Litíase urinária e sua relação com os achados de cristalúria e hematúria na urinálise / Urolithiasis and its relation to the urinalysis findings of crystalluria and hematuria

Introdução: Litíase urinária é a formação de cálculos no trato urinário a partir de componentes presentes na urina. É uma doença crônica associada a um alto número de recorrência e hospitalizações. O objetivo do estudo foi verificar a frequência de cristalúria e a relação entre litíase urinária e os achados de cristalúria e hematúria em pacientes da região noroeste do estado do Rio Grande do Sul. Métodos: Estudo transversal no qual foram incluídos pacientes no período de março a dezembro de 2015. Exames qualitativos de urina e prontuários médicos foram revisados buscando-se dados de cristalúria e hematúria e diagnóstico da litíase. Resultados: Foram analisadas 688 amostras de urina, e 54 (7,85%) apresentaram cristalúria. Dos casos de cristalúria, cinco (9,3%) pacientes apresentaram litíase. Foi verificada significância estatística (p = 0,010) entre as variáveis de litíase e hemácias, mas não foi evidenciada significância estatística entre as variáveis de litíase e cristalúria (AU)

Introduction: Urolithiasis is the formation of stones in the urinary tract from urine components. It is a chronic disease associated high recurrence and hospitalization rates. The aim of this study was to determine the frequency of crystalluria and the relation between urolithiasis and crystalluria and hematuria findings in patients of northwestern Rio Grande do Sul. Methods: A cross-sectional study that enrolled patients from March to December of 2015. Urinalyses and medical records were reviewed searching for crystalluria and hematuria data, and diagnosis of lithiasis. Results: 688 urine samples were analyzed, and crystalluria was found in 54 (7.85%) of them. Considering the crystalluria cases, 5 (9.3%) of the patients also had lithiasis. Statistical significance was found (p = 0.010) between the variables of lithiasis and red blood cells, but no statistical significance was found between the variables of lithiasis and crystalluria. Conclusion: Crystalluria was not associated with lithiasis, while hematuria was associated with such disease (AU)

Benefits of urinalysis.

Objective. In the pilot Iran school screening programme, the minimal cost of screening dipstick urinalysis in 1601 asymptomatic school children was determined. Methods. The cost of screening dipstick urinalysis was calculated by reviewing the literature for the prevalence of asymptomatic proteinuria, hematuria, bacteriuria, and glucosuria determined by an initial dipstick urinalysis.The minimal cost utilizing data of 3 general physicians was calculated. Costs were determined by using current charge for supplies ordered to perform tests, charges for tests performed by a commercial laboratory, and the cost of a final evaluation by a pediatric nephrologist. Results. 4.7% (76/1601) of patients were calculated to have an initial abnormal urinalysis. Upon retesting 1.37% (22/1601) of patients were calculated to have a persistent abnormality. The calculated cost was 167$ to initially screen all 1601pateints with a dipstick urinalysis or 0.092$ per patient. The calculated cost to evaluates the 22 patients with any persistent abnormality on repeat dipstick urinalysis was 0.02$ or 0.001$ per patient. This is the calculated cost for a single screening of 1601 asymptomatic pediatric patients. Conclusion. Multiple screening dipstick urinalysis in asymptomatic pediatric is costly and should be discontinued. We propose that a single screening dipstick urinalysis be obtained at school entry age, between 6 and 7 years, in all asymptomatic children.

screening for diabetic nephropathy in diabetes clinic in Khartoum- Sudan

Diabetes mellitus and its complications is one of the major health problems. This study is about the screening for one of these complications -diabetic nephropathy- in our clinical practice in Khartoum Sudan. The main objective is to determine whether the clinical practice in the diabetes clinics in Khartoum- Sudan is following the recommended guidelines for the screening for diabetic nephropathy. Prospective cross- sectional study. Populations: during the period from Jan-March 2008, 98 diabetic patients with type 1 or type 2 were randomly selected from patients attending the outpatient diabetes clinic in Omdurman Teaching Hospital. Methodology: ninety eight adult type1 and 2 diabetic patients were studied using simple, direct, standardized questionnaire, previous records were seen and a urine sample for each patient was examined for proteinuria. 6.1% of the total number of patients had urine examination on regular bases, 75.5% rarely had urine examination, while 18.4% had their urine never been examined before in the diabetes clinics. None of patients was diagnosed as having diabetic nephropathy or seen by a nephrologist. Only 7.1% of the total patients were using ACE inhibitors or ARB agents and these were prescribed for indications other than diabetic nephropathy. Testing urine of our patients we found that 18.4% had macroalbuminuria, 40.8% microalbuminuria, while40.8% had negative results. The majority of the patients with either type of albuminuria were in the age group 51-65 years and most of them had type 2 diabetes. A large number of our patients had evidence of diabetic nephropathy. However, none of them had been screened before for that. Despite the small number of patients, this study raises a serious alarm regarding the clinical practice in our diabetes clinics in Khartoum Sudan and it strongly recommends urgent intervention by the authorities to implement the international guidelines of screening and management of these patients

[Detection of urine morphine false negative results caused by adulterants]

Drug abusers are persistently tryieg to use masking techniques for hiding their addiction. Detection of false negative results of urine morphine test which caused by adulterants is the main goal of this study. Screening test for detecting urine morphine was done by two kinds of Immunochromatography rapid tests and the positive results confirmation done by TLC. Sodium chloride, vinegar, lemon juice, nitrite, hydrogen peroxide, and bleach, with effects on pH and gravity were checked as common adulterants in urine morphine check. This data showed that, double test performance without any increase in threshold amount of morphine [300ng/ml], have 100% sensitivity for preventing false negative results due to adulterants interference. Urine morphine test in double format, with and without increasing threshold amount of morphine, can reveal adulterants interference and prevent false negative reporting

Cost benefit of the routine urinalysis

In the present health care environment, cost-benefit analysis is extremely important. In this screening program, the minimal cost of screening dipstick urinalysis in 1601 asymptomatic school children was determined. The process of screening was similar to all the studies. The minimal cost utilizing 3 general physicians was calculated. Costs were determined by using current charge for supplies ordered to perform tests, charges for tests performed by a commercial laboratory, and the cost of a final evaluation by a pediatric nephrologist. Initial abnormal urinalysis was found in 4.7% [76/1601] of patients. Upon retesting 1.37% [22/1601] of patients were calculated to have a persistent abnormality. The calculated cost was 1/530/000 Rials [164.5 $] to initially screen all 1601 patients with a dipstick urinalysis or 850 Rials [0.09 $] per patient. The calculated cost to evaluate the 22 patients with any persistent abnormality on repeat dipstick urinalysis was 246/840 Rials [26.5 $] or 11.220 Rials [1.2 $] per patient. This is the calculated cost for a single screening of 1601 asymptomatic pediatric patients. Multiple screening dipstick urinalysis in asymptomatic pediatric are costly and should be discontinued. We purpose that a single screening dipstick urinalysis be obtained at school entry age, between 6 and 7 years old, in all asymptomatic children