The Experts below are selected from a list of 23982 Experts worldwide ranked by ideXlab platform
Takashi Kawahara - One of the best experts on this subject based on the ideXlab platform.
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discolored ureteral stents findings in urinalysis and Urine Culture
PLOS ONE, 2015Co-Authors: Takashi Kawahara, Hiroshi Miyamoto, Hideyuki Terao, Hiroji Uemura, Yoshinobu Kubota, Junichi MatsuzakiAbstract:Objective Discolored ureteral stents are sometimes encountered in daily clinical practice; however, the mechanism(s) underlying the development of discolored ureteral stents remain unknown. In this study, we retrospectively analyzed the characteristics of discolored ureteral stents based on the results of a urinalysis and Urine Culture. Materials & Methods We identified a total of 26 patients with discolored ureteral stents and compared the findings in the urinalyses and Urine Culture in 21 discolored versus 45 non-colored ureteral stents. Results The median and mean (±SD) duration of stenting time was 78.0 and 81.3 (± 21.3) days for the discolored ureteral stents and 69.0 and 74.9 (± 19.8) days for the non-colored ureteral stents, respectively (P = 0.25). The discolored ureteral stents were associated with a higher mean Urine pH than the non-colored ureteral stents (mean: 6.4 vs 6.0, P< 0.05). There were no significant differences between the two groups in the RBC (P = 0.51) and WBC (P = 0.35) counts in the urinalyses. In addition, the rate of a positive Culture in the patients with discolored stents [20 of 21 (95.2%)] was significantly (P <0.01) higher than that observed in the patients with non-colored ureteral stents [33 of 45 (73.3%)]. Conclusions In this study, the subjects with discolored ureteral stents showed a significantly higher likelihood of having a positive Urine Culture and also demonstrated higher pH values in the urinalyses. However, no clear cut-off point to predict discoloration was indicated.
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Discolored ureteral stents: findings in urinalysis and Urine Culture.
PLOS ONE, 2015Co-Authors: Takashi Kawahara, Hiroshi Miyamoto, Hideyuki Terao, Hiroji Uemura, Yoshinobu Kubota, Junichi MatsuzakiAbstract:Objective Discolored ureteral stents are sometimes encountered in daily clinical practice; however, the mechanism(s) underlying the development of discolored ureteral stents remain unknown. In this study, we retrospectively analyzed the characteristics of discolored ureteral stents based on the results of a urinalysis and Urine Culture. Materials & Methods We identified a total of 26 patients with discolored ureteral stents and compared the findings in the urinalyses and Urine Culture in 21 discolored versus 45 non-colored ureteral stents. Results The median and mean (±SD) duration of stenting time was 78.0 and 81.3 (± 21.3) days for the discolored ureteral stents and 69.0 and 74.9 (± 19.8) days for the non-colored ureteral stents, respectively (P = 0.25). The discolored ureteral stents were associated with a higher mean Urine pH than the non-colored ureteral stents (mean: 6.4 vs 6.0, P< 0.05). There were no significant differences between the two groups in the RBC (P = 0.51) and WBC (P = 0.35) counts in the urinalyses. In addition, the rate of a positive Culture in the patients with discolored stents [20 of 21 (95.2%)] was significantly (P
Nasia Safdar - One of the best experts on this subject based on the ideXlab platform.
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reflex Urine Culture testing in an ambulatory urology clinic implications for antibiotic stewardship in urology
International Journal of Urology, 2019Co-Authors: Kyle A Richards, Stacy Cesario, Sara L Best, Susan M Deeren, Wade Bushman, Nasia SafdarAbstract:OBJECTIVES: To evaluate the performance characteristics of urinalysis and Urine microscopy parameters for predicting Urine Culture results and to implement a reflex Urine Culture program. METHODS: We reviewed the charts of all patients presenting to our clinic January-March 2013 and June-August 2014, excluding those who were catheter-dependent or with urinary diversions. We assessed the association of urinalysis and Urine microscopy parameters on Urine Culture outcomes defining a positive urinalysis as nitrite-positive and/or the presence of ≥5 white blood cells per high-powered field with bacteria and a positive Urine Culture as ≥10 000 colony-forming units/mL excluding diphtheroids. We carried out logistic regression to assess for predictors of positive Urine Culture to inform implementation of a reflex Urine Culture program. RESULTS: A total of 2764 patients were evaluated. Logistic regression using urinalysis variables identified positive nitrites (odds ratio 18.6, P 50 white blood cells per high-powered field (odds ratio 13.6, P < 0.001) and moderate/many bacteria (odds ratio 16.8, P < 0.001) as the strongest predictors of positive Urine Culture. We used our positive urinalysis definition to implement the reflex Urine Culture program and noted a 60% reduction in Urine Culture rates over the first 3 months of implementation. CONCLUSIONS: A Urine positive for nitrites and/or ≥50 white blood cells per high powered field with bacteria seems to have a strong association with a positive Urine Culture and the best negative predictive value. A reflex Urine Culture program is an effective strategy to decrease the rates of unnecessary Urine Culture and their associated costs.
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Reflex Urine Culture testing in an ambulatory urology clinic: Implications for antibiotic stewardship in urology
International Journal of Urology, 2018Co-Authors: Kyle A Richards, Stacy Cesario, Sara L Best, Susan M Deeren, Wade Bushman, Nasia SafdarAbstract:OBJECTIVES: To evaluate the performance characteristics of urinalysis and Urine microscopy parameters for predicting Urine Culture results and to implement a reflex Urine Culture program. METHODS: We reviewed the charts of all patients presenting to our clinic January-March 2013 and June-August 2014, excluding those who were catheter-dependent or with urinary diversions. We assessed the association of urinalysis and Urine microscopy parameters on Urine Culture outcomes defining a positive urinalysis as nitrite-positive and/or the presence of ≥5 white blood cells per high-powered field with bacteria and a positive Urine Culture as ≥10 000 colony-forming units/mL excluding diphtheroids. We carried out logistic regression to assess for predictors of positive Urine Culture to inform implementation of a reflex Urine Culture program. RESULTS: A total of 2764 patients were evaluated. Logistic regression using urinalysis variables identified positive nitrites (odds ratio 18.6, P 50 white blood cells per high-powered field (odds ratio 13.6, P
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reducing unnecessary culturing a systems approach to evaluating Urine Culture ordering and collection practices among nurses in two acute care settings
Antimicrobial Resistance and Infection Control, 2018Co-Authors: Robert Redwood, Mary Jo Knobloch, Daniela Pellegrini, Matthew Ziegler, Michael S Pulia, Nasia SafdarAbstract:Inappropriate ordering and acquisition of Urine Cultures leads to unnecessary treatment of asymptomatic bacteriuria (ASB). Treatment of ASB contributes to antimicrobial resistance particularly among hospital-acquired organisms. Our objective was to investigate Urine Culture ordering and collection practices among nurses to identify key system-level and human factor barriers and facilitators that affect optimal ordering and collection practices. We conducted two focus groups, one with ED nurses and the other with ICU nurses. Questions were developed using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. We used iterative categorization (directed content analysis followed by summative content analysis) to code and analyze the data both deductively (using SEIPS domains) and inductively (emerging themes). Factors affecting optimal Urine ordering and collection included barriers at the person, process, and task levels. For ED nurses, barriers included patient factors, physician communication, reflex Culture protocols, the electronic health record, urinary symptoms, and ED throughput. For ICU nurses, barriers included physician notification of urinalysis results, personal protective equipment, collection technique, patient body habitus, and Foley catheter issues. We identified multiple potential process barriers to nurse adherence with evidence-based recommendations for ordering and collecting Urine Cultures in the ICU and ED. A systems approach to identifying barriers and facilitators can be useful to design interventions for improving Urine ordering and collection practices.
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optimizing inpatient Urine Culture ordering practices using the electronic medical record a pilot study
Infection Control and Hospital Epidemiology, 2017Co-Authors: Daniel Shirley, Harry Scholtz, Kurt Osterby, Jackson S Musuuza, Nasia SafdarAbstract:: A prospective quasi-experimental before-and-after study of an electronic medical record-anchored intervention of embedded education on appropriate Urine Culture indications and indication selection reduced the number of Urine Cultures ordered for catheterized patients at an academic medical center. This intervention could be a component of CAUTI-reduction bundles. Infect Control Hosp Epidemiol 2017;38:486-488.
Junichi Matsuzaki - One of the best experts on this subject based on the ideXlab platform.
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discolored ureteral stents findings in urinalysis and Urine Culture
PLOS ONE, 2015Co-Authors: Takashi Kawahara, Hiroshi Miyamoto, Hideyuki Terao, Hiroji Uemura, Yoshinobu Kubota, Junichi MatsuzakiAbstract:Objective Discolored ureteral stents are sometimes encountered in daily clinical practice; however, the mechanism(s) underlying the development of discolored ureteral stents remain unknown. In this study, we retrospectively analyzed the characteristics of discolored ureteral stents based on the results of a urinalysis and Urine Culture. Materials & Methods We identified a total of 26 patients with discolored ureteral stents and compared the findings in the urinalyses and Urine Culture in 21 discolored versus 45 non-colored ureteral stents. Results The median and mean (±SD) duration of stenting time was 78.0 and 81.3 (± 21.3) days for the discolored ureteral stents and 69.0 and 74.9 (± 19.8) days for the non-colored ureteral stents, respectively (P = 0.25). The discolored ureteral stents were associated with a higher mean Urine pH than the non-colored ureteral stents (mean: 6.4 vs 6.0, P< 0.05). There were no significant differences between the two groups in the RBC (P = 0.51) and WBC (P = 0.35) counts in the urinalyses. In addition, the rate of a positive Culture in the patients with discolored stents [20 of 21 (95.2%)] was significantly (P <0.01) higher than that observed in the patients with non-colored ureteral stents [33 of 45 (73.3%)]. Conclusions In this study, the subjects with discolored ureteral stents showed a significantly higher likelihood of having a positive Urine Culture and also demonstrated higher pH values in the urinalyses. However, no clear cut-off point to predict discoloration was indicated.
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Discolored ureteral stents: findings in urinalysis and Urine Culture.
PLOS ONE, 2015Co-Authors: Takashi Kawahara, Hiroshi Miyamoto, Hideyuki Terao, Hiroji Uemura, Yoshinobu Kubota, Junichi MatsuzakiAbstract:Objective Discolored ureteral stents are sometimes encountered in daily clinical practice; however, the mechanism(s) underlying the development of discolored ureteral stents remain unknown. In this study, we retrospectively analyzed the characteristics of discolored ureteral stents based on the results of a urinalysis and Urine Culture. Materials & Methods We identified a total of 26 patients with discolored ureteral stents and compared the findings in the urinalyses and Urine Culture in 21 discolored versus 45 non-colored ureteral stents. Results The median and mean (±SD) duration of stenting time was 78.0 and 81.3 (± 21.3) days for the discolored ureteral stents and 69.0 and 74.9 (± 19.8) days for the non-colored ureteral stents, respectively (P = 0.25). The discolored ureteral stents were associated with a higher mean Urine pH than the non-colored ureteral stents (mean: 6.4 vs 6.0, P< 0.05). There were no significant differences between the two groups in the RBC (P = 0.51) and WBC (P = 0.35) counts in the urinalyses. In addition, the rate of a positive Culture in the patients with discolored stents [20 of 21 (95.2%)] was significantly (P
Kate E. Creevy - One of the best experts on this subject based on the ideXlab platform.
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relationships among urinary protein to creatinine ratio Urine specific gravity and bacteriuria in canine Urine samples
Journal of Veterinary Internal Medicine, 2019Co-Authors: Alison G. Meindl, Bianca N. Lourenço, Amanda E. Coleman, Kate E. CreevyAbstract:BACKGROUND: Proteinuria is a marker of chronic kidney disease in dogs and a risk factor for increased morbidity and death. Predictive models using the results of readily available screening tests could foster early recognition. OBJECTIVE: To determine whether Urine specific gravity (USG) and semiquantitative category of dipstick protein can be used to predict urinary protein-to-creatinine ratio (UP : C) and to examine the effect of Urine Culture results on UP : C in dogs. ANIMALS: Three hundred ninety-four dogs (482 visits) presented to a university Community Practice Clinic or Veterinary Teaching Hospital between January 2011 and November 2015. METHODS: Retrospective study. Medical records were searched to identify dogs for which urinalysis, UP : C measurement, and Urine Culture testing were performed during a single hospital visit. Urine specific gravity, UP : C, dipstick protein concentration, and findings of Urine sediment analysis and Urine Culture were recorded. Regression or Spearman correlation analysis was used to test for relationships between UP : C and USG within dipstick categories and between UP : C and bacterial colony-forming units per milliliter, respectively. Cohen's kappa test was used to evaluate agreement between Urine Culture and UP : C testing. RESULTS: There were significant (P < .05) weak negative correlations (R2 range, 0.14-0.37) between UP : C and USG for all nonnegative Urine protein dipstick categories. The presence of a positive Urine Culture did not agree with the presence of abnormal UP : C (κ = -0.06). CONCLUSIONS AND CLINICAL IMPORTANCE: Within dipstick protein categories, UP : C cannot be accurately predicted from USG. Repeating UP : C measurement after resolution of urinary tract infection is advisable.
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Relationships among urinary protein-to-creatinine ratio, Urine specific gravity, and bacteriuria in canine Urine samples.
Journal of Veterinary Internal Medicine, 2018Co-Authors: Alison G. Meindl, Bianca N. Lourenço, Amanda E. Coleman, Kate E. CreevyAbstract:BACKGROUND: Proteinuria is a marker of chronic kidney disease in dogs and a risk factor for increased morbidity and death. Predictive models using the results of readily available screening tests could foster early recognition. OBJECTIVE: To determine whether Urine specific gravity (USG) and semiquantitative category of dipstick protein can be used to predict urinary protein-to-creatinine ratio (UP : C) and to examine the effect of Urine Culture results on UP : C in dogs. ANIMALS: Three hundred ninety-four dogs (482 visits) presented to a university Community Practice Clinic or Veterinary Teaching Hospital between January 2011 and November 2015. METHODS: Retrospective study. Medical records were searched to identify dogs for which urinalysis, UP : C measurement, and Urine Culture testing were performed during a single hospital visit. Urine specific gravity, UP : C, dipstick protein concentration, and findings of Urine sediment analysis and Urine Culture were recorded. Regression or Spearman correlation analysis was used to test for relationships between UP : C and USG within dipstick categories and between UP : C and bacterial colony-forming units per milliliter, respectively. Cohen's kappa test was used to evaluate agreement between Urine Culture and UP : C testing. RESULTS: There were significant (P
Alison G. Meindl - One of the best experts on this subject based on the ideXlab platform.
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relationships among urinary protein to creatinine ratio Urine specific gravity and bacteriuria in canine Urine samples
Journal of Veterinary Internal Medicine, 2019Co-Authors: Alison G. Meindl, Bianca N. Lourenço, Amanda E. Coleman, Kate E. CreevyAbstract:BACKGROUND: Proteinuria is a marker of chronic kidney disease in dogs and a risk factor for increased morbidity and death. Predictive models using the results of readily available screening tests could foster early recognition. OBJECTIVE: To determine whether Urine specific gravity (USG) and semiquantitative category of dipstick protein can be used to predict urinary protein-to-creatinine ratio (UP : C) and to examine the effect of Urine Culture results on UP : C in dogs. ANIMALS: Three hundred ninety-four dogs (482 visits) presented to a university Community Practice Clinic or Veterinary Teaching Hospital between January 2011 and November 2015. METHODS: Retrospective study. Medical records were searched to identify dogs for which urinalysis, UP : C measurement, and Urine Culture testing were performed during a single hospital visit. Urine specific gravity, UP : C, dipstick protein concentration, and findings of Urine sediment analysis and Urine Culture were recorded. Regression or Spearman correlation analysis was used to test for relationships between UP : C and USG within dipstick categories and between UP : C and bacterial colony-forming units per milliliter, respectively. Cohen's kappa test was used to evaluate agreement between Urine Culture and UP : C testing. RESULTS: There were significant (P < .05) weak negative correlations (R2 range, 0.14-0.37) between UP : C and USG for all nonnegative Urine protein dipstick categories. The presence of a positive Urine Culture did not agree with the presence of abnormal UP : C (κ = -0.06). CONCLUSIONS AND CLINICAL IMPORTANCE: Within dipstick protein categories, UP : C cannot be accurately predicted from USG. Repeating UP : C measurement after resolution of urinary tract infection is advisable.
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Relationships among urinary protein-to-creatinine ratio, Urine specific gravity, and bacteriuria in canine Urine samples.
Journal of Veterinary Internal Medicine, 2018Co-Authors: Alison G. Meindl, Bianca N. Lourenço, Amanda E. Coleman, Kate E. CreevyAbstract:BACKGROUND: Proteinuria is a marker of chronic kidney disease in dogs and a risk factor for increased morbidity and death. Predictive models using the results of readily available screening tests could foster early recognition. OBJECTIVE: To determine whether Urine specific gravity (USG) and semiquantitative category of dipstick protein can be used to predict urinary protein-to-creatinine ratio (UP : C) and to examine the effect of Urine Culture results on UP : C in dogs. ANIMALS: Three hundred ninety-four dogs (482 visits) presented to a university Community Practice Clinic or Veterinary Teaching Hospital between January 2011 and November 2015. METHODS: Retrospective study. Medical records were searched to identify dogs for which urinalysis, UP : C measurement, and Urine Culture testing were performed during a single hospital visit. Urine specific gravity, UP : C, dipstick protein concentration, and findings of Urine sediment analysis and Urine Culture were recorded. Regression or Spearman correlation analysis was used to test for relationships between UP : C and USG within dipstick categories and between UP : C and bacterial colony-forming units per milliliter, respectively. Cohen's kappa test was used to evaluate agreement between Urine Culture and UP : C testing. RESULTS: There were significant (P
