Laboratory Tests

We have still not been able to understand the human body which seems to be as perplexing as the universe we are a part of. However, with time we have developed certain techniques to dwell into the physiology and get exact reasons for some of the diseases that befall us. Lab tests involving sample of urine cannot only help the doctors diagnose but also observe medical conditions. One of these tests is urinalysis. The urine, which is adjudged by all as a body’s waste, carries important information about what’s going on inside and how things, if gone wrong, can be rectified.

Here’s how you can interpret urinalysis to diagnose various bodily issues.

Color

Color of the urine is the most evident aspect in judging somebody’s help. You must have noticed by yourself that during sickness or when on certain medication, the color of urine changes to dark yellow. The hot weather also can result in yellow color. A red or reddish-brown urine color may occur because of a presence of either hemoglobin after breakdown from the blood, myoglobin from muscle breakdown, a food dye, and consumption of beets or due to intake of a drug.

Clarity

Cloudiness in the urine sample can be due to excessive protein or because of crystallization of salts due to room temperature. People who have undergone bladder surgery often have cloudy urine because of presence of bacteria in the body. Urinary tract infection can also lead to cloudy urine.

Protein

As mentioned earlier, high protein levels in the urine can lead to cloudiness in the sample. However, detection of protein in the urine means kidneys are not functioning properly. Kidneys act as a filter and usually don’t let large molecules like proteins to get into the urine. Another reason for elevated protein levels can be intake of excess meat or urinary tract infection.

Acidity

Our kidneys work overtime to remove the excess acid from our body. The acidity is generally picked up by pH of urine. Normal pH range is from 4.5 to 9.0 and anything beyond that indicates acidity or alkalinity. Low pH level can also affect the detection of other elements including nitrites which don’t show up even if present in the sample. High nitrite values indicate presence of bacteria in the urinary tract.

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Casts

If the urine sample is tested positive for casts, it can be due to several reasons. While white casts can be due to kidney infection, red casts are a result of nephritic syndrome and muddy brown casts can indicate kidney failure.

Specific gravity

Specific gravity is another indicator that can be of great help in diagnosing various conditions. The normal range of specific gravity is 1.002 to 1.035 and any reading above this range indicates contamination or high level of glucose. A patient who receives intravenous dyes for radiography tests also gets a high reading.

Ketones and Glucose

Ketones are compounds that are produced when fatty acids are broken down for energy in the liver or kidney. Excess ketones are produced when the body is under starvation. Type I diabetics can also have excess ketones when the body is deprived of insulin and switches to burning fatty acids. Excess sugar in urine or glycosuria usually indicates diabetes mellitus.

Leukocyte Esterase

This test indicates if there is any infection present in the upper or lower urinary tract or with acute glomerulonephritis. A positive test will indicate presence of white blood cells which defend our bodies against infection. A negative test indicates there is no infection present.

Bacteria

Our genitals normally harbour bacteria because of abundant normal microbial flora of the vagina in females and external urethral meatus in both males and females. This is why only more than 100,000/ml of an individual reflects significant presence of bacteria.

All this knowledge can help you interpret urinalysis in a better way.[ad#afterpost]

Serum angiotensin converting enzyme test is a test that measures the amount of angiotensin converting enzyme in blood levels. Angiotensin converting enzyme is an enzyme that converts angiotensin I to angiotensin II. These two proteins play a vital role in regulating blood pressure. Angiotensin I is usually inactive, but when acted upon by angiotensin converting enzyme, it becomes angiotensin II.

Angiotensin II is the active form of angiotensin I. Angiotensin II causes the blood vessels to narrow. When there is a decrease in area, fluids (in this case, blood), flows faster, causing a resultant increase in blood pressure. Serum angiotensin converting enzyme test is primarily carried out to test for suspected cases of sarcoidosis, a disease that results in the formation of structures called granulomas in various organs. Granulomas are abnormal aggregations of inflammatory cells that, in some organs, form nodules.

Sarcoidosis may occur in an individual for years without any symptoms. When an organ is affected by sarcoidoisis, several symptoms may appear. These include weight loss, fatigue, arthritis and dry eyes. Skin symptoms may include rashes and lesions particularly on the face, neck and ears. The lymph nodes near the affected area may exhibit swelling (lymphadenophaty).

Sarcoidosis may also cause other symptoms depending on the area where it is located. When sarcoidosis affects the lungs, there would be lessening of the lungs air intake as well as blockages when severity increases. Sarcoidosis is usually asymptomatic, thus it is usually accidentally detected when undertaking mundane tests like x-rays, blood tests, CT scans of the chest area and lung biopsy.

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High angiotensin converting enzyme levels are a sign of sarcoidosis. An individual afflicted with sarcoidosis would have elevated levels of angiotensin converting enzyme. This could be 50% to 80% more than normal. Serum angiotensin levels are also related to the severity of sarcoidosis; rise and fall of the levels signify intensity or improvement of the condition.

Testing for serum angiotensin converting levels requires obtaining blood from the patient. Normal test results would be from 8 to 27 U/ml (units per milliliter). Individuals below the age of twenty have naturally high serum angiotensin converting enzyme levels, which may mask the presence of sarcoidosis.

There are several causes if a serum angiotenesin converting enzyme test results show low level of the enzyme. Low levels of angiotensin converting enzyme may be caused by hypothyroidism, a disorder that signifies a decrease in thyroid production. This disorder is primarily caused by iodine deficiency though other factors like radioactivity, genetics and environment may contribute to the development of the disorder.

Low levels of serum angiotensin converting enzyme may also be caused by the eating disorder anorexia nervosa. Anorexia nervosa is a disorder that generally manifests as a loss of any desire to consume food.

The disorders mentioned above can be very serious. They may escape the notice of several other tests. Undergoing a serum angiotensin converting enzyme test lets one know the possible occurrence of these disorders. This would better help him to take the appropriate steps to facilitate treatment and return to a healthy life.[ad#afterpost]

References

• James, William D.; Berger, Timothy G.; et al. (2006). Andrews’ Diseases of the Skin: clinical Dermatology. Saunders Elsevier.
• McGonagle D, McDermott MF (2006) A proposed classification of the immunological diseases. PLoS Med
• White, E.S.; Lynch Jp, 3rd (2007). Current and emerging strategies for the management of sarcoidosis. Expert Opinion on Pharmacotherapy
• Kumar MS, Safa AM, Deodhar SD, Schumacher OP (1977). The relationship of thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) in primary thyroid failure.  American Journal of Clinical Pathology

About 150 million worldwide are now suffering from alcoholism which is defined as the psychological and physical need to imbibe alcohol, usually at the expense of work, health and relationships. Throughout history, alcoholism has been one of the most prevalent problems of society. Drunken behavior can cause annoyance, repulsion, and avoidance of the person involved. Also, a person’s behavior gradually becomes erratic, eventually leading to self-destructive tendencies. Alcoholism can also aggravate preexisting medical conditions as well as greatly disrupt a person’s mental health.

Alcoholism is a difficult problem to deal with, especially if it has long been entrenched into a person’s behavioral patterns. The longer a person has become an alcoholic, the harder and the more complicated the effort needed to help the person. This involves support from the workplace, social community and family. Many institutions and employers prefer not to hire people who are alcoholics. To facilitate recognition of early signs of alcoholism and to detect alcohol use in law enforcement, work place, and educational institution, alcohol tests have become commonly administered.

Alcohol tests usually test for the presence of ethanol in the body. Body fluids are usually required for testing. These bodily fluids include urine, saliva and blood. Blood tests are usually performed to confirm if a person was in a drunken state upon commission of a crime or an administrative error. Coupled with external observations and physical on the spot tests, blood tests for alcohol use can lead to arrests and aggravated sentences. Blood tests are also performed for members of institution where alcoholic consumption is prohibited; these include the military, work places, and schools. Individuals who have chronic alcohol problems also undergo blood tests for alcohol regularly to gauge their progress.
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Ethanol is readily absorbed by the blood, thus measuring ethanol content in blood is a sure way to approximate the amount of alcohol a person has imbibed. Blood is usually obtained from a vein in the upper arm. The amount of ethanol concentration in the blood is indicative of the amount consumed and has its corresponding effects. An estimated blood alcohol content of 0.02 usually relaxes a person while 0.10 would already slow one’s reflexes, thinking, and slurs one’s speech. Intoxication is usually defined as having a blood alcohol content measurement within 0.08 to 1.0. Take note that blood alcohol content is usually expressed as a percentage of alcohol in the blood. For instance, a BAC of 0.10 means that 0.10% (one tenth of one percent) of your blood is alcohol.

To test for chronic alcohol consumption several specialized blood tests can be performed. These blood tests, coupled with an interview and observations by friends and family members is indicative of alcoholism.

One test that may indicate alcoholism is the GGT test. This test measures the amount of gamma-glutamyl-transferase, an enzyme produced by the liver. Its concentrations in the blood are sensitive to the amount of alcohol ingested. Drinking several bottles for four to eight weeks would significantly raise GGT content in blood.

Another test is the Mean Cell Volume test. This test involves actual visual observation of the red blood cells present in blood. When a person consumes alcohol, it affects the bone marrow, the site of production for red blood cells. The red blood cells appear large by a magnitude of a hundred.

Liver damage is highly indicative of prolonged chronic alcohol use. When the liver gets damage, several substances make their way into the blood. A liver panel detects these compounds and can approximate the type and extent of damage based on the composition of these proteins. Several proteins tested for by the liver panel include bilirubins, aspartate aminotransferase (enzyme), alanine aminotransferase, and alkaline phosphatase. A 1:2 ratio between alanine aminotransferase and aspartate aminotransferase may indicate alcoholic hepatitis.

Alcoholism is a serious concern because it endangers not only the life of the individual but also his or her relatives, friends, and colleagues. These blood tests that indicate alcoholism may help stem a person’s descent into dependence and lead that person into sobriety and reintroduction as a productive member of society.[ad#afterpost]

References

• The Carnegie Library 1997 The Handy Science Answer Book, Carnegie Library of Pittsburgh. Science and Technology Department.
• Rea, Caroline. 2008 Cirrhosis: Exams and tests. Retrieved from http://www.ivillage.com/cirrhosis-0/exams-and-tests/4-o-90040

Alcohol is the most commonly used drug in the world. Alcohol in small amounts induces a feeling of mild euphoria but as volume increases, inhibitions, mobility, decision making and coordination decreases with stupor and unconsciousness occurring with high dosages. Alcohol also has a synergistic effect when accompanied with use of other drugs like cannabis, barbiturates and cocaine, increasing the potency of the effect.

Law enforcement is thus concerned about public inebriation, especially when driving vehicles and in the conduct of crime. Alcohol tests may be ordered when a person is observed by law enforcement officials to be exhibiting loss of coordination, slow reaction time, vomiting, and unconsciousness or if physical appearance and demeanor indicates inebriation. Alcohol levels in a person’s body indicate the amount of alcohol consumed within a certain time frame.

There are various methods used to determine alcohol content in a person’s body, usually using a person’ breath, saliva, blood and urine. Among the different tests available to determine alcohol levels in a person’s body, urine testing is among the most reliable and the most flexible in terms of detecting for additional substances and it is the most inexpensive. However, urine testing is usually the easiest to fake, one of the most invasive and one that poses a biohazard to the tester. Urine testing also just measures the presence of alcohol ingested up to 48 hours prior, however, since alcohol takes one half to two hours to be metabolized, urine tests does not accurately predict a person’s current alcohol consumption. Urine tests are also dependent on a person’s physical status, with dilution, metabolism and other factors playing a role in the results. The presence of glucose as well as some microorganisms in the sample could also lead to higher ethanol counts since glucose can be fermented with time and sufficient temperature.
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Urine testing involves looking at a sample’s ethanol content to determine a person’s alcohol intake. Drinking alcohol or ethanol is broken down in the liver to acetaldehyde via the enzyme alcohol dehydrogenase. Acetaldehyde is in turn broken down into acetic acid as well as to other by products. Another pathway that breaks down ethanol is the cytochrome P450 2e1 pathway that breaks down ethanol to acetaldehyde and other reactive radicals. Urine testing utilizes the alcohol dehydrogenase pathway to determine alcohol in urine. This method, the alcohol dehydrogenase assay, measures the reduction of nicotinamide adenine dinucleotide to measure the amount of ethanol present in the sample.

Another, more sensitive test for alcohol in urine is the EtG test. Etg or ethyl glucoronide is another by product of alcohol metabolism. Unlike ethanol, EtG stays in the body up to 80 days, making it a useful alcohol detection method for alcohol consumption in the military and in schools. However, the sensitivity of ethyl gluoronide makes false positive an easy occurrence. Many household products, like hand sanitizers, detergents, and even antiperspirants contain alcohol. It is thus easy to trigger a positive just by moderate usage of alcohol containing products. This means that EtG tests by itself is viewed somewhat unreliable and may require corroborating results from other tests.

In converting urine test results to alcohol blood content, the assumption is usually that 1.3 parts of alcohol present in the urine equals one part present in alcohol. However, this value can vary greatly among individuals creating a source of error.

Urine testing lags behind blood testing in terms of accuracy of results. However, it still is a commonly used detection tool. Although relatively easy to fool with dilution and has numerous sources of error, it still used by law enforcement and is quite capable of withstanding legal challenge.[ad#afterpost]

References

• Advanced Safety Devices Alcohol Testing Methodology obtained from http://www.safety-devices.com/alcohol-testing-methodology.htm
• Buddy T. (2008) Widely-Use EtG Test for Alcohol Unreliable obtained from http://alcoholism.about.com/od/work/a/etg.htm
• Worthington Biochemical Corporation from A Vallee and Hoch (1955) Alcohol dehydrogenase assay obtained from http://www.worthington-biochem.com/ADH/assay.html