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Recent studies have shown that almost half of all cancers occur due to DNA damage. For the early diagnosis of cancer, a highly sensitized and swift identification for TP53 is needed since the corresponding TP53 protein is effectively recognized as "the guardian of the genome." To improve the detection sensitivity, numerous analytical methods were previously used for the determination of the TP53 protein, including denaturing high-performance liquid chromatography and enzyme-linked immunosorbent assay (ELISA). Currently, immunochromatographic tests (ICTs) that are simple to use, stable over time, and show low interference are regarded as valuable tools for the quick screening of food and environmental monitoring along with clinical diagnosis. ICTs often have limited sensitivity even if a variety of novel reporters possessing optimum photostability and improved brightness are used as signal-intensity reporters. Compared with N-(4-aminobutyl)-N-(ethylisoluminol) or luminol, a novel luminescent probe, 2',6'-diMethyl-4'-(N-succiniMidyloxycarbonyl) phenyl-10-sulfopropylacridiniuM-9-carboxylate (NSP-DMAE-NHS) has achieved a much higher efficiency, improvement in the biosensor's performance, and amplification of the signal without causing any damage to the biomolecule in terms of its biochemical activity. In this study, the reagent strip method was initially used to detect TP53 fusion protein by combining the advantages of NSP-DMAE-NHS and immunochromatography. In our experiment, the control and study lines on the strips were immobilized through HRP-conjugated goat anti-rabbit IgG and TP53 antigen, respectively. The optimized concentration of the anti-TP53 antibody-NSP-DMAE-NHS immunoconjugates was then added to the TP53 antigen samples. After, the test strips were inserted and left in the aforementioned buffer solution for an additional 20 min. Finally, a lab-made luminous measurement device was used to analyze the corresponding control and study lines on the strips. Under optimized conditions, this method was found to be ultrasensitive, with a wide range of linear responses from 0.0008 ng mL-1 to 1 µg mL-1 and a limit of detection of 0.0008 ng mL-1 (0.013 pM). Thus, a novel competitive chemiluminescent assay based on reagent strips was established for the determination of the TP53 fusion proteins. The strategy has potential applications for ultrasensitive detection in the early diagnosis of cancer.

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Human schistosomiasis is one of neglected tropical diseases that remain highly prevalent in sub-Saharan Africa (SSA). Human schistosomiasis is mainly caused by two species, Schistosoma haematobium and S. mansoni, leading to urogenital and intestinal schistosomiasis, respectively. The World Health Organization (WHO) recommends mass drug administration (MDA) with praziquantel as the primary method of global intervention. Currently, MDA with praziquantel covers over half of the target population in endemic SSA countries. However, an accurate diagnosis is crucial for monitoring and evaluating the effectiveness of MDA. The standard diagnosis of both urogenital and intestinal schistosomiasis relies on the microscopic identification of eggs. However, the diagnostic sensitivity of this approach is low, especially for light or ultra-light infections. This is because Schistosoma eggs are laid inside of the venous plexus of the urinary bladder or mesenteric vein, where the adult flukes live. Approximately half of the eggs circulate in the blood vessels or are packed in neighboring tissues, while the remaining half are expelled into the lumen of the urinary bladder or intestine intermittently when the blood vessels are ruptured. In the field setting, the accuracy of any diagnostic method is critical for proper management of the intervention. The present article reviews the recent prevalence of urogenital schistosomiasis in SSA and highlights the practical limitations of diagnostic methods such as urine microscopy, urine reagent strips, molecular diagnosis, and ultrasound scanning in the field setting. Despite continuous global efforts to eliminate schistosomiasis over the past 20 years, many areas still remain endemic in SSA. No single diagnostic approach achieves acceptable sensitivity and specificity in the field setting. Therefore, any field survey should employ a combination of these methods based on the purpose of the study to accurately monitor and evaluate urogenital schistosomiasis. Based on diagnostic values and a cost-benefit analysis, a urine reagent strip test can replace urine microscopy in the field setting. The WHO criteria by ultrasound diagnosis should be updated including the echogenic snow sign and contour distortion.

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The performance of the urine reagent strips (URS) in detecting the presence and estimating the intensity of Schistosoma haematobium infection was evaluated using urine filtration microscopy as a reference standard. Urine samples collected from 1288 school-age children living in five villages of the Afar and one village in the Gambella Regional States of Ethiopia between October 2021 and April 2022 were examined using urine filtration and URS. The prevalence of S. haematobium infection was 31.6% based on urine filtration and 32.1% using URS. Using results of the urine filtration as a reference, the sensitivity, specificity, negative predictive values, and accuracy of the URS in detecting S. haematobium egg-positive urine specimens were 73.7%, 87.8%, 87.1%, and 82.8%, respectively. Sensitivity increased significantly with an increase in the urine egg count. Specificity was greater in low prevalence settings and among children aged 5-9 years. The level of hematuria detected was trace (19.1%), weak (30.2%), moderate (36.0%), or high (14.7%). The log odds of showing higher-level hematuria significantly increased as the number of egg counts in urine increased. In conclusion, URS remains good in rapidly screening individuals for S. haematobium infection, but the sensitivity of the test could be lower, particularly when the intensity of the infection is light.

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Background: Spontaneous bacterial peritonitis (SBP) is a bacterial infection associated with a high mortality rate in cirrhotic patients. The gold standard for the detection of SBP is a manual cell count from ascitic fluid; however, alternative screening methods are under investigation. In particular, leukocyte esterase reagent strips (LERS) has been studied as an alternative method to detect SBP with a low cost and instant turnaround time. Therefore, this study aims to evaluate the performance of LERS in the detection of SBP. Methods: A literature search was performed for studies evaluating LERS for the detection of SBP on PubMed, Embase, Scopus, Cochrane, and clinical trial registries. Summary sensitivity, specificity, log diagnostic odds ratio (LDOR), and the area under the summary receiver operating curve (AUC) were calculated according to the respective manufacturer. Results: In total, 31 studies were evaluated. The summary sensitivity of Aution Sticks, Combur, Multistix, Periscreen reagent strips was 0.962 (95% confidence interval [CI] 0.926, 0.998), 0.892 (95% CI 0.846, 0.938), 0.806 (95% CI 0.738, 0.874), and 0.939 (95% CI 0.900, 0.979), respectively. The summary specificity of Aution Sticks, Combur, Multistix, and Periscreen reagent strips was 0.940 (95% CI 0.904, 0.976), 0.922 (95% CI 0.874, 0.970), 0.974 (95% CI 0.962, 0.985), and 0.672 (95% CI 0.381, 0.963), respectively. Conclusion: LERS appears to have a notable overall performance for the detection of SBP. LERS appeared to be an acceptable alternative to diagnose SBP in facilities without ability to perform cell count. However, there were significant differences in performance between each manufacturer.

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To determine whether leukocyte esterase reagent strip test (LERST) analysis could help distinguish inflammatory arthritis from mechanical joint effusion. We analyzed synovial fluid (SF) from consecutive patients with a non-traumatic joint effusion during a 6-month period. Inflammatory SF was defined by white blood cell (WBC) count ≥ 2000/mm3. The LERST was performed with both semi-quantitative visual analysis (VA) and automated colorimetric reader (ACR) analysis. Leukocytes ≥ 1+ was considered a positive LERST result and WBC count was the reference. We obtained 100 SF samples (87 knees, 7 ankles, 5 hips, and 1 elbow) from 100 patients (mean ± SD age 61 ± 17 years, 59% men). The laboratory analyzed 88 SF samples (37 mechanical and 51 inflammatory). The remaining 12 SF samples were 10 hemarthrosis not allowing LERST analysis and 2 samples with coagulum not allowing WBC count. As compared with the laboratory analysis, the LERST had sensitivity and specificity 55% and 89% with VA and 47% and 92% with ACR analysis. The positive and negative predictive values were 87.5% and 59% with VA and 89% and 55% with ACR analysis. We found almost perfect agreement between VA and ACR results (kappa 0.70 [95% CI 0.50-0.90]). The WBC count increased with number of + observed after VA. Our results confirm that the LERST is able to detect inflammation in SF of native joints, thereby representing a useful and cheap tool in primary care. Its low sensitivity limits its use for ruling out inflammatory disorders. Key Points • Reagent strip tests can detect inflammation in synovial fluid. • In primary care practice, this method is cheap and easy to do.

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Introducción: La peritonitis bacteriana espontánea requiere un diagnóstico temprano para el inicio de antibioticoterapia. El estudio diagnóstico ideal es el citoquímico del líquido ascítico, el cual puede ser costoso, demorado y de disponibilidad limitada en centros primarios de atención en salud. Objetivo: Evaluar la utilidad y precisión diagnóstica de las tiras reactivas Multistix 10SG para el diagnóstico de peritonitis bacteriana espontánea en pacientes cirróticos con ascitis. Materiales y métodos: Estudio observacional descriptivo de prueba diagnóstica en pacientes cirróticos con ascitis. Se determinó el conteo de leucocitos del líquido ascítico por la escala colorimétrica de la tira reactiva Multistix 10SG y se comparó con el gold standard para el diagnóstico (polimorfonucleares ≥ 250 células/mm³). Resultados: De 174 pacientes con ascitis (51,7% mujeres, promedio de edad 59 años) 30 fueron diagnosticados con peritonitis bacteriana espontánea. Con un punto de corte grado ++, la tira reactiva tuvo sensibilidad 73,3%, especificidad 96,5%, valor predictivo positivo 81,4%, valor predictivo negativo 94,5%, razón de probabilidad positiva 21,2 y razón de probabilidad negativa 0,27. Conclusiones: Las tiras reactivas tienen adecuada especificidad y valor predictivo negativo, siendo una herramienta de bajo costo, uso sencillo, rápida interpretación y fácil acceso, para apoyar la decisión de no iniciar antibiótico en pacientes con ascitis y sospecha de peritonitis bacteriana espontánea. Por su baja sensibilidad no reemplazan al estudio citoquímico como prueba de elección para el diagnóstico definitivo, pero si es útil para optimizar el abordaje inicial de estos pacientes.

Introduction: Spontaneous bacterial peritonitis requires an early diagnosis to start antibiotic therapy. The ideal diagnostic study is the cytochemical of ascites fluid, which can be expensive, delayed and of limited availability in primary health care centers. Objective: Evaluate the usefulness and diagnostic accuracy of Multistix 10SG test strips for the diagnosis of spontaneous bacterial peritonitis in cirrhotic patients with ascites. Materials and methods: Observational descriptive study of diagnostic test in cirrhotic patients with ascites. The leukocyte count of ascites fluid was determined by the colorimetric scale of the Multistix 10SG test strip and compared with the gold standard for diagnosis (polymorphonuclear ≥ 250 cells / mm³). Results: Of 174 patients with ascites (51.7% women, average age 59 years) 30 were diagnosed with spontaneous bacterial peritonitis. With a grade ++ cut-off point, the test strip had sensitivity 73.3%, specificity 96.5%, positive predictive value 81.4%, negative predictive value 94.5%, positive likelihood ratio 21.2 and negative likelihood ratio of 0.27. Conclusions: The test strips have adequate specificity and negative predictive value, being a low cost tool, simple use, quick interpretation and easy access, to support the decision not to start an antibiotic in patients with ascites and suspected spontaneous bacterial peritonitis. Due to their low sensitivity they do not replace the cytochemical study as the test of choice for the definitive diagnosis, but it is useful for optimizing the initial approach of these patients.

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INTRODUCTION: The initial examination of cerebrospinal fluid (CSF) for proteins, glucose, and leukocytes, is still the gold standard investigation in some neurological conditions like meningitis. Aims and objective of the present study were to determine the accuracy of urinary reagent strip for semi-quantitative analysis of protein, glucose, leucocytes and erythrocytes in CSF along with its role in emergency for rapid diagnosis of neurological conditions. MATERIALS AND METHODS: 360 samples of CSF were received in emergency laboratory of a tertiary care hospital in a period of 6 months. All CSF samples were subjected to two types of tests-the definitive test and the index test. CSF microscopy for leucocyte and erythrocyte as well as biochemistry tests for protein and glucose on automated biochemistry analyser were considered as definitive test. The index test for protein, glucose, leucocyte and erythrocyte for the same sample was conducted by Combur-10 urinary reagent strip. RESULT: The strip test showed a sensitivity of 99% and a specificity of 54% for proteins. With respect to glucose, the strip was highly sensitive (98%) as well as highly specific (92%).It showed a high sensitivity and specificity for leukocytes ≥ 10 cells/cumm i.e.100% and 96% respectively. For CSF erythrocytes sensitivity and specificity was 100. CONCLUSION: Urinary reagent strip can be used routinely for rapid analysis of CSF. If implemented, this technique will be useful especially in emergency settings as well as in areas with limited resources.

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BACKGROUND: In Malawi, hematobium schistosomiasis is highly endemic. According to previous studies, countermeasures have been conducted mainly in school-aged children. In this study, we focused on the age groups, which are assumed to be major labor force generation. Hematobium schistosomiasis is supposed to be related to occupational activities in schistosome-endemic countries because of its infectious route. We chronologically followed the transition of schistosome egg-positive prevalence before and after mass drug administration of praziquantel (MDA) by using a urine filtering examination. We also analyzed the effectiveness of urine reagent strips from the cost perspective. RESULTS: The egg-positive prevalence was 34.3% (95% CI 28.5-40.5) just before MDA in June 2010 and the highest prevalence was in the age of twenties. The egg-positive prevalence reduced to 12.7% (95% CI 9.2-17.3, p < 0.01) 8 weeks after the first MDA and the prevalence reduced to 6.9% (95% CI 4.6-10.0, p < 0.01) after the second MDA in August 2011. The egg-positive prevalence after MDA in 2013 was reduced from 3.8% (95% CI 2.1-6.9) to 0.9% (95% CI 0.3-3.4) and p value was 0.050. Using urine reagent strips after MDA, the positive predictive value decreased, but the negative predictive value remained high. The cost of one urine reagent strip and one tablet of praziquantel were US$0.06 and US$0.125 in 2013 in Malawi. If the egg-positive prevalence is 40%, screening subjects for MDA using urine reagent strips, the cost reduction can be estimated to be about 24%, showing an overall cost reduction. CONCLUSIONS: MDA of praziquantel can assuredly reduce schistosome egg-positive prevalence. The combination of MDA and urine reagent strips could be both a practical and cost-effective countermeasure for hematobium schistosomiasis. It is key to recognize that hematobium schistosomiasis could be considered a disease that is assumed to have some concern with occupational risk at Nkhotakota and Lilongwe in Malawi. From this point of view, it is very important to manage workers' health; the sound labor force generation is vital for economic growth and development in these areas and countries.

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CONTEXT: The provision of initial treatment to a patient with suspected meningitis depends greatly on early recognition and rapid diagnostic evaluation of cerebrospinal fluid (CSF) leukocytes, proteins, and glucose. The diagnosis is time critical and timely intervention has an implication on the prognosis and outcome. Reasonably, sound laboratorial setups are not available in our country in the primary health-care level and, even in the settings where they are available, long waiting periods precede the availability of results. AIMS: We conducted this study to emphasize the role of urine reagent strip test as a rapid diagnostic tool in CSF analysis. SETTINGS AND DESIGN:: This is a prospective single-blinded study on 100 consecutive CSF samples received with in 1h of tap. SUBJECTS AND METHODS: All the 100 samples were subjected to definitive test being CSF microscopy and biochemical analysis of proteins and sugar and index test being a semi quantitative analysis of CSF leukocytes, proteins, and sugar by urinary reagent strips. STATISTICAL ANALYSIS USED: The diagnostic accuracy of the reagent strip for different cutoff levels was estimated and tabulated in the form of sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. RESULTS: 77% of cases were in the pediatric age group and 23% cases were adults. The sensitivity and specificity for leukocytes by the strip method for ≥15 cells/cumm were 89.28% and 98.61%, respectively, which increased to 100% with an increase in the counts. The reagent strip test had a sensitivity of 85.71% and a specificity of 95.65% for the protein levels >30 mg/dl which increased to 100% with an increase in protein levels. The reagent strip test for glucose was highly specific (100%) but less sensitive. CONCLUSIONS: The results indicate that urine reagent strip is instrumental in bedside CSF analysis and has a future stand in the diagnosis of meningitis.

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BACKGROUND: The dipstick is a first-line and inexpensive test that can exclude the presence of proteinuria in dogs. However, no information is available about the analytical variability of canine urine dipstick analysis. OBJECTIVES: The aim of this study was to assess the analytical variability in 2 dipsticks and the inter-operator variability in dipstick interpretation. METHODS: Canine urine supernatants (n = 174) were analyzed with 2 commercially available dipsticks. Two observers evaluated each result blinded to the other observer and to the results of the other dipstick. Intra- and inter-assay variability was assessed in 5 samples (corresponding to the 5 different semi-quantitative results) tested 10 consecutive times over 5 consecutive days. The agreement between observers and between dipsticks was evaluated with Cohen's k test. RESULTS: Intra-assay repeatability was good (≤3/10 errors), whereas inter-assay variability was higher (from 1/5 to 4/5 discordant results). The concordance between the operators (k = 0.68 and 0.79 for the 2 dipsticks) and that of the dipsticks (k = 0.66 and 0.74 for the 2 operators) was good. However, 1 observer and 1 dipstick overestimated the results compared with the second observer or dipstick. In any case, discordant results accounted for a single unit of the semi-quantitative scale. CONCLUSIONS: As for any other method, analytic variability may affect the semi-quantitation of urinary proteins when using the dipstick method. Subjective interpretation of the pad and, to a lesser extent, intrinsic staining properties of the pads could affect the results. Further studies are warranted to evaluate the effect of this variability on clinical decisions.

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BACKGROUND: A high incidence of unexplained positive urine reagent test strip reactions was observed in healthy, untreated laboratory-housed nonhuman primates, Beagle dogs, and Sprague-Dawley rats. Exposure of urine to cage pan contaminants was the suspected cause of the positive reactions. OBJECTIVES: The objective of this study was to identify cage pan contaminants which could cause positive reagent test strip reactions. METHODS: Contaminated urine was simulated by exposing water samples to cage pan contaminants, including cleaning solutions, feces from nonhuman primates, Beagle dogs, and Sprague-Dawley rats, certified laboratory animal diets, and dietary enrichments (vegetables, fruits, and food treats). Ten samples were prepared for each contaminant and analyzed for blood, glucose, bilirubin, ketones, pH, protein, urobilinogen, nitrite, and leukocyte esterase using commercially available urine reagent test strips and an automated urine chemistry analyzer. RESULTS: Positive reactions were common for all but one analyte and frequently associated with multiple contaminants. Blood, glucose, and protein reactions had the highest incidence and/or strongest positive reactions. Positive reactions for other reagent test strip analytes were observed, but generally of lower incidence and magnitude. CONCLUSIONS: We identified a high incidence of contaminant interferences in a water matrix causing positive reagent test strip reactions, primarily for the blood, glucose, and protein reactions. These findings highlight the potential limited value of urine reagent test strip assays as reliable biomarkers for detecting kidney toxicity in nonclinical studies, and imply that urine collection methods that minimize exposure to contaminants will likely improve the diagnostic validity of reagent test strip assays.

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Bacterial contamination of blood components is the major infectious risk in transfusion medicine. Since platelets should be stored at room temperature that makes them an excellent growth medium for bacteria; it is mentioned as a major problem in transfusion medicine. Transfusion risk of a bacterial contaminated platelet concentrate is higher than viral pathogen such as HIV, HBV, HCV and HTLV. The objective of this study was to evaluation of the sensitivity and specificity of use of glucose and pH for bacterial screening of platelet concentrates compared to the Bact/Alert. 1332 platelet concentrates were screened by the Bact/Alert system for aerobic and anaerobic bacterial contamination. Bacterial contamination was also evaluated by using urine reagent strips (Multistix10 SG Bayer) and culture methods. Moreover PH screening with a pH meter (Metrohm 744 Swiss) and glucose was also used for detection of bacterial contamination. The rate of bacterial contamination detected by the Bact/Alert system in platelet concentrates was 25 in 1332 (1.9 %). It contained 15 (1.1 %) for aerobic bacteria and 10 (.8 %) for anaerobic bacteria. 226 of 1332 were considered as containing bacteria by using urine reagent strips. Six of the 226 units were also positive by the Bact/Alert system. Three of those units were culture positive for aerobic bacteria and three for anaerobic. The result of platelet concentrates that underwent pH screening by use of pH meter and a pH portion of urine reagent strips was the same. The sensitivity and specificity of considering glucose alone for detection of bacterial contamination were 12 and 98 % respectively. For pH alone, these were 24 and 83 %. For glucose and/or pH, these were 24 and 83 %; and for combination of glucose and pH, these were 12 and 98 %. Our results showed use of glucose/pH strips would improve the safety of blood products and should be encouraged.

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BACKGROUND: Microscopic examinations are usually performed to confirm urine sediments in samples flagged in automated urinalysis. The aim of this study was to analyze the review rates and the difference in urinalysis results according to review rules. METHODS: A total of 1,408 urine samples submitted for health screening were collected. The urine chemistry test and urine sediment test were performed using EikenUS 3100 (Eiken Chemical Co. Ltd., Japan) and Sysmex UF-1000i (Sysmex Co., Japan), respectively. We assessed the rate of agreement between the 2 analyses and the kappa values for white blood cells (WBCs) and red blood cells (RBCs). Microscopic examinations were performed for all cases of discordant results between the urine strip and automated sediment analysis, some cases of concordant results, and cases of albuminuria. RESULTS: The review rate was 14.3%. Microscopic examinations were additionally performed on 77 samples (77/1,207, 6.4%) including 29 and 56 samples flagged for WBCs and RBCs, respectively. Based on the results of microscopic examination, the false-positive and the false-negative results of the urine chemistry test and automatic sediment analysis were corrected. Among concordant results between two methods, a clinically significant number of false-negatives were identified (6 results of WBC detection [6/125, 4.8%] and 4 of RBC detection [4/145, 2.8%]). Among the 22 unflagged cases of albuminuria, pathologic casts were detected in 21 cases (21/22, 95.5%). CONCLUSIONS: Microscopic examination based on the combined results of the two analyses improved the quality of the test.

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PURPOSE: The use of the dipstick urinalysis has been validated for the diagnosis of symptomatic urinary infections, cystitis and pyelonephritis thanks to an excellent negative predictive value. For prostatitis, it is rather its positive predictive value that is interesting. The aim of this study is to validate its use in the screening of urinary colonizations in the preoperative assessment in urology. METHODS: A monocentric prospective study was carried out for one year in 2011 comparing the data from the urine dipstick test with a fresh-voided midstream urinary examination and culture performed on the day of admission with the same urine sample in 598 asymptomatic patients programmed for a urological procedure. The gold standard to diagnose a microbiological-confirmed urinary tract infection or colonization was uropathogen growth of ≥10(3) colony-forming units per ml (cfu/mL) with or without leucocyturia. RESULTS: The study disclosed 5% of colonized patients. The urine dipstick test had a 65% sensitivity and a 97% negative predictive value. However, the low sensitivity of the urine dipstick test entailed 34% of false negatives. CONCLUSION: In spite of a good negative predictive value linked to a low prevalence of colonized patients (5%), the low sensitivity of the urine dipstick test entails a non-negligible number of false negatives. Its use as a single test of preoperative screening would expose colonized patients to the prospect of an operation, which seems to be unacceptable for some of them, notably endoscopic ones. LEVEL OF EVIDENCE: 4.

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INTRODUCTION: Spontaneous bacterial peritonitis (SBP) requires rapid diagnosis for the initiation of antibiotics. Its diagnosis is usually based on manual examination of ascitic fluid (AF) having long reporting time. AF infection is diagnosed when the fluid polymorphonuclear leukocyte (PMNL) concentration ≥250 cells/mm(3). AIMS AND OBJECTIVES: Aim was to evaluate the diagnostic utility of leukocyte esterase (LE) reagent strip for rapid diagnosis of SBP in patients who underwent abdominal paracentesis and to calculate the sensitivity, specificity, positive, and negative predictive values. MATERIALS AND METHODS: The study was carried out on 103 patients with ascites. Cell count of AF as determined by colorimetric scale of Multistix 10 SG reagent strip was compared with counting chamber method (PMNL count ≥250 cells/mm(3) was considered positive). RESULTS AND OBSERVATIONS: Of the 103 patients SBP was diagnosed in 20 patients, 83 patients were negative for SBP by manual cell count. The sensitivity and specificity of the LE test for detecting neutrocytic SBP taking grade 2 as cut off were 95% and 96.4% respectively, with a positive predictive value of 86.4% and a negative predictive value of 98.8%. Diagnostic accuracy of LE test was 96.1%. DISCUSSION: There was a good correlation between the reagent strip result and PMNL count. The LE strip test is based on the esterase activity of activated granulocytes which reacts with an ester-releasing hydroxyphenylpyrrole causing a colour change in the azo dye of reagent strip. It is a very sensitive and specific method for the prompt detection of elevated PMNL count, and represents a convenient, inexpensive, simple, and bedside method for diagnosis of SBP. A negative LE test result excludes SBP with a high degree of certainty.

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Objective To explore the division XL automatic urine analyzer reagent strips placed time impact on nitrite (NIT) test results,to ensure that provide accurate and reliable experimental data for clinical,and improve clinical diagnostic rate. Methods Used a new load reagent storehouse article in the new reagents respectively in <5,30 min;1,2,3,3.5,4,4.5,5, 5.5,6,6.5,7 and 8 h,in different period,16 0.9 g/dl saline NIT in the false positive rate,and carried on the comparison to different times NIT false-positive rate analysis.Results <3.5 h NIT false positive rate was 0% (0/16),4~4.5 h false pos-itive rate was 18.8% (3/16),5~5.5 h false positive rate was 43.8% (7/16),6~6.5 h was 62.5% (10/16),7~8 h was 87.5% (14/16).More than 4 h each time comparison between NIT false positive rate,differences were statistically signifi-cant (χ2 =11.7~59.2,all P <0.01).Conclusion Division XL automatic urine analyzer reagent strips placed after 4 h,NIT false-positive rate started to rise,NIT false-positive rate was significantly increased after 5 h.Therefore,strengthen the divi-sion XL automatic urine analyzer reagent strips placed reasonable time management,should be in the < 3.5 h advisable,it helps reduce the NIT false positive rate.

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OBJECTIVE: This study compares the performance of urine dipstick alone with urine microscopy and with both tests combined as a screen for urinary tract infection (UTI) in febrile infants aged 1 to 90 days. METHODS: We queried the Intermountain Healthcare data warehouse to identify febrile infants with urine dipstick, microscopy, and culture performed between 2004 and 2011. UTI was defined as >50 000 colony-forming units per milliliter of a urinary pathogen. We compared the performance of urine dipstick with unstained microscopy or both tests combined ("combined urinalysis") to identify UTI in infants aged 1 to 90 days. RESULTS: Of 13 030 febrile infants identified, 6394 (49%) had all tests performed and were included in the analysis. Of these, 770 (12%) had UTI. Urine culture results were positive within 24 hours in 83% of UTIs. The negative predictive value (NPV) was >98% for all tests. The combined urinalysis NPV was 99.2% (95% confidence interval: 99.1%-99.3%) and was significantly greater than the dipstick NPV of 98.7% (98.6%-98.8%). The dipstick positive predictive value was significantly greater than combined urinalysis (66.8% [66.2%-67.4%] vs 51.2% [50.6%-51.8%]). These data suggest 8 febrile infants would be predicted to have a false-positive combined urinalysis for every 1 infant with UTI initially missed by dipstick screening. CONCLUSIONS: Urine dipstick testing compares favorably with both microscopy and combined urinalysis in febrile infants aged 1 to 90 days. The urine dipstick test may be an adequate stand-alone screen for UTI in febrile infants while awaiting urine culture results.

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BACKGROUND: The urine dipstick is widely used as an initial screening tool for the evaluation of proteinuria; however, its diagnostic accuracy has not yet been sufficiently evaluated. Therefore, we evaluated its diagnostic accuracy using spot urine albumin/creatinine ratio (ACR) and total protein/creatinine ratio (PCR) in proteinuria. METHODS: Using PCR ≥0.2 g/g or ≥0.5 g/g and ACR ≥300 mg/g or ≥30 mg/g as the reference standard, we calculated the diagnostic accuracy profile: sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC) of the receiver operating characteristic curve. RESULTS: PCR and ACR were available for 10,348 and 3,873 instances of dipstick testing. The proportions with PCR ≥0.2 g/g, ≥0.5 g/g and ACR ≥300 mg/g, ≥30 mg/g were 38.2%, 24.6% and 8.9%, 31.7%, respectively. The AUCs for PCR ≥0.2 g/g, ≥0.5 g/g, and ACR ≥300 mg/g were 0.935 (trace: closest to ideal point), 0.968 (1+), and 0.983 (1+), respectively. Both sensitivity and specificity were >80% except for PCR ≥0.5 g/g with trace cutoff. For the reference standard of ACR ≥30 mg/g, the AUC was 0.797 (trace) and the sensitivity was 63.5%. CONCLUSION: Urine dipstick test can be used for screening in older outpatients with ACR ≥300 mg/g or PCR as the reference standard for proteinuria. However, we cannot recommend the test as a screening tool with ACR ≥30 mg/g as the reference owing to its low sensitivity.

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BACKGROUND: The urine dipstick is widely used as an initial screening tool for the evaluation of proteinuria; however, its diagnostic accuracy has not yet been sufficiently evaluated. Therefore, we evaluated its diagnostic accuracy using spot urine albumin/creatinine ratio (ACR) and total protein/creatinine ratio (PCR) in proteinuria. METHODS: Using PCR > or = 0.2g/g or > or = 0.5g/g and ACR > or = 300mg/g or > or = 30mg/g as the reference standard, we calculated the diagnostic accuracy profile: sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC) of the receiver operating characteristic curve. RESULTS: PCR and ACR were available for 10,348 and 3,873 instances of dipstick testing. The proportions with PCR > or = 0.2g/g, > or = 0.5g/g and ACR > or = 300mg/g, > or = 30mg/g were 38.2%, 24.6% and 8.9%, 31.7%, respectively. The AUCs for PCR > or = 0.2g/g, > or = 0.5g/g, and ACR > or = 300mg/g were 0.935 (trace: closest to ideal point), 0.968 (1+), and 0.983 (1+), respectively. Both sensitivity and specificity were > 80% except for PCR > or = 0.5g/g with trace cutoff. For the reference standard of ACR > or = 30mg/g, the AUC was 0.797 (trace) and the sensitivity was 63.5%. CONCLUSION: Urine dipstick test can be used for screening in older outpatients with ACR > or = 300mg/g or PCR as the reference standard for proteinuria. However, we cannot recommend the test as a screening tool with ACR > or = 30mg/g as the reference owing to its low sensitivity.

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OBJECTIVE: To describe the characteristics of a diabetic population, morbidity profile, resource consumption, complications and degree of metabolic control. DESIGN: Cross-sectional study during 2010. LOCATION: Four Health Areas (91.301 people) where the integrated management organization Serveis de Salut integrated Baix Empordà completely provide healthcare assistance. PARTICIPANTS: 4.985 diabetic individuals, identified through clinical codes using the ICD-9-MC classification and the 3M? Clinical Risk Groups software. MAIN MEASUREMENTS: Morbidity profile, related complications and degree of metabolic control were obtained for the target diabetic population. We analyzed the consumption of healthcare resources, pharmaceutical and blood glucose reagent strips. All measurements obtained at individual level. RESULTS: 99.3% of the diabetic population were attended at least once at a primary care center (14.9% of visits). 39.5% of primary care visits and less than 10% of the other scanned resources were related to the management of diabetes. The pharmaceutical expenditure was 25.4% of the population consumption (average cost ?1.014,57). 36.5% of diabetics consumed reagents strips (average cost ?120,65). The more frequent CRG are 5424-Diabetes (27%); 6144-Diabetes and Hypertension (25,5%) and 6143-Diabetes and Other Moderate Chronic Disease (17,2%). The degree of disease control is better in patients not consumers of antidiabetic drugs or treated with oral antidiabetic agents not secretagogues. CONCLUSIONS: Comorbidity is decisive in the consumption of resources. Just a few part of this consumption is specifically related to the management of diabetes. Results obtained provide a whole population approach to the main existing studies in our national and regional context.

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