A retrospective study of the results of dipstick testing and microscopical examination of urine from 10 050 men undergoing health screening showed a prevalence of occult haematuria of 2-5%. Those patients with occult haematuria who were resident in the United Kingdom and registered with a general practitioner were identified and a questionnaire sent to their general practitioners asking what further investigations had been performed. The response rate was 92% (152/165 inquiries). Fifty nine general practitioners (39%) had not instigated any investigations. Among the 76 patients who underwent some further investigations abnormalities were found in 21 (28%); and among those fully investigated by examination of midstream urine, intravenous urography, and cystoscopy abnormalities were found in 12 (50%). These included bladder neoplasms (two; one in a patient aged 37), epithelial dysplasia (one), staghorn calculi (one), and chronic reflux nephropathy (one).It is proposed that occult haematuria should be fully investigated regardless of the age of the patient. IntroductionThe importance of occult haematuria as an early sign ofurinary tract disease is well known by urologists, yet it is often inadequately investigated or is accepted as a benign condition.' In younger patients haematuria most often results from urinary tract infections or disorders such as renal calculi, glomerulonephritis, or IgA nephropathy.23 Athletic haematuria is a transient phenomenon that occurs after prolonged, vigorous exercise and is unlikely to be persistent.4 In patients over 40, however, a major urinary tract lesion will be found in about 20% of those with confirmed microscopical haematuria, and in at least 10% the lesion will be malignant.' I Even when no disorder is diagnosed some patients will develop an important lesion within the next few years.5 Cancers of the urinary tract are fairly common, accounting for more than 15% of all registrations of cancer among British men.6 Furthermore, the severity of haematuria is not related to the severity of the urological lesion.5 As a carcinoma found as a result of investigating microscopical haematuria may be at an early, treatable stage it is important that haematuria detected during routine screening should be thoroughly investigated.2The development of dipstick testing has simplified the detection of occult haematuria.7 The Labstix test detects haemoglobin

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Plasma levels of total high density lipoprotein cholesterol (HDL) and Its subtractions (HDL 2 and HDL 3 ) were measured In 366 healthy Caucasian males; these values were related to a number of coronary risk factors. On unlvarlate statistical analysis, total HDL was negatively correlated with cigarette consumption, body mass Index, and serum trlglycerldes, and positively associated with level of physical activity and alcohol consumption. HDL 2 showed an Inverse relationship with cigarette consumption, body mass index, trlglycerldes, and systolic blood pressure and a positive relationship with age. HDL 3 was negatively correlated with cigarette smoking, body mass index, and trlglycerldes and positively associated with exercise level and alcohol consumption. Total HDL and HDL 2 were Inversely related to coronary risk rating, but HDL 3 snowed no significant correlation. Many of these relationships became nonsignificant after allowing for the effects of other variables. In particular, none of the HDL measurements correlated significantly with risk score after allowing for the effect of trlglycerldes. There Is Insufficient evidence at present to recommend the Inclusion of HDL subfractions as routine screening tests for heart disease. HDL subfractions and these and other risk factors in a large group of healthy men. Methods SubjectsThe study population consisted of Caucasian males attending a hearth screening center in north London. Subjects with a medical history of heart disease or diabetes or with a current complaint of angina, and those with an abnormal fasting glucose level were excluded from the study. Also excluded were subjects with electrocardiographic evidence of ischemic heart disease and those taking antihypertensive or lipid-lowering medication. We were left with a final sample of 366 healthy men.The screening process, which has been described in detail elsewhere, 20 ' 21 included a detailed medical history and physical examination, chest x-ray and 12-lead electrocardiogram, and collection of blood for a number of biochemical and hematological measurements. Blood pressure was taken using a random-zero (Gelman Hawksley) sphygmomanometer, the value recorded being the mean of two measurements. Stage V end-point was used for the diastolic pressure. Weight (kg) and height (m) were recorded for each subject, and body mass index (BMI) was calculated as weight/height 2 . Cigarette smoking, alcohol consumption, and exercise level were assessed by a computerized questionnaire. Ex-smokers and those smoking only pipes or cigars were coded as non-cigarette smokers. Teetotalers (10 subjects) were omitted from the alcohol analysis. All procedures were approved by the ethical committee of BUPA Medical Research, and informed consent was obtained from each subject.The subjects fasted overnight for 14 hours.

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Certain diagnostic kits that measure serum urate by the Barham and Trinder principle of enzymic liberation of oxygen and its combination with chromogens can give results for urate in fresh serum that are approximately 20% lower than results from serum stored at ambient temperature for 72 h. In fresh serum, antioxidants compete with chromogen for liberated peroxyl-oxygen. We postulate that during storage the interfering antioxidant substances are destroyed. In some diagnostic kits, L-ascorbate oxidase is added to the reaction, eliminating some but not all of this effect. We discuss defects of several commercially available kits for determination of serum urate and recommend comparing results of these kits with results from the phosphotungstic acid method as a precaution against falsely low results.