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Agile – affordable – accurate Training Uri-Screen Urine Strips Uri-Screen ® Urine strips.

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Presentation on theme: "Agile – affordable – accurate Training Uri-Screen Urine Strips Uri-Screen ® Urine strips."— Presentation transcript:

1 agile – affordable – accurate Training Uri-Screen Urine Strips Uri-Screen ® Urine strips

2 agile – affordable – accurate Uri-Screen ® + up to 11 parameters (Bilirubin, Urobilinogen, Ketones, Ascorbic Acid, Glucose Protein, Blood, pH, Nitrite, Leukocytes, Specific gravity) + excellent protection against runover effect, suited for visual analysis and for use in the Uri-Screen XL analyzer +clear color differentiation in medical decision area (normal / pathological) Uri-Screen ® Urine strips

3 agile – affordable – accurate Uri-Screen ® Urine strips BilirubinUrobilinogenKetoneAscorbic acidGlucoseProteinBloodpHNitriteLeukocytesSpec. gravity Multiparameter test strips can be used to establish early symptoms of the following groups of diseases. Liver and haemolytic diseases: Bilirubin and Urobilinogen Metabolic disorders: Glucose and Ketone Diseases of the kidneys and the urogenital tract: Nitrite, Blood, pH, Nitrite, Leukocytes and Spec. gravity

4 agile – affordable – accurate Uri-Screen ® Urine strips Storage of test strips: Store test strips in a cool, dry place (2-30°C), but not in the refrigerator! Close tube immediately after taking out strips Avoid exposure of test strips to light, especially to direct sunlight Sources of error: Tube has been open for a longer time (damage of most parameters) Strips had been exposed to direct sunlight before measurement (damage of most parameters) Strip container had been stored at high temperature for a longer time (reduced sensitivity for several parameters)

5 agile – affordable – accurate Uri-Screen ® Urine strips Collecting of samples Use fresh, well-mixed and uncentrifuged without any preservatives (if possible first morning urine) Use clean containers, without residues of cleaning agents or disinfectants Protect the sample from light, check it as soon as possible (within 2 hours) If the test cannot be performed immediatly, the specimen must be stored in a refrigerator (2 – 8°C) and allowed to reach room temperature again before testing (15 – 25°C).

6 agile – affordable – accurate Uri-Screen ® Urine strips Sources of error: The container may contain residues of cleaning or disinfecting agents (false positives for glucose, blood, protein) The sample is stored for a long time (false positive for nitrite, lower values for glucose, higher values for pH, lysis of erythrocytes and leucocytes) The sample is exposed to light (false negatives for bilirubin, uroblinogen) The sample has been centrifuged (analytes can be adsorbed at sediment)

7 agile – affordable – accurate Uri-Screen ® Urine strips 1.Immerse the test strip in the urine (approx. 2 seconds), so that all areas are covered. 2.Carefully wip off the excess on the rim of the container or wip the edge of the strip on absorbent paper. Only remove the required number of test strips and immediately tightly seal the package again! Do not touch the test pads!

8 agile – affordable – accurate Uri-Screen ® Urine strips 3. 3.Hold the test strips horizontal during the reaction time and when comparing it with the color scale (evaluation should be carried out in diffuse daylight). Compare the reagent areas on the strip with the corresponding color chart after 60 seconds. If Leukocytes are slightly positive after 60 seconds leave the strip for another 60 seconds and then read final result.

9 agile – affordable – accurate Uri-Screen ® Urine strips Sources of error – visual reading If the strip is not rinsed well or not stored in a horizontal position, urine between the test pads may lead to interferences or nonspecific colours If several strips are dipped into the same sample, nonspecific colours for blood or nitrite may be observed. If artificial light is used for visual evaluation, the evaluation of protein and leucocytes may lead to wrong results.

10 agile – affordable – accurate Uri-Screen ® Urine strips Parameter Details Clinical Significance Principle Sensitivity False-negative results False-positive results

11 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Detection of hepatic and biliary diseases Principle Bilirubin reacts with a diazonium salt to form an orange-red dye Sensitivity 0.5 mg/dl (8.5 µmol/l) False-negative results High concentrations of ascorbic acid or nitrite Oxidation of bilirubin due to exposure of the sample to light False-positive results Drug metabolites (e.g. phenazopyridines),High concentrations of urobilinogen

12 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Detection of hepatic and biliary diseases Principle Urobilinogen reacts with a diazonium salt to form a red coloured dye Sensitivity 0.5 mg/dl (8.5 µmol/l) False-negative results Oxidation of urobilinogen by exposure of the sample to light High concentrations of formaldehyde False-positive results Drug metabolites (e. g. phenazopyridines, p-aminobenzoic acid)

13 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Detection of ketones, which occur at increased metabolism of fat, mainly caused by uncontrolled diabetes mellitus Principle Acetoacetic acid and acetone react with nitroprusside sodium to form a violet dye (Legal‘s test).  -hydroxybutyric acid is not detected. Sensitivity Acetoacetic acid: 5 mg/dl, Acetone: 30-50mg/dl False-negative results Damaged test pad caused by long exposition to air humidity False-positive results High concentrations of: Phenylketones (phenylpyruvic acid), Phthaleins, Anthraquinone dyes, Drug metabolites (e. g. from DOPA, Captopril, Mesna)

14 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Early detection and self monitoring of diabetes mellitus Principle Oxidizing of glucose with oxygen catalyzed by glucose oxidase. The hydrogen peroxide formed by this reaction oxidizes a chromogen to a blue dye Sensitivity 40 mg/dl (2.2 mmol/l) False-negative results Presence of: Gentisic acid (metabolite of acetylsalicylic acid - ASA), pH <5, high concentrations of uric acid and high spec gravity False-positive results Traces of oxidizing cleaning agents in sample containers

15 agile – affordable – accurate Uri-Screen ® Urine strips Excellent performance in measuring glucose levels with the Uri-Screen 11 parameter strips used on the XL analyzer. No run over effects.

16 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Detection of kidney diseases (glomerular or tubular damages) Most pathological proteinurias are above 30mg/dl Very low protein concentrations are also observed at healthy people Principle A yellow indicator dye changes to green caused by interaction with protein Sensitivity 15 mg/dL Albumin Other proteins (globulines, Bence-Jones proteins, peptones, mucoproteids, albumoses) show lower sensitivity

17 agile – affordable – accurate Uri-Screen ® Urine strips False-negative results Sensitivity to different proteins is varying (high sensitivity for albumin, lower sensitivity for other proteins) False-positive results Infusion of blood substitutes (PVP) Traces of cleaning agents or disinfectants containing quaternary ammonium groups (cationic detergents) or chlorohexidine High pH of sample (pH = 9)

18 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Detection of haematuria, caused by urogenital tract or kidney diseases or haemorrhagic diseases. Principle Haemoglobin shows peroxidatic activity. It catalyzes the oxidation of a chromogen by cumene hydroperoxide to form a dye Sensitivity – 0.03 mg/dl free haemoglobin (homogenous coloration) erythrocytes/  l (spot coloration)

19 agile – affordable – accurate Uri-Screen ® Urine strips False-negative results Presence of formalin, high concentrations of nitrite or protein or high specific gravity reduce the speed of the color development False-positive results Presence of microbial peroxidases Residues of oxidizing cleaning agents in the sample containers Dipping in the same sample for several times The number of erythrocytes which are detected by sediment analysis may be lower than the result of the test strip, because lysed cells are not detected by sediment analysis

20 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Persistant high pH-values indicate urinary tract infections Principle A mixed indicator shows different colours, depending on the pH of the sample. Sensitivity - False-negative results - False-positive results -

21 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Detection of urinary tract infections, caused by bacteria Principle Most pathogenic bacteria reduce the nitrate in the urine to nitrite. The nitrite converts an aromatic amine to a diazonium salt, which is coupled with an aromatic compound to form a pink dye Sensitivity 0.05 mg/dl. Any pink coloration indicates > bacteria / ml urine

22 agile – affordable – accurate Uri-Screen ® Urine strips False-negative results Urine dwell time in the bladder is too short Urinary tract infection caused by bacteria without nitrate reductase activity Low nitrate concentration in urine due to a special diet Therapy with antibiotics High concentrations of ascorbic acid False-positive results Dipping into the same sample for several times External bacterial contamination due to long standing time Presence of phenazopyridine

23 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Detection of inflammatory kidney and urinary tract diseases Principle Granulocyte esterase, which is contained in leucocytes, cleaves an indoxyl ester. The free indoxyl reacts with a diazonium salt to form a violet dye. Sensitivity ca Leucocytes/  l

24 agile – affordable – accurate Uri-Screen ® Urine strips False-negative results Damaged test pad due to long exposition to light. Very high concentrations of protein, glucose or several drug metabolites reduce the sensitivity. False-positive results Contamination by vaginal secrets Residues of formaline in the sample container Highly coloured samples The number of leucocytes which are detected by sediment analysis may be lower than the result of the test strip, because lysed cells are not detected by sediment analysis.

25 agile – affordable – accurate Uri-Screen ® Urine strips Clinical Significance Control of kidney diseases, diuresis factor of the sample Principle An ion exchange polymer changes the pH of the test pad in the presence of cationic compounds. The change in pH is detected by a pH-indicator. Sensitivity -

26 agile – affordable – accurate Uri-Screen ® Urine strips This concludes the basic user training of the urine strips If there are any specific questions, please ask them now We will now continue with the basic user training of the Uri-Screen XL Analyzer

27 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer

28 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer Introduction Uri-Screen XL Analyzer

29 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer Preparation of strips / samples

30 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer Measure menu Manual Automatic

31 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer Data menu Worklist

32 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer Settings menu Controls Sediment

33 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer Troubleshooting Please refer to the user manual for possible errors The most common ones can be solved by the user Serious errors (hardware) can and may only be fixed by a system engineer, trained at the manufacturer and with the aid of the service manual!

34 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer Maintenance / Daily routine Carefully handle the strips Do not leave strips in the loader after finishing your daily routine Clean the analyzer on a regulary base One in a while check the accuracy of the analyzer using the grey strip (for the optics) or control solution (available through your supplier NEVER turn the analyzer off with the on/off switch during measurements, always use the EXIT option on the screen to first bring the machine down. The analyzer will let you know when it is safe to use the power button once the exit routine through the software is finished!

35 agile – affordable – accurate Training Uri-Screen XL Analyzer Uri-Screen XL ® Analyzer For users: this short user training is just intended to get to know the machine. In order to use the full potential of this machine, please refer to the user manual. For system engineers: please refer to the service manual. You will receive this manual after you have attended a complete system engineering training on the machine (including teaching the sensors, advanced trouble shooting and replacing defected parts of the analyzer). This engineering course will take place at the manufacturer. Please be advised that before using this machine in a Lab, it is highly recommended that one or two system engineers of the supplier have attended this course!

36 agile – affordable – accurate Uri-Screen ® Urine strips


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