Blood and Wine

There are other tests that can be done on urine.

1. Cytology: Microscopic study of blood cells, which can help tell where they are from.
2. BTA (Bladder Tumour Antigen): This as its name implies detects antigens to bladder cancer.
3. NMP22(Nuclear Matrix Protein 22): Bladder cancer cells release this protein into urine.
   8th May, 16:35 -Called Mandy Miller at Slough Oops! Exeter, to see if the test is vegan. Awaiting email response.

Availability

Derriford.

• Dr McCormic has wriiten to the urologist fro his views on these alternatives. I don’t expect a postive feedback.
• I have spoke to Helen Fox in Procurement and am waiting to find if Derriford have such opitons:
  Paul Stratham at Kyowa Hakko in Slough said Derriford don’t have the NMP22 kits.

Haemoglobin

wikipedia.org

Myoglobin

1.
An iron-containing protein found in muscle fibers, consisting of heme connected to a single peptide chain that resembles one of the subunits of hemoglobin. Myoglobin combines with oxygen released by red blood cells and transfers it to the mitochondria of muscle cells, where it is used to produce energy.
thefreedictionary.com

2.
Myoglobin is a single-chain globular protein of 153 amino acids, containing a heme (iron-containing porphyrin) prosthetic group in the center around which the remaining apoprotein folds. It has a molecular weight of 16,700 daltons, and is the primary oxygen-carrying pigment of muscle tissues.
wikipedia.org

haemolysis(or hemolysis)

I am trying to understand the difference between haemolyitic and non-haemolytic reads on the urine tests.

It appears that test for blood checks for haemoglobin from both broken and intact cells and to further complicate the matter ‘UriTest’cliam the sticks are equally sensitive to myoglobin.
 

1.
Origin: from the Greek Hemo-, meaning blood, -lysis, meaning to break open.

- the lysis or the breaking open of red blood cell (erythrocyte) causing the release of haemoglobin into the surrounding fluid.
biology-online.org

2.
The destruction or dissolution of red blood cells, with release of hemoglobin. Also called erythrocytolysis, erythrolysis.
medical-dictionary.thefreedictionary.com

Summary
Generally a better week in terms of bluSHing and progress on sourcing the alternative tests

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Key to data
U or M in the Date column indicates which sticks I am using. U is the original ‘UriTest’ and M is ‘Mission Urinalysis’.
Blood { N = negative, L = less than, M = more than, ± = >10, + = >25, ++ = >80, +++ = >200, * = non-haem} Cells/µL
Visual { V=very, L=little, Y=yellow, A=Almost, N=No Colour, C=Cloudy}
Taste { N=neutral, V=very, L=lightly, b=bitter, a=acidic, s=sweet, t=salty }

Date Time	pH	Blood	Visual	Taste	Notes
27April 17:01 U	7.2	L+*	LY	Lb	See Diary for today
27April 17:01 M	6.5	-	LY	Lb	See Diary for today
28April 02:48 U	8.0	-	LY	L(bt)	Not much lemon juice
28April 09:18 U	6.8	-*	LY	Lt
28April 16:33 U	7.0	-	LY	L(st)
29April 04:15 U	6.5	+**	Y	L(t)
29April 09:45 U	7.0	+*	LY	N
29April 14:51 U	6.7	-	VLY	N
30April 12:06 U	6.5	+*	VLY	N
01May 15:13 U	7.0	M±	VLY	N
02May 14:49 U	6.2	+++	LY C	a	Small Particles Visible
03May 09:48 U	6.1	M-	Y	a	See Weekly Diary

Haematuria, or ‘blood in the urine’ can be either visible (Macroscopic or Frank Haematuria) or only noticed by urine testing (Microscopic Haematuria).

From: renux.dmed.ed.ac.uk

Microscopic haematuria need not be abnormal. Over 12,500 rbc/ml is abnormal, and the detection limit for dipstick testing is approx 15-20,000 rbc/ml. Note that macroscopic haematuria carries different connotations.

Queries that arise are: Is the ‘colour’ from red blood cells or haemoglobin, where does it originate and what options are there to resolve any problems.

The following is a copy of an article from london-urology.co.uk
 
Introduction

Haematuria is a common condition and one which must be taken seriously. While there are some spurious reasons for patients reporting blood in the urine (eating beetroot, dye ingestion), most patients reporting macroscopic haematuria will be correct. An exception may be in women after the menopause confusing vaginal bleeding with blood in the urine, but this is rare.

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