Majstorović, Z. Utsöndring av stenbildande substanser i urin – kan stickprov er-sätta dygnsmängder? Examensarbete i Biomedicinsk laboratorievetenskap 15 högskolepoäng. Malmö högskola: Hälsa och samhälle, Utbildningsområde Bio-medicinsk laboratorievetenskap, 2011.Syfte. Utredning av njurstenspatienter omfattar alltid undersökning av utsönd-ringen av stenbildande substanser i urin. Samlingen av urin under ett dygn hos njurstenpatienter innebär ofta problem för patienten eftersom det inte är så sällan att de glömmer samla urin i dunken eller samlar för lång eller kort tid. Syftet med min undersökning är att undersöka om det finns alternativ till att samla urin under 24 timmar i de fall där utsöndringen av stenbildande substanser är konstant över dygnet. Frågeställningen är om utsöndringen av stenbildande substanser kan upp-skattas genom att relatera deras koncentration i urin till koncentrationen av kreati-nin i urin eftersom utsöndringen av kreatinin är relativt konstant över dygnet. I så fall bör koncentrationen av stenbildande substanser i urin kunna relateras till kon-centrationen av kreatinin i urin på samma sätt som vid narkotikaanalys. Metod. Försökspersonerna samlade all urin i exakt 24 timmar. Den första urinportionen sparades i ett separat kärl medan all efterföljande urin samlades i en separat dunk . Efter ca en vecka gjordes en ny urinsamling, denna gång bara i en dunk. Dygnsut-söndringarna jämfördes med varandra och med kreatininindex i stickprovet. Re-sultat. Ett starkt samband fanns mellan kreatininindex av kalcium och dygnut-söndringen av kalcium. Sambandet var något mindre starkt för magnesium och saknades för fosfat och kalium. Slutsats. Resultaten talar mot att kreatininindex generellt kan användas för att skatta utsöndringen av njurstensbildande substanser. Däremot verkar kreatininindex relativt väl förutsäga utsöndringen av kalcium och i viss mån även magnesium. / Majstorović, Z. Secretion of stone-forming substances in the urine - can spot urine sample replace 24 hour urine collection? Degree project in Biomedical Laboratory Science, 15 credits points. Malmö University, Health and Society, Department of Biomedical Laboratory Science, 2011.Objective. Clinical investigation of kidney stone patients always includes moni-toring of the secretion of stone-forming substances in the urine. However, 24 h urine collection is difficult for the patient and prone to error. The purpose of this study is to examine whether there are alternatives to the collecting of urine under the period of 24 hours in cases where the secretion of stone-forming substances is constant across days. The question is whether the excretion of stone-forming sub-stances can be estimated by relating the concentration of urine to the creatinine concentration of urine, since the excretion of creatinine is relatively constant over a day. If so, the concentration of stone-forming substances in urine could be relat-ed to the concentration of creatinine in urine in the same way as drug analyses commonly are. Method. The subjects collected a 24h collection of urine. The first urine portion was stored in a container, while all subsequent urine was collected in a separate container. After about a week, another timed collection of urine was performed, but this time only in one container. The 24 h solute excretions were compared to each other and to the solute creatinine index. Results. A strong cor-relation was found between the creatinine index of calcium and the 24 h excretion of calcium. A somewhat weaker correlation was found for magnesium and a lack of correlation for phosphate and potassium. Conclusion. Results indicate that creatinine indexes in general do not predict 24 h excretions. However, creatinine index appears to predict the excretion of calcium and, to some extent, magnesium.

Bakgrund: Det förekommer att personer är beroende av en kvarliggande urinkateter för att kunna miktera. Den urinuppsamlingspåsen som kopplas till urinkatetern kan se olika ut. En vanlig komplikation är kateterassocierad urinvägsinfektion vilket kan leda till döden. För att undvika komplikationer ska sjuksköterskan informera personerna om egenvård av urinkatetern.  Syfte: Syftet var att beskriva vuxna personers upplevelser av att leva med en kvarliggande urinrörskateter eller en suprapubiskateter i vardagen. Metod: Litteraturöversikten som genomfördes utgick från 12 artiklar med kvalitativ design där resultaten utgår från ett patientperspektiv. Data samlades in från 2 olika databaser. Fribergs analysmetod för kvalitativa artiklar användes.   Resultat: I resultatet framkom tre huvudteman; förändrad självbild, känslan av okunskap och känslor kopplade till komplikationer. Åtta subtema identifierades; acceptansen av urinkatetern och urinuppsamlingspåsen, påverkan på det sexuella samlivet, behovet av planering, osäkerheten till behovet av urinkatetern, behovet av information, oro för flödeshinder, oro för infektioner och smärta.  Slutsats: Urinkatetern kan upplevas som besvärlig eller som en lättsamhet beroende på om den orsakar problem om den löser problemen i vardagen. Urinuppsamlingspåsen upplevs som en begränsning i vardagen och mycket planering behövs när personen ska lämna hemmet. Det finns en känsla av okunskap då personen inte fått tillräckligt med information om urinkatetern. / Background: It occurs that some people are in need of an indwelling urinary catheter to micturate. The urine-collection bag that is connected to the urinary catheter has different appearances.  A common complication is a catheter associated urinary tract infection that can lead to death. The nurse should inform the person about self-care of the urinary catheter, to avoid complications.   Aim: The aim was to describe adult peoples’ experiences of living with an indwelling urinary catheter or a suprapubic catheter in the daily life.  Method: This literature review has its origin within 12 articles with a qualitative design where the results were written from the patients' perspective. Data was collected from two different databases. The method of Friberg was used to analyse the data.  Results: The results were based on three major themes; altered self-image, the feeling of ignorance and feelings related to complications. Eight sub themes were identified; acceptance of the urinary catheter and the urine-collection bag, impact on the sexual intercourse, the need of planning, the uncertainty of the needs for the urinary catheter, the need for information, worries for blockage, worries for infections and pain.  Conclusion: The urinary catheter can be experienced as difficulty or as a lightness depending on if it causes troubles or solves problems in the daily life. The urine collection bag experiences as a limitation in daily life and much planning is needed when the person should leave the home. A feeling of ignorance occurs when the person has not received enough information about the urinary catheter.

<p>(From abstract) </p> <p>In the first study, the urine collection method was effectively applied for evaluation of intestinal permeability using Cr-EDTA, an indigestible oral marker, demonstrating the applicability of the procedure in 1-week-old and 6-week-old neonatal heifer calves (n=15 calves). Calf health observations were recorded during the entire urinary catheterization process and collection period to evaluate any negative health reactions to the procedure, or localized reactions. Proportion of localized reactions were analyzed, and the proportions did not exceed 20% for the calves catheterized at either 1 week or 6 weeks of age. </p> <p>In the second study, the developed catheterization procedure and urine collection method was applied using Cr-EDTA as an oral marker to investigate if L-GLN supplementation would offer improvement to intestinal permeability. In this larger study, 30 Holstein heifer calves [1.5 ± 0.5 days old; 37.1 ± 0.86 kg body weight (<strong>BW</strong>)] were blocked by serum total protein, BW, and age, and randomly assigned to 1 of 2 treatments: <strong>GLN</strong> [24% crude protein (<strong>CP</strong>)], 17% fat milk replacer (<strong>MR</strong>) +10 g L-GLN/kg MR powder) or <strong>NS</strong> (24% CP, 17% fat MR). MR was reconstituted to 12.5% solids with warm water and fed 3.8 L/calf/d until weaning. Calves were weaned at 56.4 ± 0.5 days of age, and had <em>ad libitum</em> grain (17% CP, 2% fat) and water access throughout the experimental period.</p> <p>During the preweaning period, calves were individually housed in hutches and health observations, which included respiratory and fecal scores, were assessed daily. Body weight was measured weekly, and grain and MR intake was assessed daily to calculate average daily gain (<strong>ADG</strong>), average daily feed intake [<strong>ADFI</strong>; grain intake (dry matter (<strong>DM)</strong> basis) + MR intake (DM basis)], and feed efficiency (<strong>G:F</strong>; ADG:ADFI). At weaning, calves were weighed, moved to pens (n = 3 pens/treatment, 4-5 calves/pen), provided free access to grain and grass hay, and then weighed 2 weeks post-weaning. Additionally, urinary catheters were placed at 1 and 6 weeks of age, and calves were orally dosed with 1 L Cr-EDTA in their MR. Urine samples were then collected over a 24-hr period for Cr output analysis as an <em>in vivo</em>biomarker of intestinal permeability. </p> <p>Blood was collected on study days 1, 2, 5, 7, 14, 21, 42, 56, and 70 to measure haptoglobin, serum amyloid A, leukocyte data, neutrophil: lymphocyte (<strong>N:L</strong>), glucose, non-esterified fatty acids, insulin, and cortisol. Two study periods were identified for data analysis representing greater (<strong>P1</strong>; weeks 1-3) and reduced (<strong>P2</strong>; weeks 4-8) enteric disease susceptibility. Data were analyzed using PROC GLIMMIX or PROC MIXED in SAS 9.4 with calf as the experimental unit. There was a decrease in total preweaning Cr output (<em>P</em> < 0.05) for GLN calves, and Cr output in 1 week old calves was decreased (<em>P</em> = 0.04) in GLN versus NS calves. The N:L was decreased overall (<em>P</em> = 0.03) and during P2 (<em>P</em> = 0.01) and P2 neutrophil count tended to be reduced (<em>P</em> = 0.07) in GLN versus NS calves. There were no MR treatment differences for ADFI, ADG, body measurements, post-absorptive metabolic biomarkers, disease scores, and therapeutic treatments (<em>P</em> > 0.10). In summary, L-GLN supplementation improved intestinal integrity and biomarkers of physiological stress in pre-weaned Holstein heifer calves managed under production-relevant conditions.  </p>