Ua meaning medical: Urine Test Definition, Disease Detection, and Results
definition of UA by Medical dictionary
(an-ji’na, an’ji-) [L. angina, quinsy, fr. angere, to choke]
1. Angina pectoris.
2. Acute sore throat. anginal (an-ji’nal, an’ji-nal), adjective
Abdominal pain that occurs after meals, caused by insufficient blood flow to the mesenteric arteries. This symptom typically occurs in patients with extensive atherosclerotic vascular disease and is often associated with significant weight loss. Synonym: intestinal angina; bowel ischemia
Medical intervention for abdominal angina can include supportive care including anticoagulant therapy. Surgical intervention includes angioplasty, partial colectomy, (removing the ischemic section of the bowel and reconnecting the remaining ends). It may be necessary to create a colostomy or ileostomy and to correct blockages in the mesenteric arteries. The patient must be monitored for signs and symptoms of peritonitis and/or sepsis. As the patient recovers, patient education focuses on prevention of further episodes, recognition of signs and symptoms including cramping abdominal pain after eating, blood in the stool, red or black stools, diarrhea and/or constipation. It also includes instructions and support for living with permanent or temporary colostomy or ileostomy.
Attacks of angina pectoris occurring while a person is in a recumbent position.
angina of effort
Angina pectoris with onset during exercise. Synonym: exertional angina
Angina of effort.
See: Ludwig angina
An oppressive pain or pressure in the chest caused by inadequate blood flow and oxygenation to heart muscle. It is usually due to atherosclerosis of the coronary arteries and in Western cultures is one of the most common emergent complaints bringing adult patients to medical attention. It typically occurs after (or during) events that increase the heart’s need for oxygen, e.g., increased physical activity, a large meal, exposure to cold weather, or increased psychological stress. See: illustration; table
Patients typically describe a pain or pressure located behind the sternum and having a tight, burning, squeezing, or binding sensation that may radiate into the neck, jaw, shoulders, or arms and be associated with difficulty in breathing, nausea, vomiting, sweating, anxiety, or fear. The pain is not usually described as sharp or stabbing and is usually not aggravated by deep breathing, coughing, swallowing, or twisting or turning the muscles of the trunk, shoulders, or arms. Women, diabetics, and the elderly may present with atypical symptoms, such as shortness of breath without pain.
In health care settings, oxygen, nitroglycerin, and aspirin are provided, and the patient is placed at rest. Morphine sulfate is given for pain that does not resolve after about 15 min of treatment with that regimen. Beta-blocking drugs (such as propranolol or metoprolol) are used to slow the heart rate and decrease blood pressure. They are the mainstay for chronic treatment of coronary insufficiency and are indispensable for treating unstable angina or acute myocardial infarction. At home, patients should rest and use short-acting nitroglycerin. Patients with chronic or recurring angina pectoris may get symptomatic relief from long-acting nitrates or calcium channel blockers. Patients with refractory angina may be treated with combinations of all of these drugs in addition to ranolazine, a sodium channel blocker.
The pattern of pain, including OPQRST (onset, provocation, quality, region, radiation, referral, severity, and time), is monitored and documented. Cardiopulmonary status is evaluated for evidence of tachypnea, dyspnea, diaphoresis, pulmonary crackles, bradycardia or tachycardia, altered pulse strength, the appearance of a third or fourth heart sound or mid- to late-systolic murmurs over the apex on auscultation, pallor, hypotension or hypertension, gastrointestinal distress, or nausea and vomiting. The 12-lead electrocardiogram is monitored for ST-segment elevation or depression, T-wave inversion, and cardiac arrhythmias. A health care provider should remain with the patient and provide emotional support throughout the episode. Desired treatment results include reducing myocardial oxygen demand and increasing myocardial oxygen supply. The patient is taught the use of the prescribed form of nitroglycerin for anginal attacks and the importance of seeking medical attention if prescribed dosing does not provide relief. Based on his needs, the patient should be encouraged and assisted to stop smoking, maintain ideal body weight, lower cholesterol by eating a low-fat diet, keep blood glucose under control (if the patient is diabetic), limit salt intake, and exercise (walking, gardening, or swimming regularly for 45 min to an hour every day). The patient is also taught about prescribed beta-adrenergic or calcium channel blockers and any other needed interventions should they become necessary.
Four major forms of angina are identified: 1. stable: predictable frequency and duration of pain that is relieved by nitrates and rest; 2. unstable: pain that is more easily induced and increases in frequency and duration; 3. variant: pain that occurs from unpredictable coronary artery spasm; and 4. microvascular: impairment of vasodilator reserve that causes angina-like chest pain even though the patient’s coronary arteries are normal. Severe and prolonged anginal pain is suggestive of a myocardial infarction.
|I||Ordinary physical activity, such as walking or climbing stairs, does not cause angina. Angina occurs with strenuous, rapid, or prolonged exertion at work or recreation.|
|II||Slight limitation of ordinary activity. Angina occurs on walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, in cold, or in wind, under emotional stress, only during the few hours after awakening, or walking more than two level blocks and climbing more than one flight of stairs at a normal pace and in normal conditions.|
|III||Marked limitation of ordinary physical activity. Angina occurs on walking one to two level blocks and climbing one flight of stairs in normal conditions at a normal pace.|
|IV||Inability to carry on any physical activity without discomfort—angina symptoms may be present at rest.|
Angina pectoris occurring in the days or weeks before a myocardial infarction. The symptoms may be unrecognized by patients without a history of coronary artery disease.
Unrecognized angina pectoris that presents with symptoms other than chest pain or pressure. The patient may experience dyspnea on exertion, heartburn, nausea, pain in the arm, jaw pain, tenderness in back or arms (in women), or other atypical symptoms. Silent angina pectoris occurs most often in older adults, in women, in postoperative patients who are heavily medicated, or in patients with diabetic neuropathy.
Angina that occurs with exercise and is predictable. It is usually promptly relieved by rest or nitroglycerin.
Angina that has changed to a more frequent and more severe form. Its symptoms include chest pain that occurs with minimal exertion (or that progresses from pain with exertion to pain occurring with minimal exertion or at rest) and may be an indication of a severe obstruction in a coronary artery and impending myocardial infarction. It is a medical emergency, and should be aggressively managed.
Angina due to spasm of the coronary arteries rather than from exertion or other increased demands on the heart. The pain typically occurs at rest. During coronary catheterization the spasm is usually found near an atherosclerotic plaque, often in the right coronary artery. Infusions of ergonovine may provoke it. On the electrocardiogram, the diagnostic hallmark is elevation of the ST segments during episodes of resting pain. Treatments include nitrates and calcium channel blocking drugs. Beta-blocking drugs, frequently used as first-line therapy in typical angina pectoris, are often ineffective with this angina.
Synonym: Prinzmetal angina
Necrotizing ulcerative gingivitis.
Angina that has changed to a more frequent and more severe form. Its symptoms include chest pain that occurs with minimal exertion (or that progresses from pain with exertion to pain occurring with minimal exertion or at rest) and may be an indication of a severe obstruction in a coronary artery and impending myocardial infarction. It is a medical emergency, and should be aggressively managed.
Medical Dictionary, © 2009 Farlex and Partners
Urinalysis – Mayo Clinic
A urinalysis is a test of your urine. It’s used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes.
A urinalysis involves checking the appearance, concentration and content of urine. For example, a urinary tract infection can make urine look cloudy instead of clear. Increased levels of protein in urine can be a sign of kidney disease.
Unusual urinalysis results often require more testing to find the source of the problem.
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Why it’s done
A urinalysis is a common test that’s done for several reasons:
- To check your overall health. A urinalysis might be part of a routine medical exam, pregnancy checkup or pre-surgery preparation. Or it might be used to screen for a variety of disorders, such as diabetes, kidney disease or liver disease, when you’re admitted to a hospital.
- To diagnose a medical condition. A urinalysis might be requested if you have abdominal pain, back pain, frequent or painful urination, blood in your urine, or other urinary problems. A urinalysis can help diagnose the cause of these signs and symptoms.
- To monitor a medical condition. If you’ve been diagnosed with a medical condition, such as kidney disease or a urinary tract infection, your doctor might recommend testing your urine regularly to monitor your condition and treatment.
Other tests, such as pregnancy testing and drug screenings, might rely on a urine sample, but these tests look for substances that aren’t included in a typical urinalysis.
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How you prepare
If you’re having only a urinalysis, you can eat and drink before the test. If you’re having other tests, you might need to fast before the test. Your health care provider will give you specific instructions.
Many drugs, including nonprescription medications and supplements, can affect the results of a urinalysis. Before a urinalysis, tell your doctor about medications, vitamins or other supplements you take.
What you can expect
You might collect a urine sample at home or at your health care provider’s office. Providers typically give out containers for urine samples. You might be asked to collect the sample at home first thing in the morning, when your urine is more concentrated.
You might be instructed to collect the sample midstream, using a clean-catch method. This method involves the following steps:
- Cleanse the urinary opening. Women should spread the labia and clean from front to back. Men should wipe the tip of the penis.
- Begin to urinate into the toilet.
- Pass the collection container into your urine stream.
- Urinate at least 1 to 2 ounces (30 to 60 milliliters) into the collection container.
- Finish urinating into the toilet.
- Deliver the sample as directed by your health care provider.
- If you can’t deliver the sample to the designated area within 60 minutes of collection, refrigerate the sample, unless your provider has told you otherwise.
In some cases, if needed, your provider can insert a thin, flexible tube (catheter) through the urinary tract opening and into the bladder to collect the urine sample.
The urine sample is sent to a lab for analysis. You can return to your usual activities immediately.
For a urinalysis, your urine sample is evaluated in three ways: visual exam, dipstick test and microscopic exam.
A lab technician examines the urine’s appearance. Urine is typically clear. Cloudiness or an unusual odor can indicate a problem, such as an infection. Protein in urine can make it appear foamy.
Blood in the urine can make it look red or brown. Urine color can be influenced by what you’ve just eaten or by certain drugs you’re taking. For example, beets or rhubarb might tint your urine red.
A dipstick — a thin, plastic stick with strips of chemicals on it — is placed in the urine. The chemical strips change color if certain substances are present or if their levels are above typical levels. A dipstick test checks for:
- Acidity (pH). The pH level indicates the amount of acid in urine. The pH level might indicate a kidney or urinary tract disorder.
- Concentration. A measure of concentration shows how concentrated the particles are in your urine. A higher than normal concentration often is a result of not drinking enough fluids.
- Protein. Low levels of protein in urine are typical. Small increases in protein in urine usually aren’t a cause for concern, but larger amounts might indicate a kidney problem.
- Sugar. The amount of sugar (glucose) in urine is typically too low to be detected. Any detection of sugar on this test usually calls for follow-up testing for diabetes.
- Ketones. As with sugar, any amount of ketones detected in your urine could be a sign of diabetes and requires follow-up testing.
- Bilirubin. Bilirubin is a product of red blood cell breakdown. Usually, bilirubin is carried in the blood and passes into your liver, where it’s removed and becomes part of bile. Bilirubin in your urine might indicate liver damage or disease.
- Evidence of infection. Either nitrites or leukocyte esterase — a product of white blood cells — in your urine might indicate a urinary tract infection.
- Blood. Blood in your urine requires additional testing. It may be a sign of kidney damage, infection, kidney or bladder stones, kidney or bladder cancer, or blood disorders.
Sometimes performed as part of a urinalysis, this test involves viewing drops of concentrated urine — urine that’s been spun in a machine — under a microscope. If any of the following levels are above average, you might need more tests:
- White blood cells (leukocytes) might be a sign of an infection.
- Red blood cells (erythrocytes) might be a sign of kidney disease, a blood disorder or another underlying medical condition, such as bladder cancer.
- Bacteria, yeast or parasites can indicate an infection.
- Casts — tube-shaped proteins — can be a result of kidney disorders.
- Crystals that form from chemicals in urine might be a sign of kidney stones.
A urinalysis alone usually doesn’t provide a definite diagnosis. Depending on the reason your provider recommended this test, you might need follow-up for unusual results. Evaluation of the urinalysis results with other tests can help your provider determine next steps.
Getting standard test results from a urinalysis doesn’t guarantee that you’re not ill. It might be too early to detect disease or your urine could be too diluted. Tell your provider if you still have signs and symptoms.
For specifics about what your urinalysis results mean, talk with your health care provider.
Oct. 14, 2021
Types, Results, Nitrites/Nitrates, pH, & More
What Is Urinalysis?
Urinalysis is a series of tests on your urine, or pee. Doctors use it to check for signs of common conditions or diseases. Other names for it are urine test, urine analysis, and UA.
Why Is Urinalysis Done?
You may have a urinalysis as part of a routine check of your overall health, like during your yearly physical. Urinalysis is one way to find certain illnesses in their earlier stages. They include:
Your doctor may want to test your urine if you’re getting ready to have surgery or are about to be admitted to the hospital. Urinalysis can be part of a pregnancy checkup, too.
If you have symptoms of a kidney or urinary tract problem, you may have the tests to help find out what the problem is.
You might also have this test regularly if you have a condition such as a kidney disease that needs to be watched over time.
How Does a Urinalysis Work?
There are three ways to analyze urine, and your test might use all of them.
One is a visual exam, which checks the color and clarity. If your pee has blood in it, it might be red or dark brown. Foam can be a sign of kidney disease, while cloudy urine may mean you have an infection.
A microscopic exam checks for things too small to be seen otherwise. Some of the things that shouldn’t be in your urine that a microscope can find include:
The third part of urinalysis is the dipstick test, which uses a thin plastic strip treated with chemicals. It’s dipped into your urine, and the chemicals on the stick react and change color if levels are above normal. Things the dipstick test can check for include:
- Acidity, or pH. If the acid is abnormal, you could have kidney stones, a urinary tract infection (UTI), or another condition.
- Protein. This can be a sign your kidneys aren’t working right. Kidneys filter waste products out of your blood.
- Glucose. A high sugar content is a marker for diabetes.
- White blood cells. These are a sign of infection or inflammation, either in the kidneys or anywhere else along your urinary tract.
- Nitrites. This means that there is an infection with certain kinds of bacteria.
- Bilirubin. If this waste product, which is normally eliminated by your liver, shows up, it may mean your liver isn’t working properly.
- Blood in your urine. Sometimes this is a sign of infections or certain illnesses.
How Do I Prepare for a Urinalysis?
If urinalysis is the only test you’re having, you should be able to eat and drink normally before the procedure. Beets and food dyes can discolor your urine, so you may want to watch what you eat beforehand.
Be sure to let your doctor know about all the medicines you take, including over-the-counter drugs, vitamins, and supplements. If you’re having your period, let the doctor know before the test.
You’ll either be asked to collect a urine sample at home and bring it with you, or you’ll make it at your doctor’s office. The office will give you a container for the sample.
The best results come from using what’s known as the “clean catch” method. Here are the steps:
- Wash the area around the urinary opening.
- Start to pee into the toilet.
- Stop midstream.
- Let 1-2 ounces flow into the container.
- Finish peeing in the toilet.
- Follow your doctor’s directions for handing over the sample.
For babies and other people unable to provide a sample this way, a doctor may have to insert a soft, narrow tube called a catheter through the urinary opening and into the bladder.
What Do the Urinalysis Results Mean?
A urinalysis is just one piece of information about what’s going on in your body. The test can show warning signs but can’t tell your doctor for sure that anything is wrong with you. The results may be a clue that you need more tests and follow-up. The next steps depend on why you had the test in the first place.
For example, if your results are only slightly abnormal and you don’t have any other symptoms of an illness, your doctor may not do other tests. If you already have a kidney issue or urinary tract infection, your doctor may want to change your treatment plan.
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds that pass through the urine.
Urine appearance and color; Routine urine test; Cystitis – urinalysis; Bladder infection – urinalysis; UTI – urinalysis; Urinary tract infection – urinalysis; Hematuria – urinalysis
How the Test is Performed
The sample is sent to a lab, where it is examined for the following:
PHYSICAL COLOR AND APPEARANCE
How the urine sample looks to the naked eye:
- Is it clear or cloudy?
- Is it pale, or dark yellow, or another color?
The urine sample is examined under a microscope to:
- Check if there are any cells, urine crystals, urinary casts, mucus, and other substances.
- Identify any bacteria or other germs.
CHEMICAL APPEARANCE (urine chemistry)
- Examples of specific urinalysis tests that may be done to check for problems include:
- Red blood cell urine test
- Glucose urine test
- Protein urine test
- Urine pH level test
- Ketones urine test
- Bilirubin urine test
- Urine specific gravity test
- Iron supplements
- As part of a routine medical exam to screen for early signs of disease
- If you have signs of diabetes or kidney disease, or to monitor you if you are being treated for these conditions
- To check for blood in the urine
- To diagnose a urinary tract infection
- Red blood cells
- White blood cells
- Urinary tract infection
- Kidney stones
- Poorly controlled diabetes
- Bladder or kidney cancer
Physical examination describes the volume, color, clarity, odor, and specific gravity.
Chemical examination identifies pH, red blood cells, white blood cells, proteins, glucose, urobilinogen, bilirubin, ketone bodies, leukocyte esterase, and nitrites.
Microscopic examination encompasses the detection of casts, cells, crystals, and microorganisms.
Light and Temperature: If exposed for a considerable period of time, bilirubin and urobilinogen may decompose due to their instability under these conditions. Additionally, room temperature favors the growth of microorganisms, such as bacteria.
Bacterial Growth: Contamination of the sample or pathogenic bacteria may produce a variety of inaccurate results. For example, they may produce a false-positive blood reaction and affect the specimen’s pH towards acidity or alkaline.
Alkaline pH: This concentration may show false-positive results regarding the presence of protein.
Glucose: If present in the sample, it may be metabolized by microorganisms and cause a decrease in the sample’s pH.
Contrast Agents: May produce false-positive results of specific gravity.
Exercise: May alter the specific gravity and electrolyte concentration of the sample.
Foods and Drugs: May alter the urine’s color, odor, or pH value. Examples include, but are not limited to, red beets, blackberries, rhubarb, food coloring (e.g., aniline), ibuprofen, chloroquine, metronidazole, deferoxamine, nitrofurantoin, phenytoin, rifampicin, phenolphthalein, phenothiazines, and imipenem/cilastatin.
- Preservatives: Although used occasionally, they can alter the accuracy of the results. Some examples include:
Thymol: May generate false-positive reactions for albumin.
Formaldehyde: May cause false-positive results for leukocyte esterase, peroxidase reaction, urobilinogen, and glucose if strips are used.
Hydrochloric Acid: Although used to preserve cell structures and determine steroid concentrations, it affects the sample’s pH.
Mercury Salts: May produce false-negative results for leukocyte esterase reaction.
- Boric Acid: While commonly used to preserve bacteria present in urine, this substance may reduce the sensitivity of the leukocyte reagent on dipsticks and alter initial pH values. Moreover, excessive concentrations may prevent bacterial growth in samples reserved for culture.
Not routinely reported
Cystine Decomposition: Sulfuric smell
Dehydration/Prolonged Room Temperature: Strong smell
Diabetes Mellitus: Honey
Diabetic Ketoacidosis: Fruity/sweet
Gastrointestinal-bladder Fistula: Fecal smell
Maple-syrup Urine Disease: “Burnt sugar. “
Prolonged Bladder Retention: Ammoniacal
Urinary Tract Infection: Pungent or fetid
- Medications and Diet: Onions, garlic, asparagus
Normal: USG = 1.002-1.035 (usually 1.016 to 1.022). O = 50-1200 mOsm/kg (usually 275-900 mOsm/kg) [Both parameters are lab dependent]
Variations according to the patient’s diet, health, hydration status, and physical activity.
High Values: Contrast media, dehydration, decreased renal blood flow (shock, heart failure, renal artery stenosis), diarrhea, emesis, excessive sweating, glycosuria, hepatic failure, syndrome of inappropriate antidiuretic hormone (SIADH)
Low Values: Acute tubular necrosis, acute adrenal insufficiency, aldosteronism, diuretic use, diabetes insipidus, excessive fluid intake (psychogenic polydipsia), impaired renal function, interstitial nephritis, hypercalcemia, hypokalaemia, pyelonephritis
False Elevation: Dextran solutions, intravenous (IV) radiopaque contrast media, proteinuria
Normal: 0. 5 to 1.5 cc/kg/hour or 600 and 2,000 mL daily in adults (typically 1,000– 1,600 mL/day)
Anuria (less than 100 cc/day) and oliguria (less than 500 cc/day): Severe dehydration from vomiting, diarrhea, hemorrhage or excessive sweating; renal disease, renal obstruction, renal ischemia secondary to heart failure or hypotension
- Polyuria (greater than 2,500 – 3,000 cc/day): Alcohol or caffeine consumption, diabetes mellitus, diabetes insipidus, diuretics, increased water intake, saline or glucose intravenous therapy
Albuminuria of 30 mg/day to 300 mg/day is an indicator of early renal disease, glomerular injury, and risk of progression of renal disease
Other Associations: Multiple myeloma, congestive heart failure, Fanconi syndrome, Wilson disease, pyelonephritis, and physiological conditions (strenuous exercise, fever, hypothermia, emotional distress, orthostatic proteinuria, and dehydration)
False-positive: Alkaline or concentrated urine, phenazopyridine, quaternary ammonia compounds
- False-negative: Acid or dilute urine, primary protein is not albumin
Dipstick test for blood detects primarily the peroxidase activity of erythrocytes, but myoglobin and hemoglobin can also catalyze this reaction. Thus, a positive test result indicates hematuria, myoglobinuria, or hemoglobinuria.
Normal: Negative (usually) or less than or equal to 5 RBCs per mL (lab-dependent value)
Hematuria: Renal calculi, glomerulonephritis, pyelonephritis, tumors, trauma, anticoagulants, strenuous exercise, exposure to toxic chemicals
Hemoglobinuria: Hemolytic anemias, RBC trauma, strenuous exercise, transfusion reactions, severe burns, infections (i.e., malaria)
Myoglobinuria: Muscle trauma eg, rhabdomyolysis, prolonged coma, convulsions, drug abuse, extensive exertion, alcoholism/overdose, muscle wasting diseases
False-positive: Dehydration, exercise, hemoglobinuria, menstrual blood, myoglobinuria
- False-negative: Captopril, elevated specific gravity, acid urine, proteinuria, vitamin C
Associations: Diabetes mellitus, Cushing syndrome, Fanconi syndrome, glucose infusion, pregnancy.
Glucosuria with normal plasma glucose without other features of Fanconi syndrome is due to a benign condition referred to as renal glycosuria and is due to a mutation in the sodium-glucose linked transporter 2
False-positive: Ketones, levodopa
- False-negative: Elevated specific gravity, uric acid, vitamin C
Normal: There is no bilirubin in normal urine
Associations: Liver dysfunction, biliary obstruction, congenital hyperbilirubinemia, viral or drug-induced hepatitis, cirrhosis
False-positive: medications such as phenazopyridine that have a similar color at the low pH of the reagent pad
- False-negative: stale/old urine specimens, chlorpromazine, selenium 
The degradation product of bilirubin metabolism from bacteria in the intestine
Normal: 0.1 mg/dL to 1 mg/dL in random samples or up to 4 mg/daily
Elevation: Hemolysis, liver disease (cirrhosis, hepatitis), sickle cell disease, thalassemia
Decrease: Antibiotic use, bile duct obstruction
False-positive: Elevated nitrite levels, phenazopyridine, porphobilinogen, sulfonamides, and aminosalicylic acid
- False-negative: Prolonged exposition to daylight, formaldehyde, high levels of nitrites
Products of body fat metabolism
Associations: Uncontrolled diabetes mellitus (diabetic ketoacidosis), pregnancy, carbohydrate-free diets, starvation, febrile illness.
False-positive: Acid urine, elevated specific gravity, mesna, phenolphthalein, some drug metabolites (e.g., levodopa, captopril)
False-negative: Stale/old urine specimens.
- Remember: Reagent strips do not detect beta-hydroxy-butyric acid, only acetoacetic acid and acetone
Products originating from the reduction of urinary nitrates
Associations: Urinary tract infection (UTI) from a nitrate reductase-positive bacteria (E. coli, Proteus, Enterobacter, Klebsiella, Streptococcus faecalis and Staphylococcus aureus)
False-positive: Contamination, exposure of dipstick to air, pigmented materials, phenazopyridine
False-negative: elevated specific gravity, elevated urobilinogen levels, nitrate reductase-negative bacteria, acid urine, vitamin C, urine with less than 4 hours of bladder resting, absent dietary nitrates
An enzyme present in certain WBCs (except lymphocytes)
Associations: Inflammation of the urinary tract, sterile pyuria (balanitis, urethritis, tuberculosis, bladder tumors, nephrolithiasis, foreign bodies, exercise, glomerulonephritis, corticosteroids, and cyclophosphamide), fever, glomerulonephritis, pelvic inflammation
False-positive: Contamination, highly pigmented urine, strong oxidizing agents, Trichomonas
- False-negative: Elevated specific gravity, glycosuria, ketonuria, proteinuria, some oxidizing drugs (cephalexin, nitrofurantoin, tetracycline, gentamicin), vitamin C
- Red Blood Cell Casts
- Associations: Glomerulonephritis, vasculitis, intrinsic renal disease (tubulointerstitial nephritis, acute tubular injury/necrosis), strenuous exercise (see image attached)
- White Blood Cell Casts
- Associations: Pyelonephritis, interstitial nephritis, glomerulonephritis, renal inflammatory processes (see image attached)
- Epithelial Cell Casts
- Associations: Acute tubular injury/necrosis, interstitial nephritis, glomerulonephritis, eclampsia, nephritic syndrome, transplant rejection, heavy metal ingestion, renal disease
- Granular Casts
- Associations: Glomerular or tubular disease, pyelonephritis, advanced renal disease, viral infections, stress/exercise, non-specific
- Waxy (broad) Casts
- Associations: Advanced renal failure (dilated tubules with decreased flow)
- Fatty Casts
- Associations: Heavy proteinuria (nephrotic syndrome), renal disease, hypothyroidism, acute tubular necrosis, diabetes mellitus, severe crush injuries
- Associations: Interstitial nephritis, acute tubular necrosis, UTI, kidney transplant rejection, hepatorenal syndrome
- Epithelial cell
Squamous, transitional, or renal tubular cells
Type of cell encountered depends on the location of the disease process
Normal: Less than or equal to 15-20 squamous epithelial cells/high-power field
Squamous (most common): Contamination
Transitional: Normal, UTI
- Renal Tubular: Heavy metal poisoning, drug-induced toxicity, viral infections, pyelonephritis, malignancy, acute tubular necrosis
- Bacteria, Fungi, or Parasites
- Calcium Oxalate
Most commonly encountered crystal in human urine
Refractile square “envelope” shape
- Associations: Ethylene glycol poisoning, acid urine, hyperoxaluria, normal (see image attached)
- Amorphous Phosphate (Calcium and magnesium Phosphate)
- Associations: Alkaline urine, decreased urine volume, a diet rich in calcium, prolonged immobilization, overactive parathyroid glands, bone metastases, normal
- Triple Phosphate (Struvite)
- Associations: Antibiotics containing sulfa
Chemical tests to detect and measure the level of various substances in the urine
Often, examining urine under a microscope
- Kidney infection or disease
- Urinary tract infection (UTI)
- Enlarged prostate (men only)
- Kidney or bladder stones
- Certain diseases (like sickle cell anemia and cystic kidney disease)
- Injury to the kidneys
- Urinalysis. Urine is tested for various cells and chemicals, such as red and white blood cells, germs, or too much protein.
- Blood tests. Blood is checked for high levels of waste products.
- Intravenous pyelogram (IVP). A series of X-rays of the kidney, ureters (the tubes connecting the kidneys and bladder), and bladder is done after a contrast dye is injected into a vein. This is done to look for tumors, kidney stones, or any blockages, and to check blood flow in the kidneys.
- Ultrasound. An imaging test that uses high-frequency sound waves to make images of the organs of the urinary tract on a computer screen.
- Cystoscopy. A thin, flexible tube and viewing device, is put in through the urethra to examine the parts of the urinary tract for structure changes or blockages, such as tumors or stones.
- Blood in the urine means there are red blood cells (RBCs) in the urine. Often, the urine looks normal. But when checked under a microscope, it contains a high number of red blood cells. In some cases, the urine is pink, red, or the color of tea, which can be seen without the use of a microscope.
- Most of the causes of blood in the urine are not serious. For example, in some cases, strenuous exercise will cause blood in the urine.
- Some more serious causes of blood in the urine are cancer, infection, enlarged prostate (men only), kidney or bladder stones, and certain diseases (like sickle cell anemia and cystic kidney disease).
- Blood in the urine can often be diagnosed with urine tests. If these are not clear, imaging tests may be needed to look at the urinary tract.
- Treatment depends on the cause of the blood in the urine.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
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How to Prepare for the Test
Certain medicines change the color of urine, but this is not a sign of disease. Your provider may tell you to stop taking any medicines that can affect test results.
Medicines that can change your urine color include:
How the Test will Feel
Why the Test is Performed
A urinalysis may be done:
Normal urine varies in color from almost colorless to dark yellow. Some foods, such as beets and blackberries, may turn urine red.
Usually, glucose, ketones, protein, and bilirubin are not detectable in urine. The following are not normally found in urine:
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
Abnormal results may mean you have an illness, such as:
Your provider can discuss the results with you.
There are no risks with this test.
If a home test is used, the person reading the results must be able to tell the difference between colors, because the results are interpreted using a color chart.
Chernecky CC, Berger BJ. Urinalysis (UA) – urine. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:1146-1148.
Riley RS, McPherson RA. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 28.
Urinalysis – StatPearls – NCBI Bookshelf
Around 6,000 years ago, laboratory medicine began with the analysis of human urine as uroscopy, which later became termed urinalysis. The word “uroscopy” derives from two Greek words: “ouron,” which means urine and “skopeoa,” which means to ‘behold, contemplate, examine, inspect’. Ancient physicians spoke of urine as a window to the body’s inner workings and reflected different diseases. For instance, Hindu civilizations recognized a “sweetness” in certain people’s urine, which attracted black ants. Hippocrates (460–355 BC) hypothesized that urine was a filtrate of the humors in the body, originating from the blood filtered through the kidneys. In Aphorisms, he described bubbles on the surface of fresh urine as a sign of long-term kidney disease and associated urinary sediment with fever. Galen used the phrase “diarrhea of the urine” to describe excessive urination. Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively on urine called “De Urinis”, determined heating urine would precipitate proteins, documenting proteinuria as a disease state. Ismail of Jurjani, an eleventh-century physician, acknowledged food and aging altered urine composition and was the first to propose 24 hours urine collection.
By the late 12th-century, a French scholar named Gilles de Corbeil taught and classified 20 different types of urine, recording differences in urine sediment and color. De Corbeil also introduced the “matula,” a glass vessel in which a physician could assess color, consistency, and clarity. In 1630, Nicolas Fabricius de Peiresc, a French astronomer and naturalist, did the first microscopic description of urine crystals as “a heap of rhomboidal bricks. ”  Posteriorly, in the early-mid 1800s, Richard Bright, an English physician, pioneered the field of kidney research leading him to be ultimately recognized as the “father of nephrology.” These few examples illustrate how urinalysis was the first laboratory test developed in the history of medicine, how it has been persistently used for several thousand years, and how it continues to be a formidable and cost-effective tool to obtain crucial information for diagnostic purposes.
Specimen Requirements and Procedure
Urine is an unstable fluid; it changes composition as soon as it is eliminated through micturition. Accurate collection, storage, and handling are crucial to maintaining the sample’s integrity.
Urine samples collected from the first void or “morning urine” are considered the best representative for testing. The urine accumulated overnight in the bladder is more concentrated, thus provides an insight into the kidneys’ concentrating capacities and allows for the detection of trace amounts of substances that may not be present in more diluted samples.  However, other types of urine specimens may be ordered according to specific purposes (randomly, 2-hours postprandial, 24-hour collection). Furthermore, urine should be ideally examined within the first hour after the collection due to the instability of some urinary components (cells, casts, and crystals). If not possible, the sample should be refrigerated at 4 degrees C for up to 24 hours, which will slow down the decomposition process. Any specimen older than 24 hours cannot be used for urinalysis.
There are two methods to obtain a urine specimen: non-invasive and invasive techniques. Spontaneous voiding is the main non-invasive technique, although other strategies may be used in children who cannot yet control their voiding (i.e., bag urine). In contrast, urethral catheterization and suprapubic bladder puncture are the two invasive procedures described to date. The fundamental principle of either technique is to obtain a specimen without external contamination.
Spontaneous voiding is the simplest and most commonly used method in clinical practice. Before collecting the sample, health personnel should be provided clear instructions to patients in order to minimize the chance of contamination from penile/vaginal microbiota (“clean-catch” method). Most urine collection kits include a sterile container with a lid and sterile moist towels to wipe the urethral area before collection; if not, cotton wool or toilet tissue and/or tap water with soap may be used. Traditionally, male patients are instructed to retract the foreskin and clean the glans of the penis before urinating. Consequently, females should clean the labia and urethral meatus as well before collection. Currently, it is under debate the need for these standard precautions, and even many areas no longer perform them.
Subsequently, the patient should first void a small amount of urine into the toilet and afterward position the container mid-stream in the flow of urine. Approximately, only 15 mL to 30 mL of urine is sufficient for accurate analysis, so, in most cases, patients should be advised not to fill the containers to their full capacity. Finally, the container is closed with careful precautions not to contaminate its lid or rim, and the patient may finish urinating in the toilet, bedpan, etc. The sample must be labeled before or immediately following collection, and it should not be on the lid.
Invasive urine collection is warranted when patients cannot cooperate, have urinary incontinence or external urethral ulceration that increases contamination risk. Both of these techniques pose a risk for the inoculation of pathogens, thus causing urinary tract infections.
Urethral catheterization involves a small French urinary catheter passed through the urethral meatus after the previous cleansing with proper equipment. Depending on the catheter, personnel may or may not need a sterile syringe. In cases where patients already have a urinary catheter placed, the specimen should never be taken from the catheter bag as it is considered contaminated.
Suprapubic needle aspiration of the bladder is both the most invasive and uncomfortable procedure of all previously mentioned and may generate false-positive results (protein, red and white cells) as a consequence of blood contamination. They are generally reserved for situations where samples may not be obtained or are persistently contaminated through previous methods, which usually occurs in small children. The main advantage is that, by bypassing the urethra, it minimizes the risk of obtaining a contaminated sample.
Before the procedure, trained personnel must identify the bladder by examination. If not distinguished, it is recommended to hydrate the patient and wait until correct identification or use ultrasound guidance if available. After proper cleaning with an antiseptic solution and anesthetizing the skin located approximately 5 cm above the pubic symphysis, a small needle (i. e., 22-gauge spinal needle x 10 cm in adults) is inserted approximately at 60 degrees at the point identified previously. The needle is directed slightly caudal or cephalic in adults or children, respectively, according to the anatomic location. Usually, the needle will enter the abdominal bladder after advancing it approximately 5 cm in adults. Finally, attempt to aspirate using a sterile syringe. If a sample is not obtained, advance the needle applying continuous suction on the syringe. If unsuccessful after an additional 5 cm in adults, withdraw the needle and repeat the procedure. If unsuccessful, personnel should seek help from a specialist or use ultrasound guidance if not previously done.
A complete urinalysis consists of three components or examinations: physical, chemical, and microscopical.
The following factors may alter the results of a urine sample analysis:
Results, Reporting, Critical Findings
Only in a few instances, the color, odor, and/or appearance are of clinical significance; nonetheless, any abnormal finding should be noted.
Specific Gravity (USG)/Osmolality (O)
The urinary specific gravity (USG) and osmolality are of special importance because they indicate the kidney’s capacity to dilute or concentrate urine. USG is defined as the ratio between the density of urine and the density of an equal volume of pure distilled water. Normal values are lab-dependent since there are multiple methods to calculate this parameter (hydrometer, dipstick reagent pad, refractometer, and harmonic oscillation or urinometry). As it depends primarily on mass, it is not a truly reliable measure for quantifying the exact number of solute particles. Thus, USG is commonly used to rapidly estimate screen urine concentration, employing the term hyposthenuric and hypersthenuric depending on whether the USG is diminished, or elevated. Isosthenuria connotes urine with a fixed specific gravity and portends renal disease. Conversely, osmolality is a measure of the sum of all dissolved particles in urine. It is more reliable and accurate than USG for evaluating kidney function. Urine osmolality ranges from 50-1200 mOsmol/kg; the key is to always compare to serum osmolality to establish a pathological condition. Both parameters directly correlate; for example, a USG of 1.010 approximates to a urine osmolality of 300 mOsm/kg.
Urine pH is a vital piece of information and provides insight into tubular function. Normally, urine is slightly acidic because of metabolic activity. A urinary pH greater than 5.5 in the presence of systemic acidemia (serum pH less than 7.35) suggests renal dysfunction related to an inability to excrete hydrogen ions. On the contrary, the most common cause of alkaline urine is a stale urine sample due to the growth of bacteria and the breakdown of urea releasing ammonia. Determination of urinary pH is helpful for the diagnosis and management of urinary tract infections and crystals/calculi formation.
Proteinuria is another critical finding. In normal conditions, the glomerular capillary wall is permeable to molecules of less than 20,000 Daltons. Most of the small fraction of filtered proteins are reabsorbed and metabolized by the proximal tubule cells. Thus, proteins are normally present in urine in trace amounts. From the total urinary proteins, approximately one-third of the total is albumin, another third is a protein secreted by the tubular cells called Tamm–Horsfall glycoprotein, and the rest is made up of plasma proteins such as globulins. Proteinuria can be classified into a transient or persistent, with the first one typically been a benign condition (i.e., orthostatic proteinuria due to prolonged standing). For the latter, persistent proteinuria can my categorized as a glomerular pattern, a tubular pattern, and an overflow pattern. The first occurs when proteins that are not normally filtered (i.e., albumin, transferrin) pass by a damaged glomerular capillary wall. Thus, this pattern may be seen with low serum albumin, secondary generalized edema, and high serum lipids as in nephrotic syndrome. Usually, protein excretion is greater than 3.0 g/day to 3.5 g/day. The tubular pattern results from the tubular cells’ inability to reabsorb filtered proteins. Consequently, small serum proteins are typically seen in the microscopic examination, and proteinuria is not relatively high (approximately 1 g/day to 2 g/day). Finally, overflow proteinuria occurs when excessive concentrations of small proteins in plasma are filtered, and tubular cells reabsorption’s capacity is surpassed, which occurs in conditions such as rhabdomyolysis (myoglobin) and multiple myeloma (Bence Jones light chains). This phenomenon harms tubular cells, and they may be seen on microscopic examination. Qualitative assessment of minimal amounts of proteinuria serves as a marker for glomerular injury and risk of progression of renal disease. Normal albumin excretion is less than or equal to 29 mg/g creatinine. It is best to express albuminuria per gram of creatinine. According to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines, albuminuria can be classified into three stages: A1 (less than 30 mg/g creatinine; normal to mildly increased), A2 (30 mg/g to 300 mg/g creatinine; moderately increased, formerly termed as “microalbuminuria”), and A3 (greater than 300 mg/g creatinine; severely increased).
Normal: Proteinuria less than or equal to 150 mg/day (typically albuminuria less than 30 mg/day) or 10 mg/dL
Glycosuria occurs when the filtered load of glucose exceeds the tubular cells’ ability to reabsorb it, which normally happens at a glucose serum concentration of around 180 mg per dL. Furthermore, nitrites are not normally found in urine, and it is highly specific for urinary tract infection. However, due to its low sensitivity, a negative result does not rule out infection.
Casts are a coagulum composed of the trapped contents of tubule lumen and Tamm-Horsfall mucoprotein. They originate in the lumen the distal convoluted tubule or collecting duct with pH alterations or long periods of urinary concentration or stasis. The casts preserve the cylindrical shape of the tubule in which they were formed. Only a few hyaline or finely granular casts may be seen under normal physiological conditions. Cellular casts can dissolve within 30 to 10 minutes depending on the pH of the urine sample, thus promptly testing is mandatory for appropriate testing.
End products of metabolism are found highly concentrated in the urine and can precipitate in the form of crystals. The presence of crystals is not necessarily associated with pathological states, although several types of crystals are associated with certain diseases. For example, cholesterol crystals are seen in polycystic renal disease and nephrotic syndrome and polycystic renal disease; leucine and tyrosine crystals are associated with severe liver disease.
Urinalysis is an ancient diagnostic screening test that has stood the test of time and is still useful in clinical laboratories since it plays a critical role in the health assessment process. For some, a urinalysis is considered as the most common, simple, and relevant screening exam that provides clinicians with valuable information about the general health status of a patient, including hydration, urinary tract infection, diabetes mellitus, and liver or renal disease.
Quality control and Lab Safety
Multiple reagent strips and tablets are used for several semiquantitative and qualitative tests, which allow the analysis of diverse parameters such as glucose, albumin, specific gravity, hydrogen ions, electrolytes, leukocytes, leukocyte esterase, nitrite, ketones, blood, bilirubin, urobilinogen, and heme. Most reagent strips are narrow bands of plastic 4 mm to 6 mm wide and 11 cm to 12 cm long with a series of absorbent pads. Each pad contains reagents for different reactions, so various tests can be carried out simultaneously. The reagent strip method comprises multiple complex chemical reactions. A color change on the pad demonstrates a reaction which can be compared to a color chart provided by the manufacturer for result interpretation. When using this method, it is essential to test the urine promptly, understand the advantages and limitations of each test, and establish controls.
Reagent strips are designed to react progressively, modifying color for positive reactions along the strip at specific periods. The fundamental principle corresponds to read the strip at the specified time from the manufacturer to obtain accurate results. These times are established on the label of the bottle containing the particular strip. Furthermore, the reagent trips should never be stored in alternative containers because they have a relatively short shelf life. Expired strips may produce inaccurate results, the expiration date is also located on the bottle.
Additionally, some computerized urine analyzers are available for reading reagent strips. They show the analysis on a small screen and print them out to include in the patient’s records. These analyzers comprise greater accuracy, convenience, simplicity, and time savings. However, they may not be able at many facilities due to financial limits.
Enhancing Healthcare Team Outcomes
A urinalysis is a valuable test commonly used in clinical practice. Depending on the technique and hospital, most samples are usually collected by nurses or phlebotomists who must determine whether or not the specimen meets the minimum requirements for proper analysis. They should be familiar with each method of collection and educate patients for appropriate sampling in the outpatient setting. In addition, as many conditions may alter the sample analysis (food, drugs, exercise, intercourse, room temperature, daylight, etc.), adequate recording and communication between the interprofessional team ensure discarding possible false-positive or false-negative results. Accurate collections provide key information for screening multiple systemic diseases and monitor treatment progress.
Finally, careful consideration of current guidelines must be done at all times. For example, the American Academy of Pediatrics no longer recommends performing routine screening urinalysis for asymptomatic children and adolescents. However, in adults, it is an excellent cost-effective screening test in primary care to screen for certain diseases.
Triple Phosphate Crystals, Urine. Contributed by RWTH Aachen (CC by 2.0) https://creativecommons.org/licenses/by/2.0/
Uric acid Crystals in Urine. Contributed by Iqbal Osman (CC by 2.0) https://creativecommons.org/licenses/by/2.0/
Red cell cast. Contributed by Bharat Sachdeva MD
White Blood Cell Cast. Contributed by Bharat Sachdeva MD
Urinalysis and Urine Culture – Kidney and Urinary Tract Disorders
Chemical tests look for protein, glucose (sugar), ketones, blood, and other substances. These tests use a thin strip of plastic (dipstick) impregnated with chemicals that react with substances in the urine and quickly change color. Sometimes the test results are confirmed with more sophisticated and accurate laboratory analysis of the urine.
Examining the urine under a microscope may be done to check for the presence of red and white blood cells, crystals, and casts (impressions of the kidney tubules created when urinary cells, protein, or both precipitate out in the tubules and are passed in the urine).
Protein in the urine (proteinuria) can usually be detected by dipstick when present in large amounts. Protein may appear constantly or only intermittently in the urine, depending on the cause. Proteinuria may occur normally after strenuous exercise, such as marathon running, but is usually a sign of a kidney disorder. Small amounts of protein in the urine may be an early sign of kidney damage due to diabetes. Such small amounts may not be detected by dipstick. In these cases, urine will need to be collected over a period of 12 or 24 hours and tested by a laboratory.
Ketones in the urine (ketonuria) can often be detected by dipstick. Ketones are formed when the body breaks down fat. Ketones can appear in the urine as a result of starvation or uncontrolled diabetes mellitus and occasionally after drinking significant amounts of alcohol.
Blood in the urine (hematuria) is detectable by dipstick and confirmed by viewing the urine with a microscope and other tests. Sometimes the urine contains enough blood to be visible, making the urine appear red or brown.
Leukocyte esterase (an enzyme found in certain white blood cells) in the urine can be detected by dipstick. Leukocyte esterase is a sign of inflammation, which is most commonly caused by a urinary tract infection.
The acidity (pH) of urine is measured by dipstick. Certain foods, chemical imbalances, and metabolic disorders may change the acidity of urine. Sometimes a change in acidity can predispose the person to kidney stones.
The concentration of urine (also called the osmolality, roughly indicated by specific gravity) can vary widely depending on whether a person is dehydrated, how much fluid a person has drunk, and other factors. Urine concentration is also sometimes important in diagnosing abnormal kidney function. The kidneys lose their capacity to concentrate urine at an early stage of a disorder that leads to kidney failure. In one special test, a person drinks no water or other fluids for 12 to 14 hours. In another test, a person receives an injection of vasopressin (also called antidiuretic hormone). Afterward, urine concentration is measured. Normally, either test should make the urine highly concentrated. However, in certain kidney disorders (such as nephrogenic diabetes insipidus Nephrogenic Diabetes Insipidus In nephrogenic diabetes insipidus, the kidneys produce a large volume of dilute urine because the kidney tubules fail to respond to vasopressin (antidiuretic hormone) and are unable to reabsorb… read more ), the urine cannot be concentrated even though other kidney functions are normal.
Sediment in urine can be examined under a microscope to provide information about a possible kidney or urinary tract disorder. Normally, urine contains a small number of cells and other debris shed from the inside of the urinary tract. A person who has a kidney or urinary tract disorder usually sheds more cells, which form a sediment if urine is spun in a centrifuge (a laboratory instrument that uses centrifugal force to separate components of a liquid) or allowed to settle.
Hematuria (Blood in the Urine)
What is blood in the urine?
Blood in the urine means there are red blood cells (RBCs) in the urine. Often, the urine looks normal to the naked eye. But when checked under a microscope, it contains a high number of red blood cells. In some cases, the urine is pink, red, or the color of tea, which you can see without a microscope.
What causes blood in the urine?
Most of the causes of blood in the urine are not serious. For example, heavy exercise may cause blood in the urine, which often goes away in a day.
Other, more serious causes include:
Some medications cause blood in the urine. And many people have it without having any other related problems.
What are the symptoms of blood in the urine?
There not be enough blood in the urine to change the color, but in severe cases, the urine may look pink, red, or tea colored.
How is blood in the urine diagnosed?
Your doctor will review your medical history and do a physical exam. Other tests may include:
If these tests aren’t clear you may need other tests, such as:
How is blood in the urine treated?
If you have blood in your urine that lasts more than a day, see a health care provider, especially if you have unexplained weight loss, discomfort with urination, frequent urination, or urgent urination.
Treatment will depend on the cause of the blood in the urine.
Key points about blood in urine
Tips to help you get the most from a visit to your health care provider:
Abbreviations in medical prescriptions
What is eHealth • Registration and entry into eHealth- EMCI
EMCI “ What is eHealth and how to connect to the system
The introduction of the eHealth system – eHealth began simultaneously with the start of medical reform in Ukraine.The key task is to bring the standards of providing medical care closer to the European level and provide citizens with access to quality medical services. What is eHealth and how to work with the system – further in the material.
What is eHealth
In a general sense, eHealth is a collection of information services for doctors, patients and government agencies of the health care system, designed to organize all medical information.
For medical institutions – these are automated workflow management tools – medical information systems.
For patients – convenient web services and mobile applications for remote appointment with a doctor, access to their own medical information and online consultations.
For the state, the eHealth system is a source of data on the performance of the entire health care system, which is the basis for making strategic management decisions. Here, the main task of eHealth is to provide the necessary tools for managing and monitoring the use of medical and financial resources of the state, creating conditions for transparent market competition in the field of medical services.
In general, eHealth is what unites different healthcare industries into a single information space:
eHealth in Ukraine: structure of the
Ukraine has chosen a two-tier e-health system model for itself. Its essence lies in the fact that the eHealth system structurally consists of central and peripheral levels, which ideally should develop synchronously.
The central component of the eHealth system is the central database of the public eHealth system, which stores data in a central repository. This data is available to the Ministry of Health, NHSU and the health care providers connected to the system. Information in eHealth comes from the peripheral level of the system – medical institutions that transmit data through medical information systems (MIS).
MIS for a medical institution is a tool designed not only for transferring data to the eHealth CDB, but also for solving local issues of managing a medical institution.
Connect and log into eHealth
All medical institutions that have concluded contracts with the NHSU under the medical guarantees program are required to send data to the central component of the e-health system as of 2020. To do this, the MISs used by these medical institutions must be connected to eHealth. The decision to connect the MIS is made by the SE “Electronic Health”: after testing the functionality for compliance with technical regulations.
The functionality of MIS Health 24 and EMCImed for primary and specialized medical care has been successfully tested and is connected to the eHealth CDB.
In particular, users have access to such functionality for working with the electronic health care system:
For specialized care
Who can log on to eHealth?
Login to the eHealth system is available only for registered users – employees of medical and pharmaceutical institutions, as well as the National Health Service of Ukraine.
How do I get an eHealth authorization code?
The e-Health program has multilevel protection. Therefore, when logging in, users must go through two-factor authorization:
- Through the MIS
- Directly at the entrance to eHealth via OAuth. 2
installed in the medical institution
The user receives the authorization code to enter the eHealth system in an SMS message, after which he must also enter his key.
This ensures the differentiation of access rights to data and the list of operations that can be performed by a specific user.It also provides for a mandatory periodic update of the password for access to the system.
20 useful applications for doctors and patients – Blog Imena.UA
The current information age has influenced not only medicine, but also changed the patient. Now we don’t have enough consultation and subsequent prescription. We want to know exactly who, how and for what is treating us. We want to receive advice from highly qualified specialists, buy drugs from trusted manufacturers, have access to adapted literature and keep abreast of the latest news related to the medical field.
Health care workers, in turn, want to get easy and quick access to a variety of thematic resources and to be able to communicate with the patient virtually. Informed means armed. We have collected the best, in our opinion, medical applications that can satisfy the needs of both patients and doctors.
Available for: Android, iOS, Windows Phone
Price: 6 Free
One of the most informative resources for both physicians and non-specialists.Medscape is something like the universal medical reference book , which includes original articles on various topics, news from the world of medicine, annotations to drugs, tests for their compatibility, etc. The app is completely free, but you need to register an account (also free).
Thanks to a convenient and simple interface, an excellent search option and a database that covers a huge number of monographs, clinical images, video tutorials on research and manipulation, more than 7 thousand items.drug reviews, drug instructions, Medscape has received recognition from many medical practitioners around the world .
Available for: Android, iOS
Price: 6 Free (Essentials $ 159.99 / year, Epocrates Plus $ 174.99 $ / year)
This is the gold standard for medical applications. The popularity and reliability of Epocrates can be seen by looking at the following figures: more than a million practicing doctors from all over the world use this application in their work, every second doctor from the USA trusts Epocrates .Doctors use this app to find out information about drugs and their interactions , find new suppliers and quickly calculate values such as BMI (body mass index).
Most of the content in the app is free, but if you want to access additional information (laboratory guidelines, alternative medicines, and disease information), an in-app purchase is required at the price listed above.
Read by QxMD
Available for: Android, iOS
Price: 6 Free (paid subscription)
The app that organizes all your medical literature. Using a journal format, the program allows you to read and download studies, journals and articles from a wide variety of sources (open access journals, Pubmed and documents from related institutions). With open access to a huge amount of free content, doctors can easily find the latest news in their specialty and organize all the available data.Read is free, but some magazines and Pubmed may require an institutional or individual subscription.
Available for: Android, iOS, Windows Phone
Price: paid (from $ 499 / year and above)
Another major player in the medical applications market. It is not for nothing that hundreds of thousands of doctors around the world have installed this application and were satisfied with its work. UpToDate is replete with medical knowledge to answer most of the questions.The UpToDate download itself is free, but in order to access the information stored in it, you or your organization need to have a subscription to the database. The price of the latter starts at $ 499 / year.
Available for: Android, iOS, Windows Phone
Price: Free (full version from $ 3.99)
Applications with which you can monitor the progress of pregnancy are in the greatest demand among users of medical services.There are enough similar applications on iTunes or Google Play, from which it is difficult to choose something worthwhile. Today Pregnancy + is one of the best of its kind. With this handy, simple and beautifully crafted tool, expectant mothers (and the rest of their family) can keep a pregnancy journal, upload ultrasound scans, track symptoms, log doctor visits, receive nutritional advice, and more. Also, this application will help with choosing a name.
Available for: Android, iOS
Price: 91,236 Free
The largest social network for doctors in the United States (about 40% of medical professionals use this application).Through a mobile and web platform, physicians can use Doximity’s functionality to securely share HIPAA data, send faxes, read personalized healthcare news, and organize careers and jobs. It should be noted that Doximity is intended exclusively for healthcare professionals. The app is free to download but requires online registration (also free).
Available for: Android, iOS
Price: formally free (monthly subscription – 10.99 $, annual subscription -119.9 $)
Diagnostic assistant application. With the help of this application (with confirmed research results, peer-reviewed in dozens of specialized publications) the practitioner has the opportunity to double-check the diagnosis. The Isabel database contains over 6,000 reports of diseases and symptoms, and also provides the ability to disaggregate results by age, patient gender, etc. Online access is required to use the application. Isabel is free, but you need to purchase a paid subscription to use all the features.
Calculate by QxMD
Available for: Android, iOS, Windows Phone
Price: 6 Free
Calculate from the creators of Read (discussed above) is a handy healthcare tool designed specifically for doctors. It is especially useful for doctors practicing in cardiology, oncology, obstetrics. Calculate transforms the authoritative scientific medical research into practical tools for diagnosis, drug dosage, treatment management, and more.d.
Virtual Practice for Doctors
Available for: Android, iOS , web version
You can upgrade to a premium version that offers additional functionality: Patient Portal and Personal Domain. However, the regular free version also allows you to keep in touch with the patient outside of work. Contact means video chat, remote patient monitoring and the ability to answer text questions from patients.
NEJM This Week
Available for: iOS
Price: 6 Free
The app from the trusted New England Journal of Medicine offers access to the most recent articles , allows you to view images of various medical pathologies, listen to and view audio and video reviews of articles.
Available: Android, iOS
Price: 6 Free
One of Health eVillages’ tools for regions of the planet lacking regular care.This app is suitable for doctors, nurses, medical students and other healthcare professionals. Skyscape is a universal reference book , in which you can find any information related to medical topics, from an anatomical atlas to practical recommendations for the management of patients with a specific disease. Also in Skyscape there is a well-known pharmacological reference book RxDrugs , a huge number of monographs and built-in calculators.There is additional paid content.
Figure 1 – Medical Images
Available: Android, iOS
Price: 6 Free
View and share medical images with other professionals using this free application. Hundreds of thousands of users submit, comment and search medical images through the visual database Figure 1. This application is suitable for those doctors who want to get feedback from colleagues regarding a rare case in their practice or are looking for such cases to study.The application ensures patient privacy through automatic face blocking and elimination of identifying information.
Available: Android, iOS
Price: 6 Free
Popular medical resource similar to Calculate, Medscape and Epocrates in terms of functionality. Additionally offers an easy-to-use library where healthcare professionals can search and save important materials.Omnio users also get free access to Merck Manual , one of the best-selling medical textbooks in the world.
Available: Android, iOS
Price: 6 Free
Application for individual patient use. MyChart creates direct communication between patients and healthcare professionals. Users have the ability to check test results, track therapy and vaccinations, pay medical bills, monitor appointments, and download medicine and health data from other apps.
Available: Android, iOS
Price: 6 Free
Brings a solid and extensive medical database to your mobile device. DynaMed subscribers ($ 395 / yr for PCP) get full functionality of the solution support tool on mobile devices. Includes medical resources, health care point information, reviews of over 3,400 diverse, constantly updated topics.The DynaMed team is keenly aware of the news from the world of medicine and immediately adds them to the application database.
Available: Android, iOS
Price: 6 Free
A tool for patients and doctors that helps to find prescribed drugs at the lowest cost. In addition to the comparative description of prices, the application has an electronic discount card valid for more than 60 thousand rubles.pharmacies.
Price: 6 Free (premium version available)
With this application you can create your own electronic medical record. In the GooPatient database, you can enter: age, vaccinations, allergies to certain drugs, past illnesses and surgical interventions, discharges, courses of treatment, etc. GooPatient allows you to store digitized test results (MRI, ultrasound), copies of insurance, prescriptions, etc.e. The paid version allows you to register an account for several family members.
Price: paid ($ 3.99)
This application was developed by members of the American College of Cardiology, for whose students it is, by the way, free. CardioSmart is designed specifically for tablets and the is a great tool for discussing cardiovascular health with patients. The doctor will be able to visually demonstrate to the patient what exactly happens to the heart muscle during myocardial infarction or describe the process of coronary angiography. In view of the fact that mortality from CVD continues to be extremely high, it is very important to convey the necessary information to the patient on time.
ICE: In Case of Emergency
Price: paid ($ 2.55)
Created in order to save the user’s life – the application can store information necessary in an emergency: blood type, allergy to medications, chronic diseases, medications taken, surgical interventions in the past, etc.e. You can also create a list of “emergency” contacts of relatives or attending physician. The application creates a widget on the lock screen that allows access to all of the above information without having to enter the PIN .
It is important to remember that all medical applications designed for both doctors and patients are just a tool to improve and speed up the treatment process, search for drugs, or familiarize themselves with the information you need. Therefore, you should never neglect an in-person consultation with a specialist.
what is it, where does it come from, how is
Possibilities for detecting Helicobacter pylori infection by gastroscopy:
Standard gastroscopy must necessarily include the determination of Helicobacter Pylori infection in the stomach – urease test. Without this analysis, your treatment may not be possible. In addition, it is very important to conduct a urease test using high-quality reagents, in full compliance with the methodology.Good clinics, as a rule, buy ready-made standard kits from European manufacturers.
When conducting a study of the stomach, one of the most common Helicobacter additional tests is to determine the presence of the bacteria Helicobacter pylori (Helicobacter pylori) in the stomach. According to the first letters of the Latin name of this bacterium, the test for it is often called the HP test. The name “urease test” is also used. This name comes from the ability of Helicobacter to secrete the enzyme urease.During the test, this enzyme breaks down urea and, as a result of a change in the acidity of the medium, the color of the test changes to bright red.
The value of Helicobacter is hard to overestimate. This bacterium was discovered back in the 80s by Australian scientists, in 2005 for this discovery they received the Nobel Prize, and therefore universal final recognition.
At the moment, it has been proven that Helicobacter is the main cause of gastritis, gastric ulcer and duodenal ulcer, stomach cancer.The important role of Helicobacter pylori infection in the occurrence of pancreatitis and cholecystitis is also recognized.
When carrying out an endoscopic examination (gastroscopy) to carry out a urease test in the stomach from the antrum and the body of the stomach, it is necessary to take 2 fragments of the mucous membrane from the antrum and the body of the stomach and place them in a special reagent. By changing the color, a conclusion is made about the presence (the color turns red – the test is positive) or the absence of Helicobacter pylori infection (the color has not changed – the test is negative).
The fact that pieces of mucous membrane are taken with biopsy forceps and they come into contact with blood (the possibility of contracting hepatitis, HIV) must be taken into account by the patient when choosing a medical institution for gastroscopy with a urease test. Forceps should be in sufficient quantity and sterilized after each patient with quality disinfectants. In addition, with poor-quality processing, particles of the mucous membrane with Helicobacter can be transferred from one patient to another.
The accuracy of determining Helicobacter pylori infection is strongly influenced by the intake of antibiotics, acid-lowering drugs (omez, pariet, nexium, ranitidine, famotidine), bismuth preparations (DE-NOL). It is recommended not to take them for at least 2 weeks before gastroscopy.
In addition, during gastroscopy with local anesthesia, it is often possible to take 1 fragment of the gastric mucosa, usually due to the gag reflex, which reduces the accuracy of the determination of H. pylori. Therefore, and for a number of reasons, we recommend undergoing gastroscopy in medication sleep.
How to wear a medical mask correctly and which side to wear
Viral infections are transmitted mainly by contact and airborne droplets. Protective medical masks are designed to contain the spread of infectious diseases through the air. As statistics show, they are an effective means of preventing an epidemic – they help healthy people to protect themselves from infection, and those who are sick do not infect others.But in order for the protection to be as effective as possible, you need to know how to wear a mask correctly and follow the rules for its operation.
In this article we will tell you about the basic nuances of wearing medical masks, give recommendations on how to properly put on, take off and dispose of them. We hope that this information will be useful to you and will help you and your loved ones stay healthy.
Mask Wearing Rules: When Does It Matter To Wear It?
It is necessary to wear a protective medical mask:
- when you are sick yourself, so as not to endanger the illness of others;
- when caring for a person who is a carrier of an infectious disease transmitted by airborne droplets;
- in cases of unfavorable epidemiological conditions (influenza epidemic, pandemic).
For people who are ill, a mask is a must-have accessory. As a preventive measure, it is especially necessary for people with weakened immunity (against the background of chronic diseases, oncology, etc.) and children.
How to put on the mask?
Viruses and bacteria are transmitted from person to person. The highest probability of infection is in public places (places with a large crowd of people or actively visited by people), as well as through direct contact with sick people in a hospital, at home, when someone from the household is sick.On the street, the likelihood of infection is minimal, but if you travel by public transport, visit a sick relative, you need to wear a medical mask.
Rules for putting on a protective mask:
- before putting on an accessory, wash your hands well with soap or disinfect with an antiseptic;
- take the mask so that the fastening loops are outside;
- Put the product on your face, making sure that the mask covers your chin, nose and mouth well;
- fix the product on the nose with a flexible piece of iron sewn into the upper edge of the mask, and make sure that the fixation does not cause discomfort;
- straighten the mask in the chin area;
- Attach the product to the head.
The disposable mask with elastic loops is easy to attach – depending on the method of attachment, the elastic bands are put on the ears or threaded through the head, leaving one loop on the neck and the other at the top of the nape. A gauze mask with ties is also fixed in the neck and back of the head. Gauze ribbons are tied tightly enough, but make sure that the tension of the material is not strong, otherwise the ties will chafe.
Wearing masks for people with a beard may cause some inconvenience, but among the many options for protective equipment, everyone will choose a comfortable model for themselves that will sit well and effectively protect the face.You can buy high-quality disposable medical masks for adults and children in the Amel Dental Store catalog.
Which side to wear the mask – white or blue?
Three-layer disposable masks are available in different colors. Does it matter which side to wear the mask? The mask, white on both sides, can be worn by either side. This will not affect the durability or comfort of wearing in any way, since both top layers are made from the same material.
If the accessory is white on one side and blue or green on the other, then it is fundamentally important which side to wear the mask.It should be worn with a white layer to the face and blue (colored) outside. Why is the right side of a medical mask so important? The reason is that each layer has its own characteristics that affect the comfort and durability of the product. The white layer absorbs moisture, protects against the accumulation of vapors under the mask. The colored layer, on the other hand, has hydrophobic properties (water-repellent), which prevents the ingress of biological and other liquids, which can be dangerous, on the face from the outside.
How long can you wear a mask on time?
Each product sold in pharmacies and specialized stores is accompanied by instructions for use, which indicates how long one mask can be worn.The duration of wearing depends on the type of accessory (for details on what protective equipment are available and how to choose the right medical mask, read here).
How often do you change a disposable mask? It is recommended to change disposable products every hour (maximum wearing time – no more than 2 hours). The same time is set for wearing gauze bandages. However, if the product is wet from coughing or fumes, then the effectiveness of protection is drastically reduced and the mask must be replaced immediately.
Special medical masks of a higher level of protection are designed for longer wearing – 6-8 hours, and even after the specified time they continue to protect. Valve medical respirators can be worn for several days, but it is important to change the filter on time.
As for the question of how much to wear a medical mask, here too, each product has its own rules. Thus, disposable masks must be disposed of immediately after use. They cannot be washed, steamed or disinfected.Cloth / gauze masks can be worn for a long time, the main thing is to change them in a timely manner, after each use, be sure to wash and iron with the steaming mode turned on. The service life of such masks, as well as elastic Pitt masks and respirators, is from several months to several years.
How to remove the protective mask correctly so as not to get infected?
The main rule for removing the protective mask is to never touch the fabric of the product, so as not to inadvertently transfer germs from the fabric to the skin of the hands and face.The mask is removed by the fastening loops (ties).
Further, regarding the disposal of protective equipment: according to the prescription, the three-layer disposable mask is immediately rolled up with the outside inward, placed in an airtight bag and thrown into the trash can. Reusable products after use, depending on the model, are washed with soap, washed, antiseptic treatment is carried out, filters are changed.
After removing the mask, wash your hands thoroughly or treat them with an antiseptic.Only after hand disinfection can a clean mask be put on.
How to wear a medical mask: general guidelines
We’ve told you when and why to wear honey. mask. However, the mask is only one of many measures to prevent infectious diseases.
By itself, it is powerless to resist viruses and bacteria, if you do not follow the other safety rules:
- balanced nutrition, healthy lifestyle, strengthening immunity;
- hygiene – thoroughly washing and treating hands with antiseptic agents;
- avoiding touching your face with your hands;
- keeping distance from other people in transport, other public places;
- compliance with quarantine measures if you are sick, in order to avoid the spread of infection and infecting others;
- Avoiding particularly crowded places during periods of outbreaks of infectious diseases (epidemics).
Take care of yourself and your loved ones. Be healthy!
What is a virus, where does it live and what it wants – we explain complex things in simple words | Hromadske TV
What are viruses?
These are the first living organisms on the planet and at the same time – provocateurs of diseases.
The causative agents of diseases are different: in the form of a cell (these are bacteria), in a smaller form, these are viruses.
But don’t think that viruses are simpletons compared to bacteria.This is not so, because they are alive, they have DNA or RNA, they are capable of mutations, reproduction and survival in difficult conditions.
When did viruses appear and what are their benefits?
Viruses are believed to be indigenous to our planet.
There is a version that they came to Earth at the time of its creation, because they also live in space.
If we take into account that life on our planet began with viruses, then viruses are good.
Once an experiment proved that under conditions of complete sterility the organism is not viable.This proves the need for us to deal with viruses. They are super important for the immune system.
Do you know that doctors have a concept of “snotty age”?
It lasts from 2 to 9 years, when children are often sick. This is an absolutely normal process for our life. This is how children become familiar with viruses, produce natural weapons against them (immunity) and adapt to life on the planet.
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What are they not to be confused with and why?
Viruses should not be confused with bacteria, especially during treatment.
For example, antibiotics do not cure viruses. Antibiotics exist to treat bacteria.
Viruses are, for example, influenza, colds, measles, mumps, rubella, polio.
And bacterial diseases are, for example, tuberculosis, typhoid, cholera or tonsillitis.
Bacteria cause different symptoms and disease patterns than viruses.Because it is a complex form of life.
Where do viruses live and what do they like?
Viruses most of all like to live in a living organism – a person, an animal or a plant. It is in the body that viruses do their favorite thing – reproduction.
But they can survive outside the body. Mostly somewhere on door handles, tables, rails of minibuses and other surfaces.
The duration of their life outside the body depends on the favorable conditions. Viruses love low temperatures, humidity, fog.Under such conditions, it is easy for them to migrate from person to person.
How and why do viruses enter the body?
For reproduction. Because self-reproduction is the meaning of their life. Only in the body can viruses continue their genus, because for this they need a cell.
It should be understood that viruses do not appear in people because of a hat forgotten at home, cold lemonade or an unbuttoned jacket.
Viruses always live in nature, but the weather affects their ability to survive outside the body and quickly migrate from person to person.
In short, this winter is the ideal time for viral diseases.
How to protect yourself from viruses?
Mandatory step number one is vaccination.
There is no universal vaccine. Individual vaccines save, for example, from viral diseases, which are called “mandatory” in human life: rubella, chickenpox, measles and the like. Avoiding these viruses is already a big win. Unfortunately, people still sometimes die from measles or polio.
Step number two – hygiene.
As you already know, viruses can live on different surfaces. Touching a doorknob that has a virus on it and then licking your finger or scratching your eyes is sick.
An integrated approach helps protect against viruses, says immunologist Fyodor Lapiy. The “snotty age” trains the immune system, vaccination protects against “obligatory” diseases, and hygiene and caution are our basic safety measures:
“A patient needs a mask so as not to infect others.Your clean hands matter to other people too. Therefore, there is a question of a social contract, in other words – responsibility. ”
Disease of the pancreas
The pancreas (pancreas) is a secretory organ that secretes pancreatic secretions containing enzymes into the duodenum (DPC) 1.2 . This property of the pancreas is called exocrine pancreatic function. the enzymes contained in the secret, when mixed with food, ensure normal digestion and assimilation of all food components – proteins, fats and carbohydrates 1 .
Exocrine pancreatic insufficiency (EPI) is a condition characterized by a deficiency of exocrine pancreatic enzymes or a lack of conditions for their work, which leads to improper digestion of food or indigestion 1 .
Violation of the exocrine function of the pancreas (or exocrine pancreatic insufficiency) significantly affects the processes of digestion and, as a result, many functions of the body.This is due to the fact that pancreatic enzymes play an important role in the digestion of all the main components of food: proteins, fats and carbohydrates, so necessary for the normal functioning of the body 2.3 .
The main clinical signs of EPI: bloating (flatulence), a feeling of heaviness and indigestion in the epigastrium after eating, frequent loose stools (diarrhea), nausea, vomiting, abdominal pain, weight loss, growth retardation in children, diabetes mellitus, osteoporosis 4 …
In this case, steatorrhea and weight loss are late symptoms of the disease 4 .
A decrease in the digestive function of the pancreas (exocrine insufficiency) can be observed in many diseases of the gastrointestinal tract 4 . Some of these diseases occur at birth, such as cystic fibrosis, while others may occur later in life, such as chronic pancreatitis 4 .
Quite often, secondary pancreatic insufficiency can develop, in which the pancreas itself is not damaged and it is able to produce a sufficient amount of enzymes, however, for one reason or another, enzymes cannot fully exert their effect.This can be observed with cholelithiasis, after cholecystectomy, with cholestatic liver diseases, with hypoacid conditions, after resection of the stomach. In addition, with a decrease in gastric acidity, bacterial overgrowth often occurs in the duodenum and jejunum, which changes the pH in the intestinal lumen and disrupts absorption processes 4 .
If you have been diagnosed with EPI, you should discuss with your doctor or dietitian about a diet that meets all your nutritional needs.
– Replacement therapy with preparations of pancreatic enzymes.
Your doctor may prescribe a treatment for you called pancreatic enzyme replacement therapy or PTPP. ZTPPF is the main type of treatment for EPI – it provides replenishment of the deficiency of digestive enzymes 5 . When taken with food, PTPP helps break down nutrients
with food, and eliminate the symptoms of EPI 5 .