The "Uroscreen" test for significant bacteriuria in pregnancy

The "Uroscreen" as a screening test for significant bacteriuria has been assessed and shown to have an accuracy of 88.3 percent: there is a false positive rate of 56.6 percent of positive tests, or 14.4 percent of all tests, when compared with single plate cultures. All cases of significant bacteriuria associated with E.coli were detected by the "Uroscreen". It is recommended that the routine described be used. A urine screening test for significant bacteriuria has for the second time been assessed against the standard of significant bacteriuria; which in this series has been shown to have a confidence of 96 percent. It has been confirmed that routine screening for significant bacteriuria post partum is necessary, and appears most important in the primigravida. Post partum infection offers an explanation for the increase in prevalence of significant bacteriuria with parity. The figures confirm those of the University of the West Indies and indicate the prevalence of significant bacteriuria in the general pregnant population of Jamaica and the Caribbean may be similar to or higher than that found in series from other countries (AU)

The "uroscreen" test for significant bacteriuria in pregnancy

A series is described in which 500 mid stream specimens of urine were collected from 265 women in the antenatal and postnatal period, and the results of the "Uroscreen" test and plate culture were correlated. Analysis of the results showed only a 50 percent correlation. In the 249 antenatal women there was a 10.9 percent incidence of significant bacteriuria by plate culture, and the "Uroscreen" correlated in 72.8 percent of these cases. There was only a 66.6 percent, instead of an expected 80 percent, confirmation of the first plate culture; and this is felt to reflect the fact that the urines were not examined when freshly voided. Of those found to have significant bacteriuria, 22.7 percent were found to have renal abnormality, on radiological examination. From this small series and an examination of the literature, it is concluded that for consistent results two consecutive, freshly voided, mid stream, early morning specimens of urine, which has been in the bladder for at least two hours must be examined. A delay of more than an hour or two, or refrigeration at 4§C for 24 hours or more before examination may yield unreliable information. It is urged that as significant bacteriuria was found for the first time in the puerperium. It is felt that the presence of significant bacteriuria in mothers might indicate those infants who could profitably have urine examination. A current investigation is being undertaken to test "Uroscreen" against a standard of an expected 95 percent accuracy. (AU)

Nephroblastoma (Wilms' tumor): case report

A case of nephroblastoma in a 6-day old infant, treated by nephrectomy only, is reported. This is probably the youngest successfully treated case. The importance of thorough routine physical examination of infants is stressed. Intrasagittal injection for pyelography is mentioned as an alternative to intraveneous, subcutaneous and intramuscular injection. Local anesthesia is recommended for nephrectomy in infants with small tumors. The literature on the clinical aspect of the disease is reviewed (Summary)

Cardiac arrest complicating surgery

A case of cardiac arrest, occuring during an abdominal operation and treated successfully by cardiac massage, is recorded. The importance of early diagnosis and immediate treatment with cardiac massage by a trans thoracic approach is stressed. Factors probably responsible for the recovery of this patient are suggested. The site of the thoractomy incision and drainage of the chest are discussed. (AU)

Silent rupture of the uterus

A case of silent rupture of the uterus is described in a multipara who had two normal deliveries following classical Caesarean section and in whom the signs and symptoms were unusually vague. The difficulty of diagnosis is discussed and the incidence of rupture of the uterus in St. Kitts, B.W.I., is compared with other series in the United States. (AU)