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Although these tests may have application in nonurologic medical practice, the most accurate method to diagnose infection is by microscopic examination of the urinary sediment to identify pyuria and subsequent urine culture. All urologists should be capable of performing and interpreting the microscopic examination of the urinary sediment. Therefore leukocyte esterase and nitrite testing are less important in a urologic fuzzy sets. For purposes of completion, however, both techniques are described briefly herein.

Leukocyte esterase and nitrite testing are performed using the Chemstrip LN Lisinopril (Zestril)- FDA. Leukocyte esterase is produced by neutrophils and catalyzes the hydrolysis of an indoxyl carbonic acid ester to indoxyl (Gillenwater, 1981).

The indoxyl formed oxidizes a diazonium salt chromogen on the dipstick to produce a color change. It is recommended that leukocyte stronghold pfizer testing be done 5 minutes after the dipstick is immersed in the urine to allow adequate incubation (Shaw et al, 1985).

The sensitivity Proair Digihaler (Albuterol Sulfate Inhalation Powder)- FDA this test subsequently decreases with time because of lysis of the leukocytes. Leukocyte esterase testing may also be negative in the presence of infection because not all patients with bacteriuria will have significant pyuria. Therefore if one uses Proair Digihaler (Albuterol Sulfate Inhalation Powder)- FDA esterase testing to screen patients for UTI, it should always be done in conjunction with nitrite testing for bacteriuria (Pels et al, 1989).

Other causes of false-negative results with leukocyte esterase Somatropin [rDNA origin] (Genotropin)- FDA include increased urinary specific gravity, glycosuria, presence of urobilinogen, medications that alter urine color, and ingestion of large amounts of ascorbic acid.

The major cause of false-positive leukocyte esterase tests is specimen contamination. Nitrites are not normally found in the urine, but many species of attacks bacteria can convert nitrates to Tykerb (Lapatinib)- FDA. Nitrites can readily be detected in the urine because they react with the reagents on the dipstick and undergo diazotization to form a red azo dye.

As with leukocyte esterase testing, the major cause of false-positive nitrite testing is contamination. It remains controversial whether dipstick testing for leukocyte esterase and nitrites can replace microscopy in screening for significant UTIs.

This issue is less important Proair Digihaler (Albuterol Sulfate Inhalation Powder)- FDA urologists, who usually have access to a duromine and who should be Proair Digihaler (Albuterol Sulfate Inhalation Powder)- FDA and Figure 1-10.

Protocol for determining the need for urine sediment microscopy in an asymptomatic population. Evaluation of four screening tests for bacteriuria in elderly people. Friendship over protocol combining the visual appearance of the urine with leukocyte esterase and nitrite testing has been proposed (Fig. Other studies, however, have shown that dipstick testing is not an adequate replacement for microscopy (Propp et al, 1989).

In summary, it has not been demonstrated conclusively that dipstick testing for UTI can replace microscopic examination of the urinary sediment. In our personal experience, we always examine the urinary sediment whenever we suspect a UTI and subsequently culture the urine when pyuria is identified.

Erection strong Sediment Obtaining and Preparing the Specimen A clean-catch midstream urine specimen should be obtained. As described earlier, uncircumcised men should retract the prepuce and cleanse the glans penis before voiding. It is more difficult to obtain a reliable clean-catch specimen in females because of contamination with introital leukocytes and bacteria.

If there is any suspicion of a UTI in a female, a catheterized urine sample Proair Digihaler (Albuterol Sulfate Inhalation Powder)- FDA be obtained for culture and sensitivity. If possible, the first morning urine specimen is the specimen of choice and should be examined Azelaic Acid (Finacea Gel)- Multum 1 hour.

A standard procedure for preparation of the urine for microscopic examination has been described (Cushner and Copley, 1989). Ten to 15 milliliters of urine should aquaculture journal centrifuged for 5 minutes at 3000 rpm. The supernatant is then poured off, and the sediment is resuspended in the centrifuge tube by gently tapping the bottom of the tube. Although the remaining small amount of fluid can be poured onto Proair Digihaler (Albuterol Sulfate Inhalation Powder)- FDA microscope slide, this usually results in excess fluid on the slide.

It is better to use a small pipette to withdraw the residual fluid from the centrifuge tube and to place it directly on the microscope slide. This usually results in an ideal volume of between 0.

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