Screening urinalysis

AA, azelaic acid AN, oral antiandrogen blank, N/A BPO, benzoyl peroxide lab, CBC, chem screen, urinalysis OA, oral antibiotic Ol, oral isotretinoin PA, physical assessment PT, pregnancy test SLA, serum lipid analysis TA, topical antimicrobial TR, topical retinoid. 

Table 1 provides the urinalysis test results for the 4,847 arrestees, While PCP was tested for by an EMIT test only, cocaine, opiates and methadone were tested for by both EMIT and thin layer chromatography (TLC). (The EMIT test for opiates is not specific to morphine, the metabolite of heroin, and can detect the recent use of a variety of opiates. A specimen positive for opiates is most likely to indicate the use of heroin in this population, however.) Our analyses will use only the results from the EMIT tests, because we have learned that the TLC general drug screen is less sensitive for detecting recent use of these illicit street drugs (Wish et al. 1983 Wish et al. 1984). 

Other diagnostic tests to consider for differential diagnosis erythrocyte sedimentation rate, urinalysis, toxicology, chest x-ray, heavy metal screen, HIV testing, cerebrospinal fluid (CSF) examination, electroencephalography, and neuropsychological tests such as the Folstein Mini Mental Status Exam. 

Basic laboratory tests complete blood count, blood chemistry screen, thyroid function, urinalysis, urine drug screen... 

Patients with type 2 DM should have a routine urinalysis at diagnosis as the initial screening test for albuminuria. If positive, a 24-hour urine for quantitative assessment will assist in developing a treatment plan. If the urinalysis is negative for protein, a test to evaluate the presence of microalbuminuria is recommended. 

Despite what you might hear on the net, urinalysis, if done correctly, is a very accurate scientific procedure. I know of no labs that simply report the results of the initial EMIT screening without confirming the sample on GC/MS. The fact is, labs WANT you to test negative, because then they only have to run an EMIT test on your urine (a few cents). If you test positive, they must then confirm the positive result on GC/MS, which is considerably more expensive.. . . Incidentally, the machine which tests the hair is a relative of the GC/MS, but is FAR more precise. It can accurately detect levels of THC in a solution that are below 1 ng/mL ... 

Objective data include a thorough physical evaluation (including a thorough neurological exam), supplemented by laboratory data such as routine blood work, urinalysis, chest x-ray, EGG, and drug screen (see Role of the Laboratory later in this chapter). All this information is routinely collected when a person first enters the hospital on an outpatient basis, however, the clinician may select only those tests deemed appropriate at the time. 

Price RG, Taylor SA, Chivers I et al. (1996) Development and validation of new screening tests for nephrotoxic effects. Hum Exper Toxicol 15 S10-S19 Price RG, Berndt WO, Finn WF et al. (1997) Urinary biomarkers to detect significant effects of environmental and occupational exposure to nephrotoxins, III. Minimal battery of tests to assess subclinical nephrotoxicity for epidemiological studies based on current knowledge 19 535-552 Price RG (2000) Urinalysis to exclude and monitor nephrotoxicity. Clin Chim Acta 297 173-182 Price RG (2002) Early markers of nephrotoxicity. Comp Clin Pathol 11 2-7... 

On the other hand, only classes of substances can be detected with most lA. Cross reactivity of interfering substances cannot be excluded. They have been developed for urinalysis, therefore the usefulness for the matrix "hair" has to be investigated. Additionally, lA can only be used as screening procedures in cases where the... 

Systemic evaluation of the patient includes a complete blood count, blood chemistry, thiamine level, urinalysis, serum vitamin B12 and folate levels, heavy metal screening (lead, mercury, arsenic), and tests for megaloblastic anemia. The hair may also be tested for indications of toxicity. 

Delanghe J. New screening diagnostic techniques in urinalysis. Acta Clin Belg. 2007 62 155-61. 

Proteinuria is a common finding in patients with kidney disease, and the use of a dipstick assay is an important screening test in any patient suspected of having renal disease. Among patients with suspected or proven CKD, including reflux nephropathy and early glomerulonephritis, and those with hypertension or previously detected asymptomatic hematuria, annual urinalysis for proteinuria is accepted as a useful way of identifying patients at risk of... 

WooUiandler S, Pels RJ, Bor DH, Himmelstein DU, Lawrence RS. Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders. I. Hematuria and proteinuria. JAMA 1989 262 1214-9. 

As CKD presentation is often asymptomatic, recommended screening studies include serum creatinine measurement, urinalysis, and/or imaging studies of the kidneys. Diabetes, hypertension, genitourinary abnormalities, and autoimmune diseases represent some of the more common conditions associated with kidney disease. People who are older or those who have a family history of kidney disease should also be screened. If the serum creatinine is elevated, or more appropriately the GFR decreases, or if there are abnormalities in the urinalysis or imaging studies, an evaluation for CKD should be performed. ... 

Urinalysis and urine pesticide/metabolite screen—if recent exposure... 

Blood lead levels provide the best indicators of lead poisoning but do not reflect total body burden (Lee and Moore 1990). The inhibition of erythrocyte 8-aminolevulinic acid indicates lead exposure, but most centers still use blood lead levels for screening (Lee and Moore 1990 Roper et al. 1993 Schaffer and Campbell 1994). Zinc protoporphyrin indicates neurotoxicity from lead but does not have the sensitivity for assessing low levels of exposure (Anger and Johnson 1985 Royce and Needleman 1995). Radiological examination of the abdomen and long bones does not reliably portray exposure. The same holds true for the examination of red blood cells for basophilic stippling and the assay of hair and nail levels for lead (Roper et al. 1993). The Centers for Disease Control and Prevention (CDC) does not recommend use of scarification of the forearm with 25% sodium sulfite solution to assess for black discoloration of skin, a procedure recommended in some sources. Medical centers perform an edetate disodium calcium provocative chelation test with urinalysis and complete blood... 

Specific gravity Toxicology screening Uric acid Urinalysis... 

---