Evaluation of the Urine Drug Abuse Screening Tests.

BACKGROUND: Substance use is an important public health problem and increasing all over the world. Different methods have been defined for drug abuse testing in medical laboratories. We aimed to compare two urine drug screening methods with liquid chromatography-tandem mass spectrometry (LC-MS/MS). METHODS: A total of 102 patients' urine samples were analyzed by test dip card and EMIT (enzyme multiplied im-munoassay technique). Randomly selected samples (n = 51; 50%) were also analyzed by LC-MS/MS as the reference method. RESULTS: The drug results of all patients analyzed with the test card and EMIT were compatible. Nine of 51 samples (18%) were negative according to all methods. The sensitivity and specificity percentages of AMP, COC, MDMA, OPI/MOP, and THC using test card were 70/96, 100/100, 47/100, 50/100, and 80/85, respectively. Similarly, the sensitivity and specificity percentages of AMP, COC, MDMA, OPI/MOP, and THC using EMIT were 76/97, 100/100, 57/100, 56/100, and 76/91, respectively. CONCLUSIONS: The performances of two immunochemical methods were similar for AMP, BZO, COC, MDMA, OPI/MOP, and THC whereas lower than LCMS/MS for AMP, MDMA, OPI/MOP, and THC. A sample that is positive according to any immunochemical method should be confirmed by definitive techniques such as LC-MS/MS.

miR-21-3p and miR-192-5p in patients with type 2 diabetic nephropathy.

OBJECTIVES: Microribonucleic acids (microRNA/miRNA/miR-) are predicted to be useful in the early diagnosis, monitoring, and treatment of diabetic nephropathy (DN). We aimed to investigate the relationship of DN to miR-21-3p, miR-29a-3p, miR-29b-3p, miR-29c-3p, miR-126-3p, miR-129-1-3p, miR-137, miR-192-5p, miR-212-3p, and miR-320c. METHODS: There were 50 healthy controls and 100 patients with type 2 diabetes mellitus (T2DM). The diabetic patients were divided into three subgroups: normal to mildly increased (A1, n=51), moderately increased (A2, n=25), and severely increased (A3, n=24) albuminuria. The biochemical measurements were analysed using Roche Cobas 8000. The plasma miRNAs were analysed using RT-qPCR based on SYBR green chemistry. RESULTS: The relative expression of miR-21-3p was significantly lower in the (A3 p=0.005, 6.6-fold decrease) and DN (A1 + A3) (p=0.005, 6.6-fold decrease) groups compared to the controls. The relative expression of miR-192-5p was also significantly lower in the DN group (p=0.027, 2.4-fold decrease) compared to the controls. The area under curve value was 0.726 for miR-21-3p and 0.717 for miR-192-5p for distinguishing the DN group from the controls. CONCLUSIONS: The decreased expressions of miR-21-3p and miR-192-5p are associated with the development of DN and may be potential biomarkers for the early diagnosis of DN.

Assessment of estimated glomerular filtration rate based on cystatin C in diabetic nephropathy.

INTRODUCTION: GFR is estimated by using creatinine and cystatin C to determine renal dysfunction. Our aim was to evaluate estimated GFR (eGFR) based on cystatin C in type 2 diabetic patients with diabetic nephropathy (DN). METHODS: Study group included 52 controls (46% male, age: 54.5±12.4) and 101 diabetic patients (46.5% male, age: 58.2±11). The diabetics were divided into three subgroups according to 24-hour urine albumin: normal to mildly increased (A1) (n=51), moderately increased (A2) (n=25), severely increased (A3) (n=25) albuminuria. Creatinine clearance (CrCl) was determined. Correlations between CrCl and eGFRs estimated according to the CKD-EPI, MDRD, and Cockcroft-Gault (CG) formulas, and ROC curves were evaluated. Data were analyzed using SPSS 22.0. RESULTS: Only CKD-EPI-cys eGFR was significantly lower in the A1 group than the controls (p=0.021). All GFRs were lower in the A3 group than the control (CKD-EPI-cr, MDRD, CKD-EPI-cys, CKD-EPI-cr-cys: p=0.0001, CG and CrCl: p=0.001) and A1 (for all GFRs p=0.0001) groups. CKD-EPI-cr (p=0.004), MDRD (p=0.01), CG (p=0.037), CKD-EPI-cys (p=0.033), and CKD-EPI-cr-cys (p=0.016) eGFRs in the A2 group were significantly different from the A1 group. All eGFRs showed a moderate correlation with CrCl in the A1group (CKD-EPI-cr and CKD-EPI-cr-cys: r=0.49, p=0.0001, MDRD: r=0.44, p=0.001, CG r=0.48, p=0.0001: CKD-EPI-cys r=0.40, p=0.004). The area under the CKD-EPI-cys ROC curve was the highest and found to be 0.847 (95%CI 0.763-0.931, p=0.0001). CONCLUSIONS: Our results showed that the CKD-EPI-cys eGFR can be useful in detecting the early stage of DN and more predictive than the others for prediction of DN.

Comparison of Cobas 6500 and Iris IQ200 fully-automated urine analyzers to manual urine microscopy.

INTRODUCTION: Urine screening is achieved by either automated or manual microscopic analysis. The aim of the study was to compare Cobas 6500 and Iris IQ200 urine analyzers, and manual urine microscopic analysis. MATERIALS AND METHODS: A total of 540 urine samples sent to the laboratory for chemical and sediment analysis were analyzed on Cobas 6500 and Iris IQ200 within 1 hour from sampling. One hundred and fifty three samples were found to have pathological sediment results and were subjected to manual microscopic analysis performed by laboratory staff blinded to the study. Spearman's and Gamma statistics were used for correlation analyses, and the McNemar test for the comparison of the two automated analyzers. RESULTS: The comparison of Cobas u701 to the manual method yielded the following regression equations: y = - 0.12 (95% CI: - 1.09 to 0.67) + 0.78 (95% CI: 0.65 to 0.95) x for WBC and y = 0.06 (95% CI: - 0.09 to 0.25) + 0.66 (95% CI: 0.57 to 0.73) x for RBC. The comparison of IQ200 Elite to manual method the following equations: y = 0.03 (95% CI: - 1.00 to 1.00) + 0.88 (95% CI: 0.66 to 1.00) x for WBC and y = - 0.22 (95% CI: - 0.80 to 0.20) + 0.40 (95% CI: 0.32 to 0.50) x for RBC. IQ200 Elite compared to Cobas u701 yielded the following equations: y = - 0.95 (95% CI: - 2.13 to 0.11) + 1.25 (95% CI: 1.08 to 1.44) x for WBC and y = - 1.20 (95% CI: - 1.80 to -0.30) + 0. 80 (95% CI: 0.55 to 1.00) x for RBC. CONCLUSIONS: The two analyzers showed similar performances and good compatibility to manual microscopy. However, they are still inadequate in the determination of WBC, RBC, and EC in highly-pathological samples. Thus, confirmation by manual microscopic analysis may be useful.