Effectiveness of latex agglutination slide test in the diagnosis of imported invasive amoebiasis in the emergency department.

We compared a latex agglutination test (LAT) with enzyme-linked immunosorbent assay and indirect hemagglutination assay in the diagnosis of invasive amoebiasis. A retrospective biological records review has included 639 patients for whom these three serological tests were performed. The sensitivity of the LAT was 97.8% and the specificity was 97%.

[Heterophilic antibodies: be carefull!]. / Anticorps hétérophiles: restez vigilants !

The determination of plasma level of cardiac troponin I or T is recommended by the French Health Authority to diagnose myocardial infarction. However false positive results associated with the presence of heterophilic antibodies are described in the literature. This interference can lead to unnecessary invasive procedures, sometimes even dangerous. We report the case of a patient with falsely elevated troponin Ic concentration due to these antibodies. This case is characterized by the intensity of the abnormalities, the diversity of biological parameters affected and the discrepancies between biology and clinic. This case report confirms that modern immunoassays are always affected by heterophilic antibodies. We present here an example of such interference.

[Validation of plasma creatinine measurement on UniCel DxC 600 according to LAB GTA 04 recommendation]. / Vérification initiale d'une nouvelle méthode de dosage de la créatinine plasmatique sur UniCel (R) DxC 600 selon les recommandations du LAB GTA 04.

The accreditation process, according to NF EN ISO 15189, implies a prior evaluation of the new reagent on-site for the implementation of each new assay technique. Thus, our new standardized method for determination of creatinine (non compensated method) in plasma or serum on UniCel DxC 600 (Beckman Coulter) has been tested according to LAB GTA 04 protocol. The reagent meets the quality criteria recommended by Valtec protocol, except fidelity with the low concentration standard (50 micromol/L). Besides there is no problem of results transferability with the two other techniques used in the laboratory (Jaffe compensated and enzymatic methods performed on Cobas Integra 800).

[Urinary dipsticks must not be used to detect diabetes-induced incipient nephropathy]. / Inefficacité des bandelettes urinaires dans la recherche de néphropathie incipiens chez les diabétiques.

INTRODUCTION: Microalbuminuria is an early indication of diabetic nephropathy in patients with Type 1 diabetes and a marker of cardiovascular in patients with type 2 diabetes. It must therefore be assessed annually in these patients. We sought to determine whether semiquantitative determination of proteinuria with urinary dipsticks was useful for this purpose. METHOD: This analysis of consecutive urinary samples among diabetic patients excluded those with dipstick results positive either for leukocyturia or nitrituria, to avoid false positives due to urinary infection. We assessed the reliability of the dipsticks in comparison with conventional microalbuminuria and proteinuria assays. RESULTS: The study included 230 patients. Positive dipstick results had good positive (95.7%) and negative (93.9%) predictive values. Low levels of microalbuminuria, however - those that lead to early adjustment of treatment, were much more difficult to identify: the negative predictive value was only 73.7% and proteinuria was no longer correlated with microalbuminuria. DISCUSSION: Urinary dipsticks cannot replace conventional assays for microalbuminuria or proteinuria.

[Sexual abuse and chemical submission, a present-day problem]. / Agressions sexuelles et soumissions chimiques, un problème d'actualité.

CHEMICAL SUBMISSION: Certain forms of sexual abuse have recourse to molecules in order to obtain the victim's submission. These fast-acting, muscle-relaxing and sedative molecules, provoke anterograde amnesia that makes subsequent legal enquiries difficult. These products can be combined with alcohol or other addictive substances, therefore facilitating their administration, without the victim knowing, and enhancing their effects. THE MOLECULES USED: Among these molecules, hydroxybutyrate and its derivatives as well as benzodiazepines, with flunitrazepam, are frequently mentioned and detected. However, many other sedative molecules can be used to obtain chemical submission. MANAGEMENT OF THE VICTIMS: Knowledge of the facts and concomitant symptoms facilitates the medical and medico-legal management of the victims, generally encountered in hospital emergency wards. The quality and quantity of toxicological samples permit the use of efficient and validated techniques in organizing medico-legal enquiries.