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A re-evaluation of the slide flocculation test for the diagnosis of schistosomiasis with adult worms as antigen.

The present study was conducted to determine whether extracts from adult Schistosoma mansoni could be coated onto cholesterol-lecithin crystals. Of particular interest was the use of stunted schistosomes (SS) recovered from rabbits. The reactions obtained with this antigen in this slide flocculation (SF) test were compared with those employing antigens from cercariae and mature adult worms. The stunted schistosome SF test (SFSS) showed a high sensitivity and specificity while cercarial antigen showed extensive cross reaction with Trichinella spiralis, Ascaris lumbricoides, and Echinococcus granulosus antisera. Both SS and cercarial antigens reacted with syphilitic sera, but the former only with high titer sera. The antigen from mature adult worms could not be coated onto cholesterol crystals, a finding which is in agreement with previous investigations. The relative simplicity of the SFSS test and its apparent high sensitivity and specificity indicates that the test may be an ideal epidemiological tool for schistosomiasis surveys. The results obtained should encourage additional study of the procedure involved and investigation into the role of lipids in flocculation tests. In addition, the findings should stimulate immunological studies of the stunted schistosomes.

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Automation of a flocculation test for syphilis on Groupamatic equipment.

A flocculation reaction employing a cardiolipid antigen was used for syphilis screening on Groupamatic equipment in parallel with conventional screening reactions: Kolmer CF, RPCF, Kahn, Kline, and RPR. The positive samples were confirmed by FTA-200, FTA-ABS, TPI, and in some cases by TPHA. There were 5,212 known samples which had already been tested by all methods and of which 1,648 were positive, and 58,636 screened samples including 65 positives. Half of the samples in the first series were taken without anticoagulant; the remainder were collected in potassium EDTA. The percentage of false positives with the Groupamatic was about 1-4 per cent. The percentage of false negatives among positve (greater than or equal+) samples varied from 0-18 to 1-3 per cent.; on the other hand the sensitivity was less good for samples giving doubtful and/or dissociated reactions in conventional screening reactions. The specificity and sensitivity of this technique are acceptable for a blood transfusion centre. The reproducibility is excellent and the automatic reading of results accurate. Additional advantages are rapidity (340 samples processed per hour); simultaneous performance of eleven other immunohaematological reactions; no contamination between samples; automatic reading, interpretation, and print-out of results; and saving of time because samples are not filed sequentially and are automatically identified when the results are obtained. Although the importance of syphilis in blood transfusion seems small, estimates of the risk are difficult and further investigations are planned.

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