação. A investigação metabolômica pode fornecer novos entendimentos sobre a doença e visa a descoberta de metabólitos específicos associados a ela. Assim, existe um potencial considerável para a implementação de perfil metabólico em análises clínicas. Dessa forma, buscou-se estabelecer uma alternativa não invasiva para identificar crianças com o RVU através da metabolômica. Para a investigação metabolômica alvo um método por eletroforese capilar acoplada ao espectrômetro de massas (CE-MS) com analisador to tipo ion trap foi desenvolvido e validado para a determinação de 27 aminoácidos em urina. Os parâmetros experimentais relacionados às configurações da interface CE-MS, eletrólito (BGE) e espectrômetro de de massas (MS) foram otimizados, proporcionando uma boa separação dos 27 aminoácidos, incluindo os isômeros L-leucina, L-isoleucina e L-alloisoleucina, em menos de 30 min. O líquido auxiliar (SHL) foi composto de 0,5% (v/v) ácido fórmico em 60% (v/v) água/metanol à uma vazão de 5 µL min-1. O BGE consistiu de 0,80 mol L-1 de ácido fórmico e 15% (v/v) de metanol. Um procedimento de stacking por pH foi implementado para aumentar a detectabilidade (uma solução de NH4OH a 12,5% (v/v) foi injetada a 0,5 psi/9 s antes das amostras). O método foi validado de acordo com os protocolos FDA e ICH, exibindo parâmetros aceitáveis. A quantificação bem sucedida dos aminoácidos em amostras de urina de um estudo piloto do RVU foi alcançada. A avaliação estatística dos resultados mostrou que alguns dos aminoácidos avaliados podem carregar informações que possibilitam discriminar as amostras de urina entre os grupos teste e controle. Para a análise metabolômica global urinária, métodos por RPLC-MS e HILIC-MS foram otimizados. Cinco colunas com diferentes propriedades foram investigadas para RPLC e quatro colunas para HILIC; adicionalmente, foram investigados a influência dos aditivos e pH da fase móvel. As condições ótimas foram determinadas avaliando o formato de pico, a relação sinal-ruído, o tempo de retenção, o número de molecular features detectados e sua distribuição durante o gradiente de eluição. A melhor condição obtida para RPLC utiliza a coluna CSH C18 e fase móvel composta por 0,1% (v/v) ácido fórmico em água (A) e 0,1% (v/v) ácido fórmico em acetonitrila (B). Para HILIC, o melhor desempenho foi obtido com a coluna zwitteriônica ZIC-HILIC e fase móvel composta por 10 mmol L-1 acetato de amônio pH 6,8 (B) e 95% (v/v) acetonitrila e 5% 200 mmol L-1 acetato de amônio pH 6,8 (A). As amostras de urina dos grupos controle e teste foram submetidas à análise metabolômica global por RPLC-MS usando o método otimizado e por CESI-MS. Os resultados indicaram que diversas rotas metabólicas podem ter sido alteradas pelo RVU. Alteração dos níveis de carnitinas e acilcarnitinas, aminoácidos e derivados, purinas e outros foi observada. Ainda, a presença de acilcarnitinas na urina podem indicar danos mitocondriais e a diminuição de triptofano e aumento do ácido quinurênico indicam uma alteração no metabolismo do triptofano

Vesicoureteral reflux (VUR) is one of the most commonly urologic conditions diagnosed among children. A high degree of this condition can cause kidney scarring, kidney failure and high blood pressure. Voiding cystourethrography is the standard method for diagnosis; however, this procedure involves sedation, bladder catheterization and exposes the child to a significant amount of radiation. Metabolomics has provided new insights about the disease and aims to discover specific metabolites associated with it. Thus, there is a considerable potential for the implementation of metabolic profile in clinical analyses. Thus, we attempted to establish a noninvasive alternative to identify children with VUR through metabolomics approach. For target metabolomics, a CE-MS method was developed and validated for the separation and quantitative analysis of 27 amino acids in urine. Experimental parameters related to the CE-MS interface (based on co-axial sheath liquid, SHL), background electrolyte (BGE) and mass spectrometer (MS) settings were optimized providing a good separation of 27 amino acids, including the isomers L-leucine, L-isoleucine and L-alloisoleucine, in less than 30 min. The SHL was composed of 0.50% (v/v) formic acid in 60% (v/v) methanol-water delivered at a flow rate of 5 µL min-1. The BGE consisted of 0.80 mol L-1 formic acid and 15% (v/v) methanol. A pH stacking procedure was implemented to enhance sensitivity (a 12.5% (v/v) NH4OH solution was injected at 0.5 psi/9 s prior to samples). The proposed method was thoroughly validated according to FDA and ICH protocols exhibiting acceptable parameters. A successful quantification of amino acids in urine samples from the VUR cohort was achieved. The statistical evaluation of the results showed that some of the amino acids may carry information for the discrimination of the urine samples between the test and control groups. For untargeted metabolomics analysis, methods by RPLC-MS and HILIC-MS were optimized. Five columns with different properties were investigated for RPLC and four columns for HILIC; additionally, the influence of additives and pH of the mobile phase were investigated. The optimum conditions were determined assessing the peak shape, signal-to-noise ratio, retention time, number of molecular features detected and their distribution during the elution gradient. The best condition obtained for RPLC uses CSH C18 column and mobile phase composed by 0.1% (v/v) formic acid in water (A) and 0.1% (v/v) formic acid in acetonitrile (B). For HILIC, the best performance was obtained with the zwitterionic ZIC-HILIC column and mobile phase composed by 10 mmol L-1 ammonium acetate pH 6.8 (B) and 95% (v/v) acetonitrile and 5% (v/v) 200 mmol L-1 ammonium acetate pH 6.8 (A). Urine samples from the control and test groups were submitted to global metabolomics analysis by RPLC-MS using the optimized method and by CESI-MS. The results indicated that several metabolic pathways may have been altered by VUR. Changes of carnitine and acylcarnitine levels, amino acids and derivatives, purines and others was observed. Furthermore, the presence of acylcarnitines in the urine may indicate mitochondrial damage and the decrease of tryptophan and increase of the kynurenic acid indicate a change in the metabolism of tryptophan

Equilíbrio acidobásico, parâmetros urinários e sanguíneos de gatos induzidos ao estresse e suplementados com composto antioxidante / Acid-base balance, urinary and blood parameters of cats stress-induced cats and supplemented with antioxidant compound

Este estudo teve como objetivo avaliar a suplementação do composto antioxidante comercial EconomasE (Alltech, Brasil ( AOX) sobre o equilíbrio acidobásico, os parâmetros urinários, o hemograma completo e a fragilidade osmótica de eritrócitos (FOE) de gatos estressados. Foram utilizados 24 gatos adultos (3,49±0,87kg), distribuídos em delineamento inteiramente ao acaso, com quatro níveis (0, 250, 500, 750mg de AOX/kg de alimento na matéria seca) e seis repetições, durante o período de 80 dias. Os gatos foram induzidos ao estresse por meio da presença de cães próximo ao recinto experimental (agente estressor; AE), do 61º dia até o final do experimento. A pressão parcial de dióxido de carbono (pCO2) e o bicarbonato (HCO3 -) aumentaram linearmente (P<0,05) conforme o aumento da ingestão de AOX. Os maiores valores de dióxido de carbono total (tCO2) (P<0,05) foram observados nos gatos alimentados com 500 e 750mg de AOX/kg de dieta. As concentrações de hemoglobina foram maiores nos animais alimentados com 250 e 500mg de AOX/kg de dieta. Os parâmetros urinários e da FOE foram semelhantes nos gatos em todas as dietas. Esses dados indicam que a suplementação com AOX apresenta efeitos benéficos no equilíbrio acidobásico e na concentração de hemoglobina de gatos induzidos ao estresse.(AU)

This study aimed to evaluate the supplementation of a commercial antioxidant EconomasE (Alltech, Brazil - AOX) on the acid-base balance, urinary parameters, red blood count (RBC) and erythrocyte osmotic fragility (EOF) of stressed cats. Twenty-four adult cats (3.49±0.87kg) were distributed in a completely randomized design with four levels (0, 250, 500, 750mg AOX/kg feed dry matter) and six replicates for a period of 80 days. Cats were induced to stress through the presence of dogs in the experimental environment (stressor agent; AE) from the 61th day to the end. Partial pressure of carbon dioxide (pCO2) and bicarbonate (HCO3) increased linearly (P<0.05) with increased intake of AOX. The highest values of total carbon dioxide (tCO2) (P<0.05) were observed in cats fed the 500 and 750mg AOX/kg diet. Hemoglobin concentration was higher (P<0.05) in animals fed the 250 and 500mg AOX/kg diet. The urinary parameters and EOF were similar among all diets. These data indicate that AOX supplementation has beneficial effects in acid-base balance and hemoglobin concentration of stress-induced cats.(AU)

Validación de un método rápido en orina por lC/MS/MS para la búsqueda de compuestos empleados en sumisión química y su aplicación a muestras reales / Validation of a fast screening method in urine by lC/MS/MS for compounds used in drug-facilitated crime (DFC) and its application to real samples

La Oficina de Naciones Unidas contra la Droga y el Delito (UNODC) en 2011 señala que "El delito facilitado por drogas (DFD) es una expresión general que abarca la violación y otras agresiones sexuales, el robo con violencia o intimidación, la extorsión de dinero y los malos tratos deliberados de ancianos o niños bajo la influencia de sustancias sicotrópicas". En este trabajo se validó un método cualitativo y rápido a partir de muestras de orina por LC/MS/MS para 39 compuestos comprendidos en los listados de sumisión química. El objetivo fue alcanzar un límite de detección un 50 % por debajo de la concentración propuesta como "Límites mínimos de funcionamiento exigidos (MRPL)" por la UNODC, para poder ser aplicado a muestras reales.

The United Nations Office on Drugs and Crime (UNODC) in 2011, states that "The Drug-facilitated crime (DFC) is a general term that includes rape or other sexual assault, robbery, money extortion, as well as the deliberate maltreatment of the elderly or children under the influence of psychotropic substances". In this work we validated a qualitative and fast method from urine samples by LC/MS/MS for 39 compounds included in the Drug-facilitated crime lists. The aim was to reach a detection limit of 50% below the proposed concentration as "minimum required performance limits (MRPL)" by UNODC in order to be applied in real samples.

Dipstick spot urine pH does not accurately represent 24 hour urine PH measured by an electrode

ABSTRACT Objectives To determine whether spot urine pH measured by dipstick is an accurate representation of 24 hours urine pH measured by an electrode. Materials and Methods We retrospectively reviewed urine pH results of patients who presented to the urology stone clinic. For each patient we recorded the most recent pH result measured by dipstick from a spot urine sample that preceded the result of a 24-hour urine pH measured by the use of a pH electrode. Patients were excluded if there was a change in medications or dietary recommendations or if the two samples were more than 4 months apart. A difference of more than 0.5 pH was considered an inaccurate result. Results A total 600 patients were retrospectively reviewed for the pH results. The mean difference in pH between spot urine value and the 24 hours collection values was 0.52±0.45 pH. Higher pH was associated with lower accuracy (p<0.001). The accuracy of spot urine samples to predict 24-hour pH values of <5.5 was 68.9%, 68.2% for 5.5 to 6.5 and 35% for >6.5. Samples taken more than 75 days apart had only 49% the accuracy of more recent samples (p<0.002). The overall accuracy is lower than 80% (p<0.001). Influence of diurnal variation was not significant (p=0.588). Conclusions Spot urine pH by dipstick is not an accurate method for evaluation of the patients with urolithiasis. Patients with alkaline urine are more prone to error with reliance on spot urine pH.

Dissolution efficiency and bioequivalence study using urine data from healthy volunteers: a comparison between two tablet formulations of cephalexin / Eficiência de dissolução e estudo de bioequivalência utilizando dados de urina de voluntários saudáveis: uma comparação entre duas formulações de comprimidos de cefalexina

The aim of the present study was to assess the bioequivalence of two cephalexin tablet formulations available in the Brazilian market (product A as reference formulation and product B as test formulation). Dissolution efficiency (DE%) was calculated for both formulations to evaluate their in vitrobiopharmaceutical features. The oral bioequivalence study was performed in twenty-four healthy volunteers in a crossover design. Single oral dose (tablet containing 500 mg of cephalexin) of each product was administered with two weeks of washout period. Urinary concentrations of cephalexin were measured by high-performance liquid chromatography (HPLC) method and pharmacokinetics parameters were estimated by urinary excretion data. The bioequivalence was determined by the following parameters: the cumulative amount of cephalexin excreted in the urine, the total amount of cephalexin excreted in the urine and the maximum urinary excretion rate of cephalexin. DE values of immediate-release cephalexin tablets (500 mg) were 68.69±4.18% for product A and 71.03±6.63% for product B. Regarding the dissolution test of the two brands (A and B) analysed, both were in compliance with the official pharmacopeial specifications, since the dissolution of both formulations was superior to 80% of the amount declared in the label after 45 minutes of test (A=92.09%±1.84; B=92.84%±1.08). The results obtained indicated that the products A and B are pharmaceutical equivalents. Confidence intervals for the pharmacokinetic parameters were in compliance with the international standards, indicating that products A and B can be considered bioequivalents and, therefore, interchangeable...

O objetivo do presente estudo foi avaliar a bioequivalência de duas formulações de cefalexina disponíveis no mercado brasileiro (produto A como formulação referência e produto B como formulação teste). A eficiência de dissolução (DE%) foi calculada para ambas as formulações para avaliar suas características biofarmacêuticas. O estudo de bioequivalência oral foi realizado em vinte e quatro voluntários sadios utilizando um desenho cruzado. Uma dose oral única (comprimido contendo 500 mg de cefalexina) de cada produto foi administrada com um período de washout de duas semanas. Concentrações urinárias de cefalexina foram mensuradas por método de cromatografia líquida de alta eficiência (CLAE) e os parâmetros farmacocinéticos foram estimados por dados de excreção urinária. A bioequivalência foi determinada pelos seguintes parâmetros: quantidade acumulada da cefalexina excretada na urina, quantidade total da cefalexina excretada na urina e a taxa de excreção máxima da cefalexina. Os valores de DE dos comprimidos de liberação imediata de cefalexina (500 mg) foram 68,69±4,18% para o produto A e de 71,03±6,63% para o produto B. Com relação ao teste de dissolução das duas marcas analisadas (A e B), ambas apresentaram-se de acordo com as especificações farmacopéicas, uma vez que a dissolução de ambas formulações foi superior a 80% da quantidade declarada após 45 minutos de teste (A=92,09%±1,84; B=92,84% ±1,08). Os resultados obtidos indicaram que os produtos A e B são equivalentes farmacêuticos. Os intervalos de confiança para os parâmetros farmacocinéticos estavam de acordo com os padrões internacionais, demonstrando que os produtos A e B podem ser considerados bioequivalentes e, portanto, intercambiáveis...

Studying inhibition of calcium oxalate stone formation: an in vitro approach for screening hydrogen sulfide and its metabolites

Calcium oxalate urolithiasis is one of the most common urinary tract diseases and is of high prevalence. The present study proposes to evaluate the antilithiatic property of hydrogen sulfide and its metabolites like thiosulfate & sulfate in an in vitro model.