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1.
Anal Bioanal Chem ; 2024 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-39153105

RESUMO

The enhanced catalytic properties of bimetallic nanoparticles have been extensively investigated. In this study, bimetallic Ag-M (M = Au, Pt, or Pd) cotton fabrics were fabricated using a combination of electroless deposition and galvanic replacement reactions, and improvement in their peroxidase-mimicking catalytic activity compared to that of the parent Ag fabric was studied. The Ag-Pt bimetallic nanozyme fabric, which showed the highest catalytic activity and ability to simultaneously generate hydroxyl (•OH) and superoxide (O2•-) radicals, was assessed as a urine glucose sensor. This nanozyme fabric sensor could directly detect urinary glucose in the pathophysiologically relevant high millimolar range without requiring sample predilution. The sensor could achieve performance on par with that of the current clinical gold standard assay. These features of the Ag-Pt nanozyme sensor, particularly its ability to avoid interference effects from complex urinary matrices, position it as a viable candidate for point-of-care urinary glucose monitoring.

2.
Infect Dis (Lond) ; : 1-9, 2024 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-39148494

RESUMO

BACKGROUND: Diagnosis of urinary tract infections (UTIs) is a frequent challenge at the emergency department (ED). The clinical usefulness of the urine Gram stain (GS) is uncertain. OBJECTIVE: We studied the GS performance to clarify its clinical utility at the ED. METHODS: Urine dipstick (UD), automated urinalysis (UF-1000i), GS and urine culture (UC) were performed in a cohort of consecutive adults presenting at the ED suspected of a UTI. GS performance was assessed and compared to UD and UF-1000i. RESULTS: A UTI diagnosis was established in 487/1358 (35.9%) episodes. Sensitivity and specificity for 'many' GS leucocytes was 33.7% and 95.4%; for 'many' GS bacteria 51.3% and 91.0%. GS diagnostic performance by ROC analysis was 0.796 for leucocytes and 0.823 for bacteria. GS bacteria performed better than UD nitrite comparable to UF-1000i bacteria. GS leucocytes underperformed compared to UD leucocyte esterase and UF-1000i leucocytes. UC was positive in 455 episodes. GS correctly predicted urine culture of gram-negative rods (PPV 84.6%). Prediction was poor for gram-positive bacteria (PPV 38.4% (cocci), 1.0% (rods)). CONCLUSION: With the exception of a moderate prediction of gram-negative bacteria in the UC, urine GS does not improve UTI diagnosis at the ED compared to other urine parameters.

3.
Clin Lab Med ; 44(3): 409-421, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39089747

RESUMO

The clinical analysis of urine has classically focused on conventional chemical-based urinalysis and urine microscopy. Contemporary advances in both analysis subsets have started to employ new technologies such as automated image analysis, flow cytometry, and mass spectrometry. In addition to new detection technologies, current analyzers have incorporated more advanced imaging, automated sample handing, and machine learning analyses into their workflow. The most advanced semiautomated analyzers can be interfaced with hospital medical record systems, and in the point-of-care setting, smartphones can be used for image analysis. This review will discuss current technological advancements in the field of urinalysis and urine microscopy.


Assuntos
Urinálise , Humanos , Urinálise/instrumentação , Espectrometria de Massas , Citometria de Fluxo , Microscopia/instrumentação , Automação Laboratorial , Aprendizado de Máquina
4.
BMC Vet Res ; 20(1): 354, 2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39118117

RESUMO

BACKGROUND: Despite the prevalence of echogenic foci floating in the urinary bladder seen in ultrasonography in dogs, surprisingly little has been written on its significance, including its potential association with urinalysis. The objective of the study was to determine the diagnostic value of the echogenic foci floating in urinary bladders in dogs. RESULTS: - Cystosonography was performed on 45 dogs. Bladder contents were examined and divided into positive (containing echogenic particles) and negative (absent echogenic particles) groups according to the presence and absence of floating echogenic particles. Five mL of urine was collected via cystocentesis. Urine analysis and culture were done and the relationship between ultrasound evaluation and urinalysis results was investigated. In dogs with bladder echogenic particles in ultrasonography, the prevalence of hematuria, pyuria, bacteriuria, and lipiduria were 88.9%, 92.6%, 29.6%, and 70.3%, respectively. However, in dogs in which echogenic particles were not observed in their bladders, the prevalence of hematuria, pyuria, bacteriuria, and lipiduria was 77%, 50%, 5.5%, and 77%, respectively. There was a significant association between bladder debris and positive urine culture, with an odds ratio of 7.15 (95% confidence interval: 0.81-63.28) compared with matched controls. Furthermore, there was a significant relationship between the presence of floating echogenic particles with pyuria, and urine color ( p ≤ 0.05). CONCLUSION: In conclusion, the present results showed the detection of bladder debris on ultrasound can be a predictor for pyuria and positive urine culture in dogs.


Assuntos
Bacteriúria , Doenças do Cão , Piúria , Ultrassonografia , Bexiga Urinária , Animais , Cães , Ultrassonografia/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/urina , Bexiga Urinária/diagnóstico por imagem , Masculino , Feminino , Piúria/veterinária , Piúria/diagnóstico por imagem , Bacteriúria/veterinária , Bacteriúria/diagnóstico por imagem , Hematúria/veterinária , Hematúria/diagnóstico por imagem , Urinálise/veterinária
5.
Healthcare (Basel) ; 12(15)2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39120178

RESUMO

A general urine test is considered one of the basic diagnostic tests using in healthcare. This study aimed to analyze sociodemographic factors associated with the frequency of urine testing in Poland. This cross-sectional survey was conducted using computer-assisted web interviewing (CAWI) between 1 March and 4 March 2024. A representative sample of 1113 adults in Poland (aged 18-86 years, 52.5% of whom were females) took part in the study. The survey showed that 46.3% of adults in Poland had a urinalysis in the last 12 months. One-fifth (20.7%) of the participants had a urinalysis more than a year ago but not more than 2 years ago. Moreover, 26.7% had a urinalysis performed 2-3 years ago. Among all participants, female gender (OR = 1.31 [1.01-1.68]; p < 0.05), being aged 70 years and over (OR = 2.22 [1.23-4.02]; p < 0.01), having children (OR = 1.45 [1.01-2.09]; p < 0.05), and having urologic diseases (OR = 2.34 [1.79-3.02]; p < 0.001) were significantly associated with having urinalysis in the last 12 months. Among respondents without urologic diseases, female gender (OR = 1.33 [1.02-1.74]; p < 0.05), being aged 60 years and over (p < 0.05), and being married (OR = 1.45 [1.09-1.94]; p < 0.05) were significantly associated with having a urinalysis in the last 12 months. There was no significant impact of educational level, occupational status, or financial situation on the frequency of urinalysis.

6.
Adv Sci (Weinh) ; : e2310225, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38958527

RESUMO

Detection of circulating tumor DNA (ctDNA) mutations, which are molecular biomarkers present in bodily fluids of cancer patients, can be applied for tumor diagnosis and prognosis monitoring. However, current profiling of ctDNA mutations relies primarily on polymerase chain reaction (PCR) and DNA sequencing and these techniques require preanalytical processing of blood samples, which are time-consuming, expensive, and tedious procedures that increase the risk of sample contamination. To overcome these limitations, here the engineering of a DNA/γPNA (gamma peptide nucleic acid) hybrid nanoreporter is disclosed for ctDNA biosensing via in situ profiling and recording of tumor-specific DNA mutations. The low tolerance of γPNA to single mismatch in base pairing with DNA allows highly selective recognition and recording of ctDNA mutations in peripheral blood. Owing to their remarkable biostability, the detached γPNA strands triggered by mutant ctDNA will be enriched in kidneys and cleared into urine for urinalysis. It is demonstrated that the nanoreporter has high specificity for ctDNA mutation in peripheral blood, and urinalysis of cleared γPNA can provide valuable information for tumor progression and prognosis evaluation. This work demonstrates the potential of the nanoreporter for urinary monitoring of tumor and patient prognosis through in situ biosensing of ctDNA mutations.

7.
Diagn Microbiol Infect Dis ; 110(1): 116439, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39024934

RESUMO

We evaluated the DxU 850m Iris Urine Microscopy analyzer as a screening tool for excluding negative urine samples (n = 1337). At a cutoff of 103 colony counts·mL-1, sensitivity was 55.1 %, specificity 68.6 %. The DxU 850m Iris does not offer acceptable prediction of culture-negative urine samples at the tested cutoff.


Assuntos
Microscopia , Sensibilidade e Especificidade , Urinálise , Urina , Humanos , Microscopia/métodos , Urinálise/métodos , Urinálise/instrumentação , Urina/microbiologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/microbiologia , Automação Laboratorial/métodos
8.
Neurourol Urodyn ; 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38989649

RESUMO

OBJECTIVES: To determine accuracy of negative urinalysis (UA) for predicting negative urine culture and the absence of urinary tract infection (UTI), and optimal urine culture growth cutoff for UTI diagnosis in men with and without urinary catheters. SUBJECTS AND METHODS: UAs with urine cultures within 1 week from adult men were identified and evaluated. Predictive values for the absence of UTI (absence of ≥1 of the following criteria: documentation of UTI diagnosis, antibiotic prescription, uropathogen presence on culture) were calculated. RESULTS: In total, 22 883 UAs were included. Negative UA had a high predictive value for negative urine culture (0.95, 95% confidence interval [CI]: 0.94-0.95) and absence of UTI (0.99, CI: 0.99-0.995) in the overall cohort. Negative UA also had a high predictive value for negative urine culture (0.93, CI: 0.90-0.95) and absence of UTI (0.99, CI: 0.98-0.999) in those with indwelling urinary catheters. The traditional threshold of culture growth of 100 000 colony-forming units (CFU)/mL did not capture 22% of UTIs. CONCLUSION: UA exhibits high predictive value for negative urine culture and absence of UTI in men, supporting a protocol wherein culture is only performed in the context of abnormal UA. The traditional 100 000 CFU/mL cut-off may have not captured a subset of UTI in the male population, and warrants further investigation.

9.
Anal Chim Acta ; 1312: 342751, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38834265

RESUMO

BACKGROUND: The abuse of the Phencyclidine-type substances, especially ketamine is a serious problem worldwide, and retrospective analysis are important for both the analysis and the identification of forms of drug abuse. The current major analytical methods, while all excellent in terms of accuracy, are time- and reagent-consuming. This depletion is made even more unfortunate by the fact that a large number of samples are negative in retrospective analyses. It is clear that a set of methods that can be analyzed both accurately and quickly need to be developed and applied to the screening and analysis of large quantities of samples. RESULTS: We described a urine test based on acoustic ejection mass spectrometry, which allows precise injection at very low volumes and near 1 ejection s-1 and data acquisition. The confidence in identification was increased by the characterization of the abundance ratio of the two pairs of ions. Urine samples could be diluted with water and loaded into a 384-well plate for sampling without complicated sample preparation. The sample in the transparent 384-well plate was pre-scanned by the laser, and then 20 nL droplets were ejected into the ion source for targeted analysis of 2 ion transitions per droplet totaling 9 targeted analytes in the sequence of acquisition methods. It took 90 min to screen 250 samples in this approach, yielding 10 ng mL-1 detection limits. Positive samples were further analyzed by UHPLC-MS/MS for confirmation and quantification of up to 36 analytes. SIGNIFICANCE: This was the first fast screening method for phencyclidine-type substances based on acoustic ejection mass spectrometry, which greatly reduces the analytical time, and can accomplish in 1.5 h what UHPLC-MS/MS needs 3 days to complete. And the samples can be analyzed without complicated sample preparation, and also can obtain good detectability. It was applied to a short-term retrospective analysis in Shanghai, and its accuracy was also extremely high.


Assuntos
Ensaios de Triagem em Larga Escala , Fenciclidina , Espectrometria de Massas em Tandem , Espectrometria de Massas em Tandem/métodos , Fenciclidina/urina , Humanos , Detecção do Abuso de Substâncias/métodos , Acústica
10.
Int J Emerg Med ; 17(1): 77, 2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-38926667

RESUMO

BACKGROUND: Clinical criteria are essential for diagnosing urinary tract infections (UTIs) followed by urine testing, including urinalysis (UA). No study has evaluated the potential related factors that may guide the appropriate collection of urine cultures. Therefore, we aimed to assess the factors that may guide the appropriate collection of urine cultures. METHODS: This was a case-control study of patients for whom a urine culture and a UA were ordered in the emergency department (ED) between February 2018 and December 2022. The cases included patients with positive cultures, whereas the controls included patients without growth. Patients were excluded if they were pregnant, underwent any urological procedure, received antibiotics within 3 days before ED presentation, or before culture collection. RESULTS: Of the 263 patients, 123 had growth and 140 did not have growth in urine cultures. In the univariate analysis, female gender, urinary symptoms, urinary white blood cell (WBC) count > 5 cells/hpf, and nitrite in urine were significantly associated with growth (P < 0.05). However, only female gender (aOR, 1.86; 95% CI, 1.06-3.24), urinary WBC count > 5 cells/hpf (aOR, 4.60; 95% CI, 2.21-9.59), and positive nitrite in urine (aOR, 21.90; 95% CI, 2.80-171.00) remained significant in the multivariable analysis. These factors also remained significant in the subgroup of patients with urinary symptoms, except for the female gender. CONCLUSION: A high urinary WBC count and positive nitrite in UA should be utilized as a guide to collect urine culture, particularly in female patients, to limit the unnecessary ordering of urine culture in the ED. These factors can be used as evidence-based UA reflex criteria as an antimicrobial stewardship intervention.

11.
Angew Chem Int Ed Engl ; 63(36): e202409477, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-38877855

RESUMO

Renal clearable nanoparticles have been drawing much attention as they can avoid prolonged accumulation in the body by efficiently clearing through the kidneys. While much effort has been made to understand their interactions within the kidneys, it remains unclear whether their transport could be influenced by other organs, such as the liver, which plays a crucial role in metabolizing and eliminating both endogenous and exogenous substances through various biotransformation processes. Here, by utilizing renal clearable IRDye800CW conjugated gold nanocluster (800CW4-GS18-Au25) as a model, we found that although 800CW4-GS18-Au25 strongly resisted serum-protein binding and exhibited minimal accumulation in the liver, its surface was still gradually modified by hepatic glutathione-mediated biotransformation when passing through the liver, resulting in the dissociation of IRDye800CW from Au25 and biotransformation-generated fingerprint message of 800CW4-GS18-Au25 in urine, which allowed us to facilely quantify its urinary biotransformation index (UBI) via urine chromatography analysis. Moreover, we observed the linear correlation between UBI and hepatic glutathione concentration, offering us a noninvasive method for quantitative detection of liver glutathione level through a simple urine test. Our discoveries would broaden the fundamental understanding of in vivo transport of nanoparticles and advance the development of urinary probes for noninvasive biodetection.


Assuntos
Biotransformação , Glutationa , Ouro , Rim , Fígado , Nanopartículas Metálicas , Ouro/química , Glutationa/metabolismo , Glutationa/química , Nanopartículas Metálicas/química , Fígado/metabolismo , Rim/metabolismo , Animais , Urinálise/métodos , Camundongos
12.
Metabolites ; 14(6)2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38921479

RESUMO

Bladder cancer usually has been diagnosed in elderly patients as it stays asymptomatic until it presents. Current detection methods for bladder cancer cannot be considered as an adequate screening strategy due to their high invasiveness and low sensitivity. However, there remains uncertainty about targets with high sensitivity and specificity for non-invasive bladder cancer examination. Our study aims to investigate the actionable non-invasive screening biomarkers in bladder cancer. Here, we employed scRNA-seq to explore the crucial biological processes for bladder cancer development. We then utilized bidirectional Mendelian randomization (MR) analysis to explore the bidirectional causal relationship between ATP-associated metabolites in urine and bladder cancer. Lastly, we used a BBN-induced mouse model of bladder cancer to validate the crucial gene identified by scRNA-seq and MR analysis. We found that (1) the ATP metabolism process plays a critical role in bladder cancer development; (2) there is a bidirectional and negative causal relationship between fructose-to-sucrose ratio in urine and the risk of bladder cancer; and (3) the higher expression of TPI1, a critical gene in the fructose metabolism pathway, was validated in BBN-induced bladder tumors. Our results reveal that fructose-to-sucrose ratio can serve as a potential target of urinalysis in bladder cancer.

13.
Cureus ; 16(4): e59069, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38800344

RESUMO

BACKGROUND: Urinalysis is the most popular test for evaluating emergency room patients with possible urinary tract infections (UTIs). Due to their speed and inexpensive cost, urine dipsticks are frequently performed in the Emergency Room. Although a urine dipstick test may be less expensive and time-saving than a laboratory study, it may not be accurate. The study evaluated the sensitivity and specificity of urine dipstick and microscopic urinalysis with a urine culture. METHODOLOGY: A prospective, observational study was conducted on adults who visited the Emergency Department at King Fahd Specialist Hospital in Buraydah and reported having dysuria, urine urgency, or frequency, as well as suprapubic or costovertebral angle soreness. Patients who could not give a trustworthy history, had symptoms of vaginal discharge, or had taken antibiotics within the previous 72 hours were excluded. RESULTS: One hundred fifty-three urine samples were collected and examined using urinalysis and dipstick. In addition, 113 (73.86%) of 153 urine samples exhibited no growth in urine culture. With a count of nine, Escherichia coli (E. coli) was the most often isolated organism among the positive cultures (5.88%). Klebsiella pneumoniae was the second most common in our sample with eight (5.23%). The urine dipstick was shown to have an overall sensitivity of 0.79, specificity of 0.39, positive productive value (PPV) of 0.30, and negative productive value (NPV) of 0.85. Urinalysis exhibited a high sensitivity of 0.95 and a poor specificity of 0.21. CONCLUSION: Our study showed that urine dipsticks may be more beneficial than urinalysis for ruling out urinary tract infections (UTIs), while urinalysis may be more helpful in verifying their presence.

14.
Front Psychol ; 15: 1364967, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38765826

RESUMO

Background: When addressing antisocial behaviour among adolescents, programs based on the paradigm of positive psychology through enhancing self-efficacy have demonstrated their effectiveness in furthering the positive development of young people with a history of antisocial behaviour. Nevertheless, there has been little research into the effectiveness of these type of programs in mitigating substance abuse among juvenile offenders. The aim of this paper is to analyse the effectiveness of a contingency management program in reducing the prevalence of relapses into drug consumption among adolescents who have committed serious crimes. Methods: The study consisted of a sample of 91 male adolescents, between 15 and 19 years, in juvenile detention, who were divided into two treatment groups. For both groups, biological testing was used to detect drug consumption upon their re-turn from leave permits from the Centre. Results: The quasi-experimental group had significantly lower rates of relapse than the quasi-control group. Furthermore, being part of the quasi-experimental group was a significant predictor of reduced rates of relapses. Conclusion: The results suggest that the incorporation of treatment strategies which reinforce feelings of self-efficacy and adequate orientation towards the future, as a complement to disciplinary sanctions, are effective in reducing relapses in drug use among adolescent offenders.

15.
Pract Lab Med ; 39: e00386, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38715658

RESUMO

Objectives: Urinalysis is a first-line test for screening for urinary tract infection. Several devices performing strip and sediment analysis have been introduced. The aim of this study was to compare the performance of Labsan Tricell-1000 and Dirui FUS-2000 automated urine analyzers with manual microscopy. Methods: 463 urine samples were analyzed. Digital image processing and particle recognition automatically display the cells in a flowing sheath fluid mixed monolayer urine sample, take the pictures of particles via digital camera, analyse these pics with a particle recognition software, transfer images of the formed elements to the screen and allow well-trained personnel to select, reclassify or remove them. Manual microscopy was used for comparison. Results: Agreement between Tricell-100 and manual microscopy was very good for RBC (Ï° = 0.80), and WBC (Ï° = 0.83); good for CaOx (Ï° = 0.69), SEC (Ï° = 0.80), YLC (Ï° = 0.72), HC (0.69) and LC (Ï° = 0.64); moderate for BAC (Ï° = 0.51), APC (Ï° = 0.43) and MT (Ï° = 0.55); fair for GC (Ï° = 0.39) and RTEC (Ï° = 0.32). Conclusions: Labsan Trion TriCell-1000 demonstrated satisfactory performance and can be used in routine urinalysis. In the case of low counts of RBC, presence of yeast, crystal, casts or cell clumping in urine sediment, characterization of urine particles should be performed by manual microscopy.

16.
Urol Ann ; 16(2): 169-174, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38818426

RESUMO

Background: Urinary tract infection (UTI) stands out as the third-most common infection following gastrointestinal and respiratory tract infections. Over the past decade, the biomarker procalcitonin (PCT) has gained prominence to facilitate the detection of bacterial infections and reduce excessive antibiotic exposure. Objective: The objective of this study was to mitigate the overuse of antibiotics, by promoting the noninitiation or early discontinuation of empirical antibiotics, which would significantly help minimize the proliferation of multidrug-resistant bacteria. Methodology: A prospective observational study was carried out at the tertiary care center in the Department of General Medicine of Kalinga Institute of Medical Sciences, Bhubaneswar, involving 200 patients with symptoms of lower UTI such as increased frequency, urgency, burning micturition, retention, and suprapubic tenderness with or without positive urinalysis. Detailed demographic profiles along with symptoms at the time of admission were recorded in a pretested structured format. To determine a positive diagnosis of UTI, signs and symptoms of UTI with or without urinary cultures were tested. The PCT level was estimated using enhanced chemiluminescence technique. Other routine tests such as complete blood count, renal function test, liver function test, urine routine microscopy, culture, chest X-ray, and ultrasonography abdomen pelvis were done and recorded. All patients, who had an initial serum PCT level of < 0.5 ng/mL, were kept under observation with only conservative and symptomatic treatments. Patients were further reviewed for improvement in symptoms and repeat urine microscopy. All patients, who had an initial serum PCT level of > 0.5 ng/mL, were initiated with antibiotics as per the culture and sensitivity reports. Patients were followed up for improvement in symptoms with reports of repeated urinalysis. Results: Our study reported the fact that 9.5% of the patients with initial serum PCT ≥ 0.5 ng/mL showed no improvement in symptoms despite starting antibiotics while significantly higher number of symptomatic patients (60%) with initial serum PCT < 0.5 ng/ml showed improvement in symptoms with conservative treatment without antibiotics. Conclusion: A lower PCT level rules out bacterial invasion and thus can be used as a novel marker in antibiotic stewardship.

18.
J Am Vet Med Assoc ; 262(8): 1039-1046, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38579782

RESUMO

OBJECTIVE: To determine the accuracy of 4 preoperative parameters (signalment, urinalysis, urine microbiological culture, and digital radiography) in predicting urocystolith composition, compare accuracy between evaluators of varying clinical experience and a mobile application, and propose a novel algorithm to improve accuracy. ANIMALS: 175 client-owned dogs with quantitative analyses of urocystoliths between January 1, 2012, and July 31, 2020. METHODS: Prospective experimental study. Canine urocystolith cases were randomly presented to 6 blinded "stone evaluators" (rotating interns, radiologists, internists) in 3 rounds, each separated by 2 weeks: case data alone, case data with a urolith teaching lecture, and case data with a novel algorithm. Case data were also entered into the Minnesota Urolith Center mobile application. Prediction accuracy was determined by comparison to quantitative laboratory stone analysis results. RESULTS: Prediction accuracy of evaluators varied with experience when shown case data alone (accuracy, 57% to 82%) but improved with a teaching lecture (accuracy, 76% to 89%) and further improved with a novel algorithm (accuracy, 93% to 96%). Mixed stone compositions were the most incorrectly predicted type. Mobile application accuracy was 74%. CLINICAL RELEVANCE: Use of the 4 preoperative parameters resulted in variable accuracy of urocystolith composition predictions among evaluators. The proposed novel algorithm improves accuracy for all clinicians, surpassing accuracy of the mobile application, and may help guide patient management.


Assuntos
Algoritmos , Doenças do Cão , Urinálise , Animais , Cães , Doenças do Cão/urina , Doenças do Cão/diagnóstico , Doenças do Cão/microbiologia , Doenças do Cão/diagnóstico por imagem , Urinálise/veterinária , Masculino , Feminino , Estudos Prospectivos
19.
Urologia ; 91(3): 582-585, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38557329

RESUMO

Cytobacteriological urine examinations (CBEU) are frequently ordered for the older adults, sometimes without straightforward indication and with the risk of prescribing empirical antibiotics. The aim of this study was to evaluate the relevance of the CBEU prescription and empiric antibiotic therapy in our geriatric hospital. Among 129 patients (mean age 84 years, sex ratio 0.69), 229 CBEU were collected with 20.9% of inappropriate indication. Cultures were sterile in 43% (n = 99) of cases and positive in 57% (n = 130) cases. Gram-negative bacilli dominated the isolated bacteria (76.9%) followed by gram-positive cocci (17.6%). In 113 patients, probabilistic antibiotic therapy was prescribed of which 68 treatments were initiated before the CBEU. Ceftriaxone and amoxicillin plus clavulanic acid were the main therapeutic option used representing 70.8% of cases. Antibiotic therapy was re-evaluated after 3 days in 74.3% of patients. Efforts to reduce the number of useless ECBUs by training doctors to follow official guidelines are a priority.


Assuntos
Antibacterianos , Urinálise , Humanos , Feminino , Masculino , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Idoso , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Infecções Urinárias/urina , Infecções Urinárias/diagnóstico , Estudos Retrospectivos
20.
SLAS Technol ; 29(3): 100137, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38657705

RESUMO

After haematology, urinalysis is the most common biological test performed in clinical settings. Hence, simplified workflow and automated analysis of urine elements are of absolute necessities. In the present work, a novel lab-on-chip cartridge (Gravity Sedimentation Cartridge) for the auto analysis of urine elements is developed. The GSC consists of a capillary chamber that uptakes a raw urine sample by capillary force and performs particles and cells enrichment within 5 min through a gravity sedimentation process for the microscopic examination. Centrifugation, which is necessary for enrichment in the conventional method, was circumvented in this approach. The AI100 device (Image based autoanalyzer) captures microscopic images from the cartridge at 40x magnification and uploads them into the cloud. Further, these images were auto-analyzed using an AI-based object detection model, which delivers the reports. These reports were available for expert review on a web-based platform that enables evidence-based tele reporting. A comparative analysis was carried out for various analytical parameters of the data generated through GSC (manual microscopy, tele reporting, and AI model) with the gold standard method. The presented approach makes it a viable product for automated urinalysis in point-of-care and large-scale settings.


Assuntos
Automação Laboratorial , Dispositivos Lab-On-A-Chip , Urinálise , Urinálise/instrumentação , Urinálise/métodos , Humanos , Automação Laboratorial/instrumentação , Automação Laboratorial/métodos , Inteligência Artificial
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