Can a urine dipstick test be used to assess smoking status in patients undergoing planned orthopaedic surgery?

Background: Progressive proteinuria implies worsening of the condition in hypertensive disorders of pregnancy and hence its quantification guides clinician in making decision and planning treatment. The gold standard is 24 hour urine protein estimation. Urine sediment cytology, also known as ‘liquid renal biopsy’ identifies and analyses the extent of renal damage.Methods: Objectives of the study were to compare the efficacy of urine dipstick test to 24 hour urine protein estimation in detecting proteinuria in pre-eclampsic patients and to describe the findings in urine sediment examination in assessing proteinuria in above patients. Urine dipstick test and sediment cytology were performed on the urinary samples of 242 pregnant women with high BP recordings (BP>140/90 mm Hg) which were collected and tested in Department of Pathology, Government Medical College, Kottayam during the study period of 18 months. This was compared with 24 hour urine protein values (gold standard).Results: About 154 patients (63.63%) had significant proteinuria of more than 300mg/24hr. Dipstick method showed 78.57% sensitivity and 81.82% specificity for prediction of significant proteinuria. Positive predictive value and negative predictive value of urine dipstick test were 88.32% and 68.57% respectively. Urine sediment examination revealed the presence of casts only in 11.98% of study population. Conclusions: Diagnostic accuracy of automated urine dipstick test in assessing proteinuria was 79.75%. For grade 1 proteinuria, diagnostic accuracy was 79.81%, for Grade 2 it increased to 93.14% and for grade 3 & 4, accuracy was 98.68%. Urine sediment examination didn’t correlate with proteinuria and hence the extent of renal damage in pre-eclampsia.

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Abstract 14200: Prognostic Significance of Dipstick Proteinuria in Heart Failure With Preserved Ejection Fraction - Insight From the Pursuit-hfpef Registry

Circulation ◽

10.1161/circ.142.suppl_3.14200 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Bolrathanak Oeun ◽

Shungo Hikoso ◽

Daisaku Nakatani ◽

Hiroya Mizuno ◽

Tetsuhisa Kitamura ◽

...

Keyword(s):

Heart Failure ◽

Prognostic Marker ◽

Composite Endpoint ◽

Study Endpoint ◽

Dipstick Test ◽

Urine Dipstick ◽

All Cause Mortality ◽

Urine Dipstick Test ◽

Group 2 ◽

Group 1

Introduction: Although albuminuria evaluated with urinary albumin-to-creatinine ratio (UACR) was shown to be a prognostic marker in patients with heart failure, measurement of UACR needs special equipment. Urine dipstick test is a simple and convenient method which is available even in community-based health care. Hypothesis: We hypothesized that dipstick proteinuria might be a prognosticator in HFpEF. Methods: We assessed 738 discharged-alive patients in the PURSUIT-HFpEF registry. Patients received urine dipstick test, and were divided into 2 groups according to the absence or presence of proteinuria (proteinuria trace or more). The study endpoint was a composite of all-cause mortality and HF hospitalization. Results: Median age was 82 years and 410 patients were female. Four hundred thirty-four patients: proteinuria-(group 1); 304 patients: proteinuria+(group 2). Group 2 was more likely male with higher frequency of diabetes, previous myocardial infarction and chronic kidney disease, but less likely to take ACEIs than group 1. Higher blood pressure, NT-proBNP, creatinine, E/e’, TRPG, and LV mass index were observed in group 2 than group 1. The composite endpoint and HF hospitalization occurred more often in group 2 than group 1 (HR: 1.43, 95%CI: 1.09-1.87, log-rank P=0.009; HR: 1.57, 95%CI: 1.14-2.15, log-rank P=0.005, respectively); but all-cause mortality did not (HR: 1.40, 95%CI: 0.92-2.11, log-rank P=0.113). Multivariable Cox regression adjusting for NT-proBNP, eGFR and other major confounding factors showed that proteinuria was associated with the composite endpoint (HR: 1.42, 95% CI: 1.05-1.94, P=0.026), and HF hospitalization (HR: 1.51, 95%CI: 1.04-2.18, P=0.030), but not with all-cause mortality (HR: 1.51, 95%CI:0.94-2.43, P=0.092). Conclusions: Dipstick proteinuria may be a prognostic marker in patients with HFpEF. Evaluation of proteinuria by urine dipstick test may be a simple but useful method for risk stratification in HFpEF.

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Blood enterovirus polymerase chain reaction testing in young febrile infants

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-321077 ◽

2021 ◽

pp. archdischild-2020-321077

Author(s):

Carla Pintos ◽

Santiago Mintegi ◽

Javier Benito ◽

Maitane Aranzamendi ◽

Leire Bonilla ◽

...

Keyword(s):

Antibiotic Treatment ◽

Clinical Decision Making ◽

Bacterial Pathogen ◽

Length Of Hospital Stay ◽

Clinical Decision ◽

Dipstick Test ◽

Urine Dipstick ◽

Young Infants ◽

Urine Dipstick Test ◽

The Impact

ObjectiveTo analyse the impact of blood enterovirus and human parechovirus PCR (ev-PCR) testing in young infants with fever without a source (FWS).DesignObservational study, subanalysis of a prospective registry.SettingPaediatric emergency department.PatientsInfants ≤90 days of age with FWS seen between September 2015 and August 2019 with blood ev-PCR, blood and urine cultures and urine dipstick test performed.Main outcome measuresPrevalence of invasive bacterial infection (IBI: bacterial pathogen in blood or cerebrospinal fluid) in infants with positive or negative ev-PCR test results. Secondarily, we also compared length of stay and antibiotic treatment in hospitalised infants.ResultsOf 703 infants, 174 (24.7%) had a positive blood ev-PCR and none of them were diagnosed with an IBI (vs 2.6% (95% CI 1.3% to 4.0%) of those with a negative result, p=0.02). Prevalence of non-IBI (mainly urinary tract infection) was also lower among infants with a positive blood ev-PCR (2.3% (95% CI 0.1% to 4.5%) vs 17.6% (95% CI 14.3% to 20.8%), p<0.01).Overall, 258 infants were hospitalised (36.6%) and 193 (74.8%) of them received antibiotics. Length of hospital stay and antibiotic treatment were shorter in those with a positive blood ev-PCR (median: 3 days vs 5 days and 1 day vs 5 days, respectively; p<0.01). Differences remained statistically significant among well-appearing infants >21 days old with normal urine dipstick.ConclusionBlood ev-PCR identifies a group of infants under 90 days of age with FWS at very low risk of IBI. This test may help to guide clinical decision making in young febrile infants.

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