Urine Film

[Edilma Howard]

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Reportedly, various urine manipulations can be performed by opioid use disorder (OUD) patients who are on buprenorphine/naloxone medications to disguise their non-compliance to the treatment. One type of manipulation is known as "spiking" adulteration, directly dipping a buprenorphine/naloxone film into urine. Identifying this type of urine manipulation has been the aim of many previous studies. These studies have revealed urine adulterations through inappropriately high levels of "buprenorphine" and "naloxone" and a very small amount of "norbuprenorphine." So, does the small amount of "norbuprenorphine" in the adulterated urine samples result from dipped buprenorphine/naloxone film, or is it a residual metabolite of buprenorphine in the patient's system? This pilot study utilized 12 urine samples from 12 participants, as well as water samples as a control. The samples were subdivided by the dipping area and time, as well as the temperature and concentration of urine samples, and each sublingual generic buprenorphine/naloxone film was dipped directly into the samples. Then, the levels of "buprenorphine," "norbuprenorphine," "naloxone," "buprenorphine-glucuronide" and "norbuprenorphine-glucuronide" were examined by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). The results of this study showed that high levels of "buprenorphine" and "naloxone" and a small amount of "norbuprenorphine" were detected in both urine and water samples when the buprenorphine/naloxone film was dipped directly into these samples. However, no "buprenorphine-glucuronide" or "norbuprenorphine-glucuronide" were detected in any of the samples. In addition, the area and timing of dipping altered "buprenorphine" and "naloxone" levels, but concentration and temperature did not. This study's findings could help providers interpret their patients' urine drug test results more accurately, which then allows them to monitor patient compliance and help them identify manipulation by examining patient urine test results.

A kidney, ureter, and bladder (KUB) X-ray may be performed to assess the abdominal area for causes of abdominal pain, or to assess the organs and structures of the urinary and/or gastrointestinal (GI) system. A KUB X-ray may be the first diagnostic procedure used to assess the urinary system.

X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film). Digital films and digital media are more commonly used now than the film media.

Other related procedures that may be used to diagnose problems of the urinary organs of the abdomen include computed tomography (CT scan) of the kidney , kidney ultrasound , kidney scan , cystography , cystometry , cystoscopy , intravenous pyelogram , kidney biopsy , magnetic resonance imaging (MRI) , prostate ultrasound , retrograde cystography , retrograde pyelogram , uroflowmetry , and renal venogram .

The urinary system helps the body to eliminate liquid waste in theblood called urea, and keeps chemicals, such as potassium and sodium,and water in balance. Urea is produced when foods containing protein,such as meat, poultry, and certain vegetables, are broken down in thebody. Urea is carried in the bloodstream to the kidneys, where it isremoved along with water and other wastes in the form of urine.

The kidneys remove urea from the blood through tiny filtering units callednephrons. Each nephron consists of a ball formed of small bloodcapillaries, called a glomerulus, and a small tube called a renal tubule.Urea, together with water and other waste substances, forms the urine as itpasses through the nephrons and down the renal tubules of the kidney.

Two ureters. These narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.

Bladder. This triangle-shaped, hollow organ located in the pelvis. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.

Urethra. This tube allows urine to pass outside the body. The brain signals the bladder muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax to let urine exit the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs.

A KUB X-ray may be performed to help diagnose the cause of abdominal pain,such as masses, perforations, or obstruction. A KUB X-ray may be taken toevaluate the urinary tract before other diagnostic procedures areperformed. Basic information regarding the size, shape, and position of thekidneys, ureters, and bladder may be obtained with a KUB X-ray. Thepresence of calcifications (kidney stones) in the kidneys or ureters may be noted.

You may want to ask your doctor about the amount of radiation used duringthe procedure and the risks related to your particular situation. It is agood idea to keep a record of your past history of radiation exposure, suchas previous scans and other types of X-rays, so that you can inform yourdoctor. Risks associated with radiation exposure may be related to thecumulative number of X-ray examinations and/or treatments over a longperiod of time.

Notify your doctor and radiologic technologist if you have taken a medication that contains bismuth, such as Pepto-Bismol, in the past four days. Medications that contain bismuth may interfere with testing procedures.

You will be positioned in a manner that carefully places the part of the abdomen that is to be X-rayed between the X-ray machine and a cassette containing the X-ray film or digital media. You may be asked to stand erect, to lie flat on a table, or to lie on your side on a table, depending on the X-ray view your doctor has requested. You may have X-rays taken from more than one position.

It is extremely important to remain completely still while the exposure is made, as any movement may distort the image and even require another X-ray to be done to obtain a clear image of the body part in question.

While the X-ray procedure itself causes no pain, the manipulation of thebody part being examined may cause some discomfort or pain, particularly inthe case of a recent injury or invasive procedure, such as surgery. Theradiologic technologist will use all possible comfort measures and completethe procedure as quickly as possible to minimize any discomfort or pain.

Erica Cirino is a writer, artist and researcher who works globally. While on assignments in places as far-off as the South Pacific Ocean and the Arctic Circle, she covers science stories that often meet at the intersection of human and wildlife health, and environmental conservation. In particular, Erica is highly focused on uncovering the depths and health effects of the global plastic pollution crisis.

Chyluria is a condition that happens when lymphatic fluid from the intestines leaks into your kidneys. In addition to an oily appearance, your urine might also have a milky white color. This is due to the presence of fat and protein in lymph fluid.

However, it can lead to complications for some people, especially those with diabetes. If you have diabetes, ketosis may be a precursor to ketoacidosis, a serious condition that requires immediate treatment. Contact your doctor right away if you have any of these symptoms in addition to oily urine:

When your body is losing more fluid than you can take in, you become dehydrated. With less water moving through your body, your urine becomes more concentrated. This can make other substances in your urine, such as fats, more visible.

If your urine turns cloudy, don't panic or self-diagnose. It's normal to have cloudy urine once in a while. If it happens more often, you have other symptoms, or if it doesn't clear up after a few days, call your doctor. They can help figure out what's going on and get your health back on track.

When your urine is cloudy, it means the pH level of your urine is alkaline. Cloudy urine may be normal. Or it may be a sign of a health issue. Check with your doctor if you don't see cloudy urine clear up in a few days.

Diabetes can cause high sugar levels in your urine. High urine sugar levels can disrupt the balance of bacteria, increasing your risk of urinary tract infections (UTIs). In turn, UTIs can cause cloudy urine.

The amount of water you drink each day determines the color of your urine. When you drink enough water, your normal pee color will be clear, light yellow, or straw-colored. As your pee turns a darker shade of yellow, that's often a sign you need to drink more water. Amber or honey-colored pee means you are dehydrated and need more fluids.

If you notice that your urine has a different appearance and it does not resolve on its own, be sure to consult your doctor for further assessment. Overall, it is not a normal finding, and should be further examined with testing. The doctor should especially evaluate kidney function and initiate prompt treatment as necessary.

What to do: If oily urine is due to nephrotic syndrome, you should continue treatment as indicated by your doctor. Treatment for this condition usually involves the use of antihypertensives, diuretics or medications that reduce immune system activity to decrease overall inflammation. Changes to diet may also be indicated. The main goal of treatment is to relieve symptoms and improve quality of life.

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