Odor, urinals

Urine appearance and color Urine culture and sensitivity Urine flow studies Urine odor Urine pH... 

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The unusual physical complaints and findings in workers overexposed to teUurium include somnolence, anorexia, nausea, perspiration, a metallic taste in the mouth and garlic-like odor on the breath (48). The unpleasant odor, attributed to the formation of dimethyl teUuride, has not been associated with any adverse health symptoms. Tellurium compounds and metaboUc products have been identified in exhaled breath, sweat, urine, and feces. Elimination is relatively slow and continuous exposure may result in some accumulation. No definite pathological effects have been observed beyond the physical complaints outlined. Unlike selenium, teUurium has not been proved to be an essential biological trace element. 

As the name implies, the odor of urine in maple syrup urine disease (brancbed-chain ketonuria) suggests maple symp or burnt sugar. The biochemical defect involves the a-keto acid decarboxylase complex (reaction 2, Figure 30-19). Plasma and urinary levels of leucine, isoleucine, valine, a-keto acids, and a-hydroxy acids (reduced a-keto acids) are elevated. The mechanism of toxicity is unknown. Early diagnosis, especially prior to 1 week of age, employs enzymatic analysis. Prompt replacement of dietary protein by an amino acid mixture that lacks leucine, isoleucine, and valine averts brain damage and early mortality. 

Beauchamp G.K., Wysocki C.J. and Wellington J.L. (1985). Extinction of response to urine odor as a consequence of vomeronasal organ removal in male guinea pigs. Behav Neurosci 99, 950-955. 

Blissitt M.J., Bland K.P. and Cottrell D.F. (1990). Discrimination between the odors of fresh estrous and non-estrous ewe urine by rams. Appl Anim Behav Sci 25, 51-60. 

Schellinck H.M., West A.M. and Brown R.E. (1992). Rats can discriminate between the urine odors of genetically identical mice maintained on different diets. Physiol Behav 51, 1079-1082. 

Bitter almond odor associated with patient suggests cyanide poisoning, metabolic acidosis, cyanide (blood) or thiocyanate (blood or urine) levels. 

Kleinfeld (1980) reported a case of arsine poisoning in a 31-y-old man. The exposure to arsine occurred from a leaking canister thought to be empty. The exposure duration was estimated to be 1-2 min, but no actual or estimated arsine concentrations were available. The victim presented with hematuria. On hospital admission, no intact erythrocytes were present in the urine, hematocrit was 43%, and hemoglobin was 9.8 g/ dL. The hematocrit dropped to as low as 18%, the correction of which required one unit of packed cells. Based upon the exposure history and the subject s note of a "garlicky" odor, the diagnosis was arsine-induced hemolytic anemia. Urinary arsenic was 7.2 mg/L on admission and 0.1 mg/L 4 d later. The patient was subsequently discharged. 

A newer therapeutic approach is the administration of betaine (6-12 g daily), which lowers homocysteine levels by favoring remethylation [33], A theoretical hazard of betaine treatment is increasing the blood methionine, sometimes to an extravagant degree ( 1 mmol/1). Experience to date indicates that betaine administration is safe, with no major side effects except for a fishy odor to the urine. Other therapeutic approaches have included the administration of salicylate to ameliorate the thromboembolic diathesis. Patients also have been treated with dietary supplements of L-cystine, since the block of the transsulfura-tion pathway in theory could diminish the synthesis of this amino acid. 

Baum, M.J. and Keverne, E.B. (2002) Sex difference in attraction thresholds for volatile odors from male and estrous female mouse urine. Horm. Behav. 41, 213-219. 

Yalcin, S.S., Tekinalp, G. and Ozalp, I. (1999) Peculiar odor of traditional food and maple syrup urine disease. Pediatr. Int. 41, 108-109. 

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