When all results were considered together the urine tube immunoassay (Model) gave 100% sensitivity and specificity as well as 100% predictive values for normal and abnormal results. The serum tube enzyme linked immunosorbent assay, while showing 100% sensitivity, was less specific, and the dipsticks were intermediate in value. CommentOur results are sufficiently encouraging to suggest that measurement of urinary hCG with ultrasensitive tube or dipstick assays should be the first line investigation in women presenting with non-specific abdominal complaints. Results equivalent to those of qualitative rapid radioimmunoassays may be obtained and appropriate further investigations such as laparoscopy, ultrasonography, and culdocentesis instituted. Qualitative tests do not differentiate ectopic from intrauterine pregnancy but offer a rapid and convenient assessment of secretion of hCG. The current assays may be simplified, and preliminary results using a two minute test (Icon, Hybritech) have been as good as those obtained with the assays described here (paper submitted for publication). These relatively simple, convenient, and commercially available enzyme labelled assays should be widely available in outpatient departments and wards for 24 hour use.I Seppala M, Kanta T, Tontti K, Stenman U-H, Chard T. Use of a rapid hCG-beta subunit radioimmunoassay in acute gynaecological emergencies.

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Laser Doppler velocimetry (LDV) is useful in measurement of relative tissue blood flow. We have found a change in both the variability of the LDV waveform and its absolute level, when measured in the supine and dependent lower limb, in patients with venous reflux. This change correlated well with simultaneous photo-plethysmographic (PPG) assessment of venous reflux and was more pronounced in patients with leg ulcers.

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