The latex-cold-precipitate test in rheumatoid arthritis. Experience after some years.
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BACKGROUND: Despite extensive literature, the diagnostic role of d-dimer for deep venous thrombosis (DVT) or pulmonary embolism (PE) remains unclear, reflecting multiple d-dimer assays and concerns about differing sensitivities and variability. PURPOSE: To systematically review trials that assessed sensitivity, specificity, likelihood ratios, and variability among d-dimer assays. DATA SOURCES: Studies in all languages were identified by searching PubMed from 1983 to January 2003 and EMBASE from 1988 to January 2003. STUDY SELECTION: The researchers selected prospective studies that compared d-dimer with a reference standard. Studies of high methodologic quality were included in the primary analyses; sensitivity analysis included additional weaker studies. DATA EXTRACTION: Two authors collected data on study-level factors: d-dimer assay used, cutoff value, and whether patients had suspected DVT or PE. DATA SYNTHESIS: For DVT, the enzyme-linked immunosorbent assay (ELISA) and quantitative rapid ELISA dominate the rank order for these values: sensitivity, 0.96 (95% confidence limit [CL], 0.91 to 1.00), and negative likelihood ratio, 0.12 (CL, 0.04 to 0.33); and sensitivity, 0.96 (CL, 0.90 to 1.00), and negative likelihood ratio, 0.09 (CL, 0.02 to 0.41), respectively. For PE, the ELISA and quantitative rapid ELISA also dominate the rank order for these values: sensitivity, 0.95 (CL, 0.85 to 1.00), and negative likelihood ratio, 0.13 (CL, 0.03 to 0.58); and sensitivity, 0.95 (CL, 0.83 to 1.00), and negative likelihood ratio, 0.13 (CL, 0.02 to 0.84), respectively. The ELISA and quantitative rapid ELISA have negative likelihood ratios that yield a high certainty for excluding DVT or PE. The positive likelihood values, which are in the general range of 1.5 to 2.5, do not greatly increase the certainty of diagnosis. Sensitivity analyses do not affect these findings. LIMITATIONS: Although many studies evaluated multiple d-dimer assays, findings are based largely on indirect comparisons of test performance characteristics across studies. CONCLUSION: The ELISAs in general dominate the comparative ranking among the d-dimer assays for sensitivity and negative likelihood ratio. For excluding PE or DVT, a negative result on quantitative rapid ELISA is as diagnostically useful as a normal lung scan or negative duplex ultrasonography finding.
C-reactive protein (CRP) is an acute-phase protein present in normal serum which increases significantly with tissue necrosis of inflammation. Presented in this review is a history of investigations of the protein, and its physical, immunological, and functional characteristics, as well as the various methods used for its detection and quantitation. The relationship of CRP to other acute-phase reactants is summarized with respect to its value in clinical diagnosis. The clinical application of CRP in detecting and monitoring post-surgical complications and in helping detect various disease states is also discussed.
The streptococcal infection cases from two outbreaks were serologically examined against two components of the streptococcal cellular wall; the M associated protein (MAP), by a latex agglutination test and the group A carbohydrate (A-CHO), by passive hemagglutination technique. Many positive cases with high levels of both antibodies were found, in rheumatic fever and glomerulo-nephritis, comparatively with the acute streptococcal infections. The differences were statistically significant. The results were correlated with the ASO titres and with the dermic cellular response.
Pancreatic elastase 1 is secreted from pancreatic acinar cells as one of the digestive enzymes. Pancreatic elastase 1 is present in serum in a complex formation with alpha 1-antitrypsin, and is measured by immunological methods. Serum pancreatic elastase 1 increases in acute pancreatitis and chronic relapsing pancreatitis. As the serum level remains high for a long period after acute pancreatitis, serum pancreatic elastase 1 is also a tumor marker for the detection of early pancreatic cancer.
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A new latex agglutination test (LAT) for detection of antibodies to measles virus in blood sera was developed. The latex diagnosticum consists of polymeric microspheres of national make carrying on their surface covalently bound measles virus antigen. The data on the specificity and sensitivity of the test are presented, and the results of titrations of blood sera from schoolchildren by traditional HI test and LAT are compared. LAT was shown to be highly sensitive, much simpler than the available methods for detection of measles antibodies and more economic, and therefore may be recommended for mass surveys.
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Simultaneous pregnancy tests were run on duplicate specimens of urine by the Friedman method and the latex flocculation method on 329 patients. Clinical correlation was available in 245 of these patients. The latex test had a sensitivity of 77 per cent and a specificity of 92 per cent in the overall diagnosis of pregnancy. The Friedman test had corresponding values of 93 per cent and 97 per cent, respectively. Not until the second month of pregnancy did the latex test become sensitive enough for practical use. The Friedman test, which takes 48 hours, is more sensitive and specific for the determination of pregnancy than the in vitro latex flocculation test, the results of which are known in four hours.