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Pelvic Inflammatory Disease: An Underestimated Serious Health Problem
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Laboratory testing helps to establish the correct diagnosis and define the severity of PID. Abnormal cervical or vaginal discharge may show white blood cells on saline wet mount microscopy (more than one leukocyte per epithelial cell). The absence of polymorphonuclear leukocytes can exclude PID (histologic endometritis) in >90% of cases. Endocervical swabs should be taken to test for N gonorrhoeae (diplococci shape) and CT (saline wet mount). A high vaginal swab for Trichomonas vaginalis and BV is helpful, but negative results do not exclude the diagnosis. Cervical and high vaginal swab cultures for both aerobic and anaerobic organisms are usually performed, whereas a urethral swab culture may be done if gonorrhea is suspected as the causative agent. It is important to note that a positive test for gonorrhea, chlamydia, or M. genitalium supports the diagnosis, but the absence of infection does not exclude PID. Serologic microfluorescence testing for the detection of immunoglobulin (Ig) G and IgM antibodies is useful. To maximize the diagnostic yield, the use of molecular methods (eg, polymerase chain reaction) on cervical specimens for chlamydia and gonorrhea is recommended. Confirmation of BV can be achieved using Amsel's criteria [40]. Erythrocyte sedimentation rate and C-reactive protein may be elevated but are nonspecific. Urine or serum pregnancy test should be requested whenever pregnancy complications are expected. Urinalysis is required to exclude urinary tract infections.
The Urinary System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The kidneys also regulate osmolality of the blood and help control the concentration of numerous electrolytes in the plasma. As a result, a urinalysis can indicate a variety of electrolyte disturbances, such as hyponatremia (excess sodium in the blood), hypernatremia (sodium depletion in the blood), hypocalcemia (abnormally low serum calcium), hypophosphatemia (low phosphate ion in plasma), and so on. Other common diseases of the urinary system are listed in Table 11.1.
General physical
Published in Keith Hopcroft, Vincent Forte, Symptom Sorter, 2020
Usually none are necessary in practice. If a febrile child is ill enough to require investigation, the problem will usually be sufficiently urgent to need management by acute admission. Urinalysis, as a pointer to UTI (assuming obtaining a urine sample is feasible), is sometimes helpful in avoiding or facilitating admission. If possible, extend this to an MSU for bacteriological analysis.
Association between selective serotonin and serotonin–noradrenaline reuptake inhibitor therapy and hematuria
Published in Nordic Journal of Psychiatry, 2023
Mehmet Sarier, Meltem Demir, Mestan Emek, Ali Özgen, Hasan Turgut, Candan Özdemir
This prospective case-control study included patients who were followed up in the psychiatric outpatient clinic of the Antalya Medical Park Hospital Complex and treated with an SSRI or SNRI between 1 January 2021 and 31 March 2021. Patients who presented to the medical check-up outpatient clinic of the same hospital between the same dates were included as the control group. Inclusion criteria of the study were receiving an SSRI or SNRI as a single-drug regimen for psychiatric treatment or being an asymptomatic medical check-up patient. Exclusion criteria were a) receiving multidrug regimens for psychiatric treatment (study group), b) receiving an SSRI or SNRI (control group), c) taking any anticoagulant/antiplatelet or nonsteroidal anti-inflammatory drug (NSAID) therapy regularly (both groups), and d) having any urological and/or nephrological disorders associated with hematuria (both groups). Urine samples for complete urinalysis were obtained from all patients included in the study during their outpatient visits. As specified in the most recent American Urological Association guideline, hematuria was defined as three or more red blood cells per high power field (RBC/HPF) on a single urine microscopy [9]. Consecutive patients who presented during the study period and met the relevant inclusion criteria were recruited until the target sample size (n = 100 per group) was reached. Data pertaining to the patients’ demographic characteristics, duration of SSRI/SNRI use, and hematuria rates were collected and compared with the control group.
The clinical and pathological relevance of waxy casts in urine sediment
Published in Renal Failure, 2022
Damin Xu, Jingzi Li, Suxia Wang, Ying Tan, Ying Liu, Minghui Zhao
Urinalysis is an important technique for diagnosis and differential diagnosis, especially in kidney diseases. In addition to biochemical tests, urinalysis also needs microscopic examination to observe the formed elements in urine sediments, including cells, casts, crystals, etc. [1]. Casts are an important component in urine sediment and are associated with a variety of renal disorders. For instance, erythrocyte casts indicate glomerular diseases especially for those with glomerular cell proliferation, while renal tubular epithelial cell casts often indicate tubular injury [2]. However, waxy casts, a common element in urine sediment, are poorly investigated on their clinical and pathological relevance. Although waxy casts are considered to indicate renal insufficiency in atlases and textbooks, few studies provided convincible evidence [3]. To the best of our knowledge, only one study investigated the issue using univariable comparisons [4]. The dearth of convincible evidence and poor understanding of waxy casts may restrict the utility of urine sediment examination. Therefore, we aim to investigate the association between waxy casts and clinicopathological indices in a biopsy-proven series of patients with various kidney diseases.
Immune response induced in rodents by anti-CoVid19 plasmid DNA vaccine via pyro-drive jet injector inoculation
Published in Immunological Medicine, 2022
Tomoyuki Nishikawa, Chin Yang Chang, Jiayu A. Tai, Hiroki Hayashi, Jiao Sun, Shiho Torii, Chikako Ono, Yoshiharu Matsuura, Ryoko Ide, Junichi Mineno, Miwa Sasai, Masahiro Yamamoto, Hironori Nakagami, Kunihiko Yamashita
During the treatment period, animals were observed daily for general signs and skin reactions in the injected region. Body weights and food consumption were measured weekly. The necropsy, hematology, biochemistry, and immune response assays were performed under isoflurane anesthesia. Urine samples were collected for urinalysis. After euthanasia, specimens were visually inspected. Organs were sampled for microscopic examination including all the blood, the skin region, inguinal lymph nodes, reproductive organs, and any other organ that appeared abnormal after the visual inspection. All injected skin sites were excised to assess the recovery of the injection site. The organ samples were fixed in 10% neutral-buffered formalin solution. Thin paraffin sections were prepared, stained with hematoxylin and eosin, and subjected to histopathological analysis.