scholarly journals An unresolved issue: The relationship between spot urine protein-to-creatinine ratio and 24-hour proteinuria

2019 ◽  
Vol 47 (3) ◽  
pp. 1179-1184 ◽  
Author(s):  
Davut Akin ◽  
Sehmus Ozmen
Keyword(s):  
Medical Records ◽  
Urine Protein ◽  
Entire Study ◽  
Spot Urine ◽  
Protein Excretion ◽  
Ratio Data ◽  
Study Population ◽  
The Mean ◽  
The Relationship ◽  
H Protein

Objective To investigate the relationship between spot urine protein-to-creatinine (sP/Cr) ratio and 24-h protein excretion in patients with different diagnoses. Methods This retrospective study analysed data from the medical records of patients admitted for24-h proteinuria determination who also had sP/Cr ratio data for the same day. Results A total of 1222 urine samples obtained from 694 adult outpatients were analysed. The mean ± SD age of the patients was 53.6 ± 15.9 years. The mean ± SD 24-h proteinuria and sP/Cr were 1.7 ± 2.4 g/day and 1.8 ± 2.4, respectively. The correlation between the sP/Cr and 24-h protein excretion was high (R2 = 0.89). The sP/Cr ratio accounted for 72% of the variability in 24-h proteinuria in the entire study population. Areas under the curve for 24-h proteinuria at 0.3 g/day, 1.0 g/day and 3.0 g/day were 0.940, 0.966, and 0.949, respectively. The mean + 2SD limits of agreement were between +2.99 and –2.73 g/day according to the Bland Altman analysis. Conclusion This current study found a clinically unacceptable deviation between 24-h proteinuria and sP/Cr ratio. Therefore, the sP/Cr ratio cannot replace 24-h proteinuria. A new method using spot urine protein and creatinine values that is able to minimize under or over estimation is still warranted.

Effect of Backrest Elevation on the Development of Ventilator-Associated Pneumonia

2005 ◽  
Vol 14 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Mary Jo Grap ◽  
Cindy L. Munro ◽  
Russell S. Hummel ◽  
R.K. Elswick ◽  
Jessica L. McKinney ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Medical Records ◽  
Pulmonary Infection ◽  
Severity Of Illness ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia ◽  
Entire Study ◽  
System Data ◽  
The Mean ◽  
The Relationship

• Background Ventilator-associated pneumonia is a common complication of mechanical ventilation. Backrest position and time spent supine are critical risk factors for aspiration, increasing the risk for pneumonia. Empirical evidence of the effect of backrest positions on the incidence of ventilator-associated pneumonia, especially during mechanical ventilation over time, is limited. • Objective To describe the relationship between backrest elevation and development of ventilator-associated pneumonia. • Methods A nonexperimental, longitudinal, descriptive design was used. The Clinical Pulmonary Infection Score was used to determine ventilator-associated pneumonia. Backrest elevation was measured continuously with a transducer system. Data were obtained from laboratory results and medical records from the start of mechanical ventilation up to 7 days. • Results Sixty-six subjects were monitored (276 patient days). Mean backrest elevation for the entire study period was 21.7°. Backrest elevations were less than 30° 72% of the time and less than 10° 39% of the time. The mean Clinical Pulmonary Infection Score increased but not significantly, and backrest elevation had no direct effect on mean scores. A model for predicting the Clinical Pulmonary Infection Score at day 4 included baseline score, percentage of time spent at less than 30° on study day 1, and score on the Acute Physiology and Chronic Health Evaluation II, explaining 81% of the variability (F=7.31, P=.003). • Conclusions Subjects spent the majority of the time at backrest elevations less than 30°. Only the combination of early, low backrest elevation and severity of illness affected the incidence of ventilator-associated pneumonia.

scholarly journals Assessment of Proteinuria in Nephrotic Syndrome in Children by Using Spot Urinary Protein/Creatinine Ratio

2018 ◽  
Vol 42 (3) ◽  
pp. 108-111
Author(s):  
Delowar Hossain ◽  
Zahiruddin ◽  
Monimul Hoque
Keyword(s):  
Nephrotic Syndrome ◽  
Total Protein ◽  
Mean Value ◽  
Urinary Protein ◽  
Urine Collection ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine ◽  
Protein Excretion ◽  
The Mean

Background: Quantification of proteinuria is usually predicted upon 24-hour urine collection. Multiple factors influence urine collection and the rate of protein and creatinine excretion. A spot urine protein-creatinine (P-C) ratio has been shown over the years to be a reliable alternative to the 24-hour collection for detection and follow up of proteinuria. The objective of the study was to evaluate the accuracy of urine protein creatinine ratio (UP/UC) in a spot sample for quantitative measurement of proteinuria in comparison with 24 hours urinary protein excretion in children of nephrotic syndrome having normal Glomerular Filtration Rate (GFR). Methodology: This was a prospective study conducted in the department of paediatrics, Sir Salimullah Medical College & Mitford Hospital Dhaka over a period of six months from January 2003. Fifty cases of Nephrotic syndrome were included who were on initial attack and relapse cases noted down into the proforma with respect to history, examination and investigation. All the patients were advised regarding 24 hours urine collection. They were asked to give a 24 hours urine sample starting at 9.00 am for total protein excretion rate. A spot urine sample was obtained and urine protein/creatinine ratio was calculated. The data was analyzed by linear regression and by calculating the correlation coefficient between urinary protein/ creatinine ratio and 24-hour urinary protein. Results: Sample size was fifty. Urine total protein in a timed 24-hour sample of nephrotic syndrome patients was in the range of 300-3150mg/m2/hour with the mean value of 1725 mg/m2/hour. While as U(Pr/Cr) ratio ranged from 3.1-27.5 with the mean value of 15.2. A significant correlation was found between timed 24-hour urinary protein and UP/UC ratio (r=0.622, p=<.001.) Conclusions: Spot urine protein-creatinine ratio is highly reliable and rapid test for quantification of proteinuria in children with nephrotic syndrome. Bangladesh J Child Health 2018; VOL 42 (3) :108-111

scholarly journals ASSESSMENT OF PHYSICA L ACT IVITY OF MEMBERS OF THE HELICO PTER EMERGENCY MEDICA L SERVICE (HEMS)

2019 ◽  
Vol 7 (2) ◽  
pp. 91-98
Author(s):  
Agata Gaździńska ◽  
Paweł Jagielski ◽  
Robert Gałązkowski
Keyword(s):  
Physical Activity ◽  
Medical Service ◽  
Helicopter Emergency Medical Service ◽  
Team Members ◽  
Winter Sport ◽  
Study Population ◽  
Downhill Skiing ◽  
The Mean ◽  
The Relationship ◽  
Financial Issues

The aim: Assessment of physical activity of members of the Helicopter Emergency Medical Service. Material and methods: The study was conducted in a group of 131 people (65 paramedics, 66 pilots), members of HEMS teams from all bases in Poland, aged 27-59. The characteristics of physical activity was obtained using the author’s questionnaire. Results: The mean age of the study population was 42.73 ± 9.58 years. Pilots were significantly older than paramedics and had significantly higher BMI values (p < 0.05). No significant relationship between the age and BMI in the analyzed groups was found (p > 0.05), while the relationship between the frequency of physical activity and BMI was demonstrated. 70% of subjects undertook physical activity less than three times a week. The most frequently chosen forms were cycling, walking and swimming. Paramedics statistically significant more often than pilots chose wall climbing (p = 0.001). Downhill skiing (61%) was the most common declared winter sport played by pilots, while hiking in the mountains – by paramedics (49%). The most important reason for pilots to take up physical activity was concern for their health (47%), while for paramedics – the pleasure (63%). Paramedics statistically significant more often than pilots indicated a large number of other activities (90.6 vs. 74.2%) and financial issues (18.8 vs. 6.1%) as barriers that prevented more involvement in physical activities. Conclusions: The frequency of physical activity undertaken by HEMS members is insufficient. Low physical activity of HEMS team members has an adverse effect on their nutritional status. It is necessary to take initiatives to promote physical activity in this professional group.

Reduced Growth in Non-Small for Gestational Age Fetuses from 35 Weeks of Gestation to Birth and Perinatal Outcomes

2021 ◽  
pp. 1-10
Author(s):  
Peña Dieste Pérez ◽  
Luis M. Esteban ◽  
Ricardo Savirón-Cornudella ◽  
Faustino R. Pérez-López ◽  
Sergio Castán-Mateo ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Outcomes ◽  
Entire Study ◽  
Birth Weight Percentile ◽  
Gestational Age At Delivery ◽  
Study Population ◽  
The Difference ◽  
Relationship Of ◽  
The Relationship

<b><i>Objective:</i></b> This study aimed to assess reduced fetal growth between 35 weeks of gestation and birth in non-small for gestational age fetuses associated with adverse perinatal outcomes (APOs). <b><i>Material and Method:</i></b> It is a retrospective cohort study of 9,164 non-small for gestational age fetuses estimated by ultrasound at 35 weeks. The difference between the birth weight percentile and the estimated percentile weight (EPW) at 35 weeks of gestation was calculated, and we studied the relationship of this difference with the appearance of APO. APOs were defined as cesarean or instrumental delivery rates for nonreassuring fetal status, 5-min Apgar score &#x3c;7, arterial cord blood pH &#x3c;7.10, and stillbirth. Fetuses that exhibited a percentile decrease between both moments were classified into 6 categories according to the amount of percentile decrease (0.01–10.0, 10.01–20.0, 20.01–30.0, 30.01–40.0, 40.01–50.0, and &#x3e;50.0 percentiles). It was evaluated whether the appearance of APO was related to the amount of this percentile decrease. Relative risk (RR) was calculated in these subgroups to predict APOs in general and for each APO in particular. Receiver operating characteristic and area under curves (AUC) for the difference in the percentile was calculated, used as a continuous parameter in the entire study population. <b><i>Results:</i></b> The median gestational age at delivery in uncomplicated pregnancies was 40.0 (39.1–40.7) and in pregnancies with APOs 40.3 (49.4–41.0), <i>p</i> &#x3c; 0.001. The prevalence of APOs was greater in the group of fetuses with a decrease in percentile (7.6%) compared to those with increased percentile (4.8%) (<i>p</i> &#x3c; 0.001). The RR was 1.63 (95% CI: 1.365–1.944, <i>p</i> &#x3c; 0.001). Although the differences were significant in all decreased percentile groups, RRs were significantly higher when decreased growth values were &#x3e;40 points (RR: 2.036, 95% CI: 1.581–2.623, <i>p</i> &#x3c; 0.001). The estimated value of the AUC for percentile decrease was 0.58 (0.56–0.61, <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> Fetuses with a decrease in the EPW between the ultrasound at 35 weeks of gestation and birth have a higher risk of APOs, being double in fetuses with a decrease of &#x3e;40 percentile points.

The Relationship of Intrauterine Growth Restriction with Placental Pathologic Changes in Newborns

2020 ◽  
Author(s):  
Hossein Dalili ◽  
Fatemeh Sadat Nayeri ◽  
Seyed Reza Mirjalili ◽  
Seyyed Nasrollah Hossein ◽  
Alireza Abdollahi ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Pathological Examination ◽  
Histological Changes ◽  
Intrauterine Growth ◽  
Study Population ◽  
The Mean ◽  
Relationship Of ◽  
The Relationship ◽  
Restriction Group

Introduction: Intrauterine growth restriction is a multifaceted problem and is associated with a significant increase in the level of morbidity and perinatal mortality. According to some studies, failure of the placenta is responsible for the most cases of intrauterine growth restriction. The aim of this study was to evaluate the placental pathologic changes in the intrauterine growth restriction (IUGR) samples and compare them with normal cases.   Methods: A study population consisted of 60 intrauterine growth restriction neonates and 60 normalized neonates born at Tehran Imam Khomeini Hospital between June 2016 and July 2017. The placenta was weighed, immediately after delivery, and the umbilical cord was separated, then stored in 10% formalin and sent for pathological examination as soon as possible. Data collection was performed according to the following items: the pathologist's report, the results of the infants' examination, and the data in the neonatal cases.   Results: The intrauterine growth restriction group showed a high frequency of placenta infarction (P < 0.001), inflammation of the villous (P < 0.001), villous fibrosis (P = 0.044), villous vascularization disorder (P = 0.001), prevalence of chorioamnionitis (P = 0.027), prevalence of Syncytiotrophoblastic knots (P < 0.001) and placental necrosis (P = 0.048) than normal group. However, the mean weight of the placenta (P < 0.001), the length and width of the macroscopic placenta changes was less (P < 0.001).   Conclusion: The results of the current study showed that a major part of the macroscopic and histological changes are detectable in the intrauterine growth restriction samples, which are considerably more common than normal, although they are not pathognomonic, but in the future, more accurate results can be obtained from more extensive studies.

scholarly journals Comparative study of 24-hour urinary protein and spot urine protein creatinine ratio in pre-eclamptic women

2021 ◽  
Vol 10 (7) ◽  
pp. 2734
Author(s):  
Rupakala B. M. ◽  
Akshata S. Hiremath
Keyword(s):  
Predictive Value ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Spearman Correlation ◽  
Urine Protein ◽  
Spot Urine ◽  
Medical College ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Urine Specimens

Background: The aim of the study was to evaluate the ability of the random urine P/C ratio to predict significant proteinuria, as well as to introduce a diagnostic test for pre-eclampsia which will avoid the inconvenience and time consumption of 24-hour urine protein collection. The objective of this study was to compare spot urine protein- creatinine ratio with 24-hour urine protein for estimation of proteinuria in pre-eclampsia.Methods: A total of 50 pregnant women with pre-eclampsia were prospectively studied for proteinuria in Rajarajeswari medical college and Hospital Bangalore for a period of 9 months from September 2018 to May 2019. Spot urine specimens for measuring P/C ratio were obtained immediately before 24-hour urine collection. The correlation between the spot urine P/C ratio and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test.Results: PCR at a cut off value 0.15 g/mmol had sensitivity and specificity of 96.6% and 55% respectively. In prediction of proteinuria of 300 mg/24 hr positive predictive value and negative predictive value 76.3% and 91.6% respectively.Conclusions: We found that there was a strong correlation between 24-hour urine protein excretion and spot urine protein creatinine ratio in pre-eclamptic women. Spot PCR can be used as a reasonable alternative to 24-hour urine protein test which is a cumbersome.

scholarly journals Spot Urine Protein Excretion in the First Year Following Kidney Transplantation Associates With Allograft Rejection Phenotype at 1-Year Surveillance Biopsies: An Observational National-Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Manca Oblak ◽  
Gregor Mlinšek ◽  
Nika Kojc ◽  
Maja Frelih ◽  
Jadranka Buturović-Ponikvar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Allograft Rejection ◽  
De Novo ◽  
First Year ◽  
Urine Protein ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Significant Difference ◽  
National Cohort

Introduction: Urine protein excretion is routinely measured to assess kidney allograft injury, but the diagnostic value of this measurement for kidney transplant pathology remains unclear. Here we investigated whether spot urine protein excretion in the first year following transplantation associates with allograft rejection phenotype at 1-year surveillance biopsies and de-novo occurrence of donor-specific antibodies (DSA).Patients and Methods: This prospective, observational national-cohort study included 139 non-sensitized patients who received a deceased donor kidney transplant between December 2014 and 2018. All patients received basiliximab induction and tacrolimus-based immunosuppression. Estimated protein excretion rate (ePER) was calculated monthly from spot urine protein-to-creatinine ratios. At 1-year, all recipients underwent surveillance graft biopsy and were screened for de-novo DSA. Screening-positive sera were subjected to single antigen bead (SAB) testing. The occurrence of de-novo DSA was determined based on SAB reactivity patterns using a mean fluorescence intensity threshold &gt;1,000.Results: Among the 139 study patients, 27 patients (19%) had histologic evidence of T cell-mediated rejection (TCMR), and 9 patients (7%) had histologic evidence of antibody-mediated rejection (AMR) at 1-year surveillance biopsy. One year after transplant, 19 patients (14%) developed de-novo DSA. Compared with patients without rejection and no de-novo DSA, mixed-effects linear regression analysis showed a significant difference in slope of ePER during the first year in patients with AMR and de-novo DSA at 1-year (46, 95% CI 25–68 mg/day/1.73 m2 per month and 34, 95% CI 20–49 mg/day/1.73 m2 per month, respectively). Patients with vascular TCMR also showed a significant difference in ePER slope over time compared with patients with non-rejection findings (31, 95% CI 9–52 mg/day/1.73 m2 per month). The discriminatory power of ePER for intragraft rejection processes was better in patients with AMR (AUC 0.95, 95% CI 0.90–0.99; P &lt; 0.001) than in those with TCMR (AUC 0.68, 95% CI 0.59–0.79; P = 0.002), with 89% sensitivity and 93% specificity for proteinuria &gt;550 mg/day/1.73m2.Conclusions: An increase in ePER in the first year following kidney transplantation associates with AMR, vascular TCMR and de-novo DSA at 1-year and may be used as a non-invasive clinical marker of intragraft endothelial cell injury.

scholarly journals CHILD DEATHS FROM CONGENITAL MALFORMATION OCCURRED IN A NORTHEASTERN CAPITAL FROM 1996 TO 2016

2019 ◽  
Vol 5 ◽  
Author(s):  
José Francisco Ribeiro ◽  
Cleidiomar Oliveira Rodrigues ◽  
Luziane Alves de Abreu Solano Nogueira ◽  
Vanessa Oliveira Rodrigues Bezerra ◽  
Arianne Lara Ibiapina Ribeiro ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Medical Records ◽  
Knowledge Score ◽  
University Hospital ◽  
Medical Clinic ◽  
Adult Intensive Care Unit ◽  
Child Deaths ◽  
Professional Category ◽  
The Mean ◽  
The Relationship

Objective: to analyze the relationship between knowledge and the adequacy of nursing annotations and their determinants. Method: An exploratory, descriptive and quantitative approach, carried out in the Medical Clinic and in the Adult Intensive Care Unit of a Brazilian university hospital. A total of 114 professionals and 41 medical records were included. Results: The professionals had a high mean score of knowledge and a low mean score of adequacy and there was no correlation between them (rs = -0,122; p > 0.05). The knowledge score was higher for professionals graduated in Nursing. The mean score of adequacy was higher for the professional category nurse if packed in Medical Clinic and with the professional that was dissatisfied with the training. Conclusion: there is no relationship between the professional's knowledge about nursing notes and the adequacy of the notes, which leads to serious ethical, legal and patient safety issues.Descritores: Anormalidades congênitas; Recém-nascidos; Mortalidade infantil; Enfermagem neonatal.

Sign in / Sign up

Export Citation Format

Share Document