Reliability of using random urine samples for "spot" determination of fractional excretion of electrolytes in cats

OBJECTIVE: To determine whether the "spot" method of determining fractional excretion (FE) of electrolytes in cats is accurate. ANIMALS: 5 clinically normal young adult female cats. PROCEDURE: Cats were acclimated to metabolism cages, and 2 consecutive 72-hour collections of urine were made to determine FE of total calcium, potassium, total magnesium, sodium, and phosphorus by conventional methods, using endogenous creatinine clearance as an estimate of glomerular filtration rate. During collections, small samples of urine were obtained by cystocentesis at 8 AM, 3 PM, and 9 PM for determination of FE of the electrolytes by use of the "spot" method. RESULTS: Values from "spot" determinations were highly variable, compared with 72-hour values, with a high percentage falling outside the range of mean +/- 2 SD for 72-hour FE values. CONCLUSIONS AND CLINICAL RELEVANCE: The "spot" method for determining FE is not precise, and if used, caution and judgement should be exercised in interpretation of the results.     

Drug use and validity of substance use self-reports in veterans seeking help for posttraumatic stress disorder.

The present study assessed drug use and the validity of self–reports of substance use among help–seeking veterans referred to a specialty clinic for the assessment of posttraumatic stress disorder (PTSD). Patients (n?=?341) were asked to provide a urine sample for use in drug screening as part of an evaluation of PTSD. Self–reports of substance use were compared with same–day supervised urine samples for 317 patients who volunteered to participate in a drug screening. Results suggested that self–reports were generally quite valid. Only 8% of the cases involved patients not reporting substance use detected by urine screens. A total of 42% of the participants were identified as using drugs of abuse (excluding alcohol) through self–report and urine drug screens. Among participants using drugs, PTSD diagnosis was significantly associated with greater marijuana and depressant use as compared with stimulant (cocaine and amphetamines) use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Advance thinking about advance directives

Stilboestrol tablets (20 x 1 mg) were given to 4 ostriches. Urine was collected over a period of 8 days and stored frozen at-20 degrees C pending analysis. Analyses were performed on a gas chromatograph-mass selective detector for the presence of parent compound and/or metabolites. Diethylstilbestrol and its metabolite, dienestrol, were detected in urine; dienestrol only for 1 day but diethylstilbestrol for 8 days after administration. Residue analysis for the use of diethylstilbestrol as growth promoter can be performed on the urine of ostriches by scanning for parent compound only since it can be detected longer than the metabolite.     

Changes in the urinary excretion level of 8-hydroxyguanine by exposure to reactive oxygen-generating substances

A simple means of measuring of 8-hydroxyguanine (8-OHGua) levels in urine was developed. Rat and human urine samples were purified by means of strong cation exchange chromatography (Amberlite CG-120), followed by cellulose partition chromatography (Whatman CF-11). Thereafter, 8-OHGua was determined by means of high performance liquid chromatography (HPLC) using an electro-chemical detector. The level of 8-OHGua in rat urine increased by a factor of 2 to 4 after an intraperitoneal administration of 2-nitropropane (25 mg/kg), paraquat (11.3 mg/kg), or hydroquinone (11 mg/kg). On the other hand, the urine of smokers and persons exposed to air polluted with car exhaust also contained 1.9 and 3.8 fold more 8-OHGua, respectively, than that of control nonsmokers. These results indicated that the amount of 8-OHGua in urine is useful marker for monitoring the level of in vivo oxidative stress.     

Stimulation of the collagen alpha 1 (I) endogenous gene and transgene in carbon tetrachloride-induced hepatic fibrosis

1. The diurnal pattern of urinary estradiol and creatinine excretion was investigated in order to evaluate the relationship between total estradiol excretion per day and the estradiol concentration or the estradiol-to-creatinine ratio from single urine samples in female common marmosets (Callithrix j. jacchus). 2. During a 36-day period, urine was collected from five adult female marmosets in 3-hr intervals during the light time of an LD 12:12 (400:0.1 lx) which corresponded to the animals' activity time. 3. Estradiol concentration was determined by radioimmunoassay after glucuronidase treatment and creatinine concentration was measured photometrically. 4. Concentration and amount of excreted estradiol, and the creatinine concentration showed a distinct diurnal pattern with significantly higher levels at the beginning of the activity time compared to later sampling times. 5. No diurnal pattern was present in the estradiol-to-creatinine ratio, but the difference between lower follicular and higher luteal phase levels of estradiol excretion remained significant in the 36-day period. 6. Correlation analyses revealed significantly positive correlations between the total estrogen mass excreted per day and the estradiol-to-creatinine ratio in "morning urine" samples. 7. Thus the estradiol-to-creatinine ratio of single urine samples collected at the beginning of the activity time provides a reliable estimate of total estrogenic output in this species. 8. Studies of the circadian pattern of urinary hormone excretion, however, require total urine sampling.     

NRG-3 in human breast cancers: activation of multiple erbB family proteins

A high-performance liquid chromatographic (HPLC) method has been developed for the analysis of several benzodiazepines and some of their metabolites in blood, plasma and urine. The method included a liquid-liquid extraction with n-hexane:ethylacetate, a gradient elution on a C8 reversed phase column with a non-electrolyte eluent and a photo diode array detection. This allowed a rapid detection, a purity check, and identification as well as quantitation of the eluting peaks. The detection limit was 10 to 30 ng and the limit of quantitation was 0.05 microgram/mL, using 1 mL of blood, plasma or urine. The procedure is applied routinely in forensic toxicological analyses involving blood, stomach content, urine and organ samples. About 30 positive cases are reported. The avoidance of the use of an electrolyte buffer in the eluent resulted in a robust procedure, free of technical problems and of long rinsing periods, suitable for routine use in forensic toxicology analysis involving blood, urine, stomach content and tissue samples.     

Erratum to Doleys.

Reports an error in "Behavioral Treatments for Nocturnal Enuresis in Children: A Review of the Recent Literature," by Daniel M. Doleys (Psychological Bulletin, 1977[Jan], Vol 84[1], 30-54). On page 33, there is an error in Table 1. The mean treatment duration for DeLeon and Mandell (1973) is given as "54.5 months." It should read: "54.5 days." In addition, one of the entries in the References is cited incorrectly. On page S3, the title of the article by Sacks and DeLeon (1973) reads: "Conditioning of two enuretics." It should read: "Conditioning of two types of enuretics." The article in question reports data on 62 enuretic children. (The following abstract of this article originally appeared in record 1977-13286-001.) Reviews recent literature on the use of behavioral treatments for functional nocturnal enuresis in children. The treatment procedures are divided into 3 categories: (a) those that used the standard urine alarm or bell-and-pad, (b) those that employed retention control training, and (c) those that modified existing stimulus or consequent events but that did not use the urine alarm or retention control training as the primary mode of treatment. The results are presented and evaluated under each of the 3 categories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Waiting list already 7 months long at Toronto's new Environmental Health Clinic

Following the head set by Nova Scotia, Ontario now has a clinic devoted to the treatment of patients with "environmental illness." It opened in Toronto last year, and patients must be referred by their family physician and complete a 16-page previsit questionnaire. They receive a 3-hour assessment in which their medical history is explored, plus a full physical examination and blood and urine tests. Dr. Frank Foley, who heads the Toronto clinic, says his patients have seen from 8 to 10 health care professionals in the 2 years before their visit and most have been told the problem is "in your head." He says they need to "have their symptoms validated and their distress acknowledged."     

Analysis of a form of oxidative DNA damage, 8-hydroxy-2'-deoxyguanosine, as a marker of cellular oxidative stress during carcinogenesis

8-hydroxy-2'-deoxyguanosine (8-OH-dG) was first reported in 1984 as a major form of oxidative DNA damage product by heated sugar, Fenton-type reagents and X-irradiation in vitro. 8-OH-dG has been detected in cellular DNA using an HPLC-ECD method in many laboratories. Analyses of 8-OH-dG in animal organ DNA after the administration of oxygen radical-forming chemicals will be useful for assessments of their carcinogenic risk. Its analysis in human leucocyte DNA and in urine is a new approach to the assessment of an individual's cancer risk due to oxidative stress. The increase of the 8-OH-dG level in the cellular DNA, detected by HPLC-ECD method, was supported by its immunochemical detection and its enhanced repair activity. The validity of the general use of 8-OH-dG as a marker of cellular oxidative stress is discussed.     

The role of urine sugar in diabetic management

The concentration of reducing sugar in the urine is commonly used in the management of diabetes in children. Supplemental doses of regular insulin are administered in response to the concentration of urine sugar according to a protocol termed the "sliding scale." This practice assumes that the concentration of sugar in urine is a good indicator of the plasma glucose concentration. This assumption was tested by comparing urine sugar concentrations in first and second voided urines with the plasma glucose concentrations in 220 children with diabetes. The correlation was good (r = .92) for both the first and second voided urine specimens. Thus, urine sugar concentrations in general define the level of plasma glucose. The large standard deviation of the plasma glucose at each concentration of urine sugar, however, limits the usefulness of urine sugar as an accurate reflection of the coincident plasma glucose concentration. The urine sugar concentration, although useful for the general management of diabetes, provides significant risk when used to guide frequent adjustments in insulin administration. Therefore, the "sliding scale" should not be used in the treatment of children with diabetes.     

"Behavioral Treatments for Nocturnal Enuresis in Children: A Review of the Literature": Erratum to Doleys.

Reports an error in the article, "Behavioral Treatments for Nocturnal Enuresis in Children: A Review of the Literature," by Daniel M. Doleys (Psychological Bulletin, 1977[Jan], Vol. 84[1], pp. 30-54). It was noted on page 38 that Schwartz, Colligan, and O'Connell (1972) reported a 46% failure rate in their use of the urine alarm. This percentage figure represents a misinterpretation of the figures in the original article. In fact, only 1 of the 14 patients who completed the treatment program failed to achieve the dryness criteria. (The following abstract of this article originally appeared in record 1977-13286-001.) Reviews recent literature on the use of behavioral treatments for functional nocturnal enuresis in children. The treatment procedures are divided into 3 categories: (a) those that used the standard urine alarm or bell-and-pad, (b) those that employed retention control training, and (c) those that modified existing stimulus or consequent events but that did not use the urine alarm or retention control training as the primary mode of treatment. The results are presented and evaluated under each of the 3 categories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Detection of hydatid antigen in urine by countercurrent immunoelectrophoresis

Hydatid antigen was demonstrated for the first time in the urine of patients with hydatid disease by countercurrent immunoelectrophoresis (CIEP). The antigen was detected in the concentrated urine of 7 of 16 (43.75% positive) patients with surgically confirmed hydatid disease, 4 of 10 (40% positive) patients with ultrasound-proven hydatid disease (daughter cysts or prominent septation and hydatid sands demonstrated by ultrasound), and 8 of 14 (57.14% positive) patients with clinically diagnosed (presumptive) hydatid disease. No antigen was detected in the concentrated urine from 24 patients with parasitic diseases other than hydatid disease. However, antigen was detected in 2 (8% false positive) of 25 concentrated urine samples collected from healthy control subjects (blood donors and students). These result suggest that the detection of hydatid antigen in the urine by CIEP is a simple, rapid, and noninvasive method of diagnosis of hydatid disease.     

Metabolism and disposition of 1,4,7,8-tetrachlorodibenzo-p-dioxin in rats

Metabolism studies of 1,4,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a relatively nontoxic dioxin congener, were undertaken to gain a better understanding of mammalian metabolism of dioxins without the problems associated with the use of the most toxic congener, 2,3,7,8-TCDD. 14C-1,4,7,8-TCDD was dosed to conventional and bile-cannulated rats at a level of 8 mg/kg. The 14C was excreted almost entirely in 72 hours with the major routes of excretion feces and bile. Metabolites were identified from the feces, bile, and urine by GC-MS or negative ion FAB MS and 1H NMR. The two major fecal metabolites were hydroxylated tetra- and triCDDs. Glucuronide and sulfate conjugates of these hydroxyl metabolites were found in the urine and bile. Minor metabolites included dichlorocatechol, dihydroxylated tetra- and triCDDs, and conjugates of these compounds.     

Liquid-liquid extraction procedure for trace determination of cyclophosphamide in human urine by high-performance liquid chromatography tandem mass spectrometry

A sensitive, specific and accurate high performance liquid chromatography/ionspray-tandem mass spectrometry procedure (HPLC/MS/MS) has been developed to quantify cyclophosphamide in human urine from hospital personnel involved in drug preparation and administration of antineoplastic alkylating agents. This methodology, which includes liquid-liquid extraction with ethylacetate, requires no derivatization procedures, preventing cyclophosphamide (CP) from possible thermal and chemical decomposition reactions. We detected the excretion of this unmetabolized alkylating drug in 50% of all the study participants. The amount of CP ranged from 0.1 ng microL-1 to 1.9 ng microL-1 urine. This methodology was validated by the use of ifosfamide as internal standard. The assay was linear over the range 0 to 3.2 ng microL-1 urine, with a lower limit of quantification of 0.2 microL-1. The limit of detection was assessed at 0.05 ng microL-1 urine. This method is characterized by a coefficient of variation < 10%. Standard calibration curves, obtained on three different days, had correlation coefficients always greater than 0.998. The intra and interday precision were within 11%, and accuracy was in the range 99-103%. The mean extracted recovery assessed at three different concentrations (0.5, 0.8, 3.2 ng microL-1) was always more than 85%. The extraction efficiency of cyclophosphamide from urine samples was also studied at six different pH values (pH 4, 5, 6, 7, 8, 10). The maximum extraction efficiency was obtained when the pH of urine solutions was adjusted to 7.0     

Determination of mercury levels in biological samples using the incomplete cubane-type sulfur-bridged nitrilotriacetato molybdenum complex by a spectrophotometer

Spectrophotometric determination of mercury levels in biological samples was investigated using incomplete cubane-type sulfur-bridged molybdenum complex, K2[Mo3S4(Hnta)3] 9H2O, ("NTA" complex; H3nta = nitrilotri acetic acid). The urine or organs of mice, which were either exposed to metallic mercury vapor or injected intraperitoneally with mercuric ion, were decomposed from four to twelve hours with a mixed solution of potassium permanganate and sulfuric acid. After the pretreatment, mercury in the urine and organs of mice was captured by the "NTA" complex. Absorbance of the resultant solution in the urine or organs of mice was also measured by a spectrophotometer under conditions similar to that of the exhalation.     

A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI

OBJECTIVES: To test the hypothesis that selected older women with mild-to-moderate stress urinary incontinence (SUI) can learn to demonstrate significantly reduced urine loss in 1 week by intentionally contracting the pelvic floor muscles before and during a cough (a skill we have termed "The Knack"). DESIGN: A prospective, randomized, single-blind interventional study. SETTING: The Older American Independence Center, a federally sponsored research program affiliated with the University of Michigan in Ann Arbor, Michigan. PARTICIPANTS: Twenty-seven women with a mean (SD) age of 68.0 (5.5) years, self-reported SUI, and demonstrable urine loss during a deep cough. INTERVENTION: Women were randomized to an immediate intervention group (Group I: n=13) who were taught the Knack after their first clinic visit, or a wait-listed control group (Group II: n=14) who were taught the Knack after 1 month. MEASUREMENTS: At 1 week after instruction, we tested the efficacy of the Knack in a standing stress test by (1) comparing the volumes of cough-related urine loss leaked by all subjects, with and without use of the Knack, and (2) comparing the volumes of cough-related urine loss leaked by Group I, using the Knack, with Group II, which had not yet been taught the Knack. RESULTS: Intra-individual results showed that at 1-week follow-up, the Knack was used to reduce urine loss resulting from a medium cough by an average of 98.2%, compared with that of a similar cough performed 1 minute before without the Knack (P=.009); likewise urine loss was reduced by an average of 73.3% (P=.003) in a deep cough. Reduction in urine loss was not significantly correlated with a digital measure of pelvic floor muscle strength. CONCLUSION: Within 1 week, selected older women with mild-to-moderate SUI can acquire the skill of using a properly-timed pelvic floor muscle contraction to significantly reduce urine leakage during a cough.     

Low dosage dopamine improves kidney function: current status of knowledge and evaluation of a controversial topic

The ability of low dose dopamine (1-3 micrograms x kg-1 x min-1) to cause selective renal vasodilation, to increase glomerular filtration rate, urine output, and natriuresis, is intuitively considered favourable. Dopamine, therefore, continues to be used in critically ill patients to preserve or improve renal function. Despite its application in a wide variety of disease states and in patients at risk of acute renal failure or with already decreased renal function, there is no conclusive evidence that "renal doses" of dopamine prevented acute renal failure or had any positive effect on patient outcome although it increased urine output and natriuresis consistently. Data from many clinical studies, however, are difficult to interpret due to small numbers of patients, the absence of control groups, the inability to exclude changes in cardiac output or to separate a diuretic effect of dopamine in the tubulus system from specific increases of glomerular filtration rate, and because of the variability of methods to determine renal performance (i.e. creatinine clearance, urine output, natriuresis, fractional excretion of sodium). Moreover, the routine use of dopamine is not innovous, since it may worsen gut ischaemia and suppress certain hormonal systems. Those who believe in the clinical benefits of "renal dose" dopamine argue that, even in the absence of an improvement in renal function, the maintenance of urine output could be useful in patients unresponsive to diuretics. Again, the clinical benefit of this diuretic action still needs to be shown. In conclusion, there is little justification for the routine administration of low-dose dopamine in patients at risk of renal failure. Large controlled clinical studies are urgently needed to determine whether dopamine improves renal function or prevents acute renal failure in patients at risk.     

In vivo adulteration: excess fluid ingestion causes false-negative marijuana and cocaine urine test results

Drug users can be highly motivated to obtain negative results on urine drug tests and may attempt to subvert the process by in vivo adulteration. The use of herbal products for "flushing" and "detoxification" is frequently advertised as an effective means of passing drug tests. Accordingly, a study was designed to determine the effects of ingestion of two herbal products, Naturally Klean Herbal Tea and Golden Seal root, and a diuretic medication, hydrochlorothiazide. The herbal tea was prepared in 1 gal of water as specified by the manufacturer. All other products were consumed with 1 gal of water. Two control conditions in which the subject consumed only water (1 gal; 12 oz) were included. The 1-gal liquid treatments were divided into 4-qt aliquots, and 1-qt was consumed each hour for 4 h. All treatments were begun approximately 22 h after smoking of a marijuana cigarette (3.58% THC) and 22 h after intranasal administration of cocaine hydrochloride. Following all treatments with excess fluid, creatinine and specific gravity dropped in 1.5-2.0 h to levels indicative of diluted specimens (<20 mg/dL creatinine, <1.003 specific gravity). Marijuana and cocaine metabolite concentrations by immunoassay (EMIT and TDx) also dropped rapidly, and the results frequently switched from positive to negative. By the time subjects had consumed 2 qt of any fluid, they were generally producing false-negative results. For example, ingestion of excess water produced dilute specimens (<20 mg/dL creatinine; <1.003 specific gravity) in an average time plus or minus the standard error of the mean of 1.47 +/- 0.17 h (N = 5) and 1.45 +/- 0.2 h (N = 5) following smoked marijuana and intranasal cocaine, respectively. In comparison, ingestion of Klean Tea produced dilute specimens in 1.36 +/- 0.07 h (N = 4) and 1.39 +/- 0.11 h (N = 4) following marijuana and cocaine administration. Recovery of urine test measures to pre-treatment levels occurred over a period of 8-10 h. Average detection times for marijuana metabolite appeared to be slightly shorter following ingestion of 1 gal of fluids compared with ingestion of 12 oz of water as a result of the time of testing being near the end of the cannabinoid metabolite excretion phase. Consequently, negative cannabinoid results induced by fluid ingestion rarely returned to positive after excess water was eliminated. In contrast, negative cocaine results reverted to positive quickly after the dilution effects disappeared. It was concluded that excess water ingestion can produce false-negative test results, but the claims of herbal products to be an aid in passing a urine test appear to be unfounded.