Urinalyses

Examination of the urine is often the first step in the assessment of a patient suspected of having, or confirmed to have, deterioration in kidney function. In the laboratory, urine is examined visually, chemically, and microscopically. New instrumental techniques are also being used to examine urine. 

The appearance (color and odor) of urine itself can be helpful, a darkening from the pale normal straw color indi- 

The dipstick test for total protein includes a cellulose test pad impregnated with tetrabromphenol blue and a citrate pH 3 buffer. The reaction is based on the protein error of indicators phenomenon in which certain chemical indicators demonstrate one color in the presence of protein and another in its absence. Thus tetrabromphenol blue is green in the presence of protem at pH 3 but yellow in its absence. The color is read after exactly 60s and the test has a lower detection limit of 150 to 300mg/L, depending on the type and proportions of protein present. The reagent is most sensitive to albumin and less sensitive to globulins, Bence Jones protein, mucoproteins, and hemoglobin. 

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 

The presence of hemoglobin in the urine may be due to glomerular, tubulointerstitial, or postrenal disease, although the latter two causes are the more common. The presence of blood in the urine can be detected by the use of a phase contrast microscope to determine the presence of red cells in the urine sediment or by use of a dipstick test. The chemical detection of hemoglobin in urine depends on the peroxidase activity of the protein, employing a peroxide substrate and an oxygen acceptor. 

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Adverse side effects of gold treatments include stomatitis, rash, and proteinuria. Complete blood counts and urinalysis should be performed before each or every other injection of gold compounds. Pmritic skin rash and stomatitis are more common adverse effects that may resolve, if therapy is withheld for a few weeks and then restarted cautiously at a lower dose. Oral gold causes less mucocutaneous, bone marrow, and renal toxicity than injectable gold, but more diarrhea and other gastrointestinal reactions appear. 

Penicillamine (29) can be effective in patients with refractory RA and may delay progression of erosions, but adverse effects limit its useflilness. The most common adverse side effects for penicillamine are similar to those of parenteral gold therapy, ie, pmritic rash, protein uria, leukopenia, and thrombocytopenia. Decreased or altered taste sensation is a relatively common adverse effect for penicillamine. A monthly blood count, platelet count, and urinalysis are recommended, and also hepatic and renal function should be periodically monitored. Penicillamine is teratogenic and should not be used during pregnancy. 

Urinalysis. Urine is collected at various times and examined with respect to its volume, specific gravity, and the presence of abnormal constituents. The results may indicate kidney damage or suggest tissue injury at other sites (77). 

Harn-untersuchung, /. investigation of urine, urinalysis. -wa(a)ge, /. urinometer. weg, m. urinary passage, -zucker, m. sugar in urine. 

Additional culture and sensitivity tests may be performed during therapy because microorganisms causing the infection may become resistant to penicillin, or a superinfection may have occurred. A urinalysis, complete blood count, and renal and hepatic function tests also may be performed at intervals during therapy. 

It also is important to take and record vital signs before the first dose of die antibiotic is given. The primary health care provider may order culture and sensitivity tests, and tiiese should also be performed before die first dose of die drug is given. Odier laboratory tests such as renal and hepatic function tests, complete blood count, and urinalysis may also be ordered by the primary health care provider. 

The nurse monitors die patient s response to therapy daily. If after several days die symptoms of the UTI have not improved or if they become worse, the nurse notifies the primary healtii care provider as soon as possible Periodic urinalysis and urine culture and sensitivity tests may be ordered to monitor die effects of drug dierapy. 

In a second more extensive study, Capronor was implanted in rats and cynomolgus monkeys. Clinical chemistry observations, physical examinations, qualitative food consumption, urinalysis, and oph-... 

Several studies have identified responses that do not involve VN participation, from marsupials to Mouse-lemurs. Where the chosen endpoint is totally unaffected by absence of the organ and in addition is dependent upon MOS activity, then it needs to be classified as VN-independent. Where VN-x results are ambiguous, as already considered for opossums (Monodelphis domestica), further analysis is desirable. For instance, Goats do not use AOS input for mating, only urinalysis, although experiential variables have not been fully explored (Ladewig et al., 1980). Examples of VN independence then exist in both altricial and precocial species. 

A current working hypothesis is that F. and chemoinvestigative behaviour are closely linked, but that it is not restricted to urinalysis by the male. Other signalling functions are indicated by the behaviour of captive and feral groups. Flehmen s role in female female interactions is clearly of equal value since it is highly correlated with rank in the Sable antelope (Hippotragus niger). Dominant females not only perform... 

Our current study of drug use and crime in arrestees in Manhattan overcame some of these measurement problems and enabled us to address some of these basic questions regarding POP use and crime. The recent use of PCP (as well as other drugs) in male arrestees was measured by a urinalysis of a specimen obtained within hours after arrest. We therefore did not have to rely on each person s accurate report that he had taken PCP. We shall use the urinalysis test results, with information from interviews with the arrestees, and from their criminal records, to describe the prevalence of PCP use in arrestees, the demographic characteristics of users and the types of offenses for which they are arrested. The next section describes our study of drug use and crime in arrestees in Manhattan. 

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). 

History (previous crises, previous medications, recreational drug use), physical examination (mandatory fundoscopic examination, blood pressure on all limbs), urinalysis, and electrolytes, blood urea nitrogen, creatinine, peripheral blood smear, complete blood count, electrocardiogram (ECG), chest X-ray, and head CT... 

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. 

Perform urinalysis, urine toxicology, thyroid function, and white blood cell count in the elderly to rule out urinary tract infection... 

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

Serum creatinine, blood urea nitrogen, urinalysis, urine osmolality, specific gravity. 

IVday, monitor urinalysis, osmolality, and specific gravity every 3 months. Thyroid function tests should be obtained once or twice during the first 6 months, then every 6-12 months monitor for signs and symptoms of hypothyroidism if supplemental thyroid therapy is required, monitor thyroid function tests and adjust thyroid dose every 1-2 months until thyroid function indices are within normal range, then monitor every 3-6 months. 

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