Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

1974 ◽  
Vol 31 (02) ◽  
pp. 273-278
Author(s):  
Kenneth K Wu ◽  
John C Hoak ◽  
Robert W Barnes ◽  
Stuart L Frankel

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 41-44
Author(s):  
Judy G. Saslow ◽  
Ernest M. Post ◽  
Carol A. Southard

Objective. As neonatal discharge before 24 hours of life becomes commonplace, the rejection of congenital hypothyroidism (CH) screening specimens obtained too early has created the need for numerous additional tests. We sought to determine whether the specimens obtained before 24 hours could be used safely. Methods. During a 31-day period we measured thyrotropin in all thyroid-screening specimens that had been obtained before 24 hours. We also examined the early specimens from every infant diagnosed in New Jersey with CH during 1993 or 1994. Results. Among the 663 specimens, those obtained at or before 12 hours and those from infants with birth weights less than 2500 g had too many low thyroxine results to be useful. Among the 515 specimens obtained at more than 12 to 24 hours from newborns weighing 2500 g or more, 37 (7%) had low thyroxine levels and 12 (2.3%) had thyrotropin levels of 20 µIU/mL (mU/L) or higher. Four hundred seventy-one of the 515 infants had subsequent specimens obtained at more than 24 hours, and none of the results were abnormal. There was no child weighing more than or equal to 2500 g who was diagnosed with CH in 1993 and 1994 whose specimen obtained at 24 hours or less was normal. Conclusions. Accepting specimens obtained at more than 12 to 24 hours from infants weighing 2500 g or more would have resulted in more than the usual number of false-positive results but no false-negative results. This would have decreased the requests for additional specimens by more than 90%.


1981 ◽  
Author(s):  
E Briët ◽  
M J Boekhout-Mussert ◽  
L H van Hulsteijn ◽  
C W Koch ◽  
H W C Loose ◽  
...  

Fifty-three patients were examined because of suspected deep venous thrombosis, by means of clinical examination, Doppler ultrasound and venography. Eighty-two legs were examined with all three methods. Venography was positive in 40 and normal in 42. The clinical examination was false positive in 4 legs and false negative in 6. The Doppler ultrasound studies gave false positive results in 3 legs and false negative results in 6. These results are better than those reported in the literature probably because the thrombosis extended to the popliteal vein or the more proximal veins in 38 of the 40 legs with deep vein thrombosis. This high percentage of upper leg vein thrombosis can be explained by the fact that 47 of the 53 patients were ambulant when they developed the signs and symptoms of thrombosis. It is concluded, that the clinical examination and Doppler ultrasonography can be used to diagnose deep vein thrombosis in ambulant patients in our clinic. We presume that the findings reported in the literature cannot be used indiscriminately as a basis for diagnostic strategies in other hospitals because of widely varying categories of patients, referral patterns and diagnostic criteria that are virtually impossible to standardize.


2018 ◽  
Vol 72 ◽  
pp. 1162-1178
Author(s):  
Aleksandra Lewandowicz-Uszyńska ◽  
Piotr Naporowski ◽  
Gerard Pasternak ◽  
Danuta Witkowska

The human immune system’s response to infection is closely related with the type of pathogen. First, a rapid, metabolically inexpensive and non-specific innate immunity is induced, then a specific acquired immunity is activated. In bacterial infections caused by intracellular pathogens, the main role is played by cellular response. In infections caused by bacterial extracellular pathogens, a crucial role is played by antibodies. The clinical symptoms of bacterial and viral infections very often are similar, which is why diagnosing them based only on medical history and physical examination is insufficient. To identify the etiological factors of infections differentiating media, biochemical tests, molecular methods and serological tests are used. The detection of microorganisms or their genetic material can be performed within a short time after the occurrence of an infection. The detection of antibodies is possible only in the appropriate time called the serological window. In a serological diagnostic of infections there are problems with an appropriate interpretation of obtained results. Cross-reactivity can give false positive results for the diagnosis of Chlamydophila pneumonia infection. The problem with the detection of Borrelia burgdorferi infection can be caused by a simultaneous coinfection with different spirochetes, syphilis, mononucleosis or HIV. In serological diagnostics of bacterial infections, the administration of antibiotics to patients before taking serum samples can be responsible for false negative results. Another reason for such results can be a weak humoral response in infected patients. In viral infections, false positive results can be caused by a coinfection of different viruses, especially from the same family or by bacterial or protozoal coinfections or by autoimmune diseases. False-negative results in viral infections often are caused by the early phase of an infection. To properly recognize an etiological factor of infection it is necessary to use an appropriate method, precision of test and collect samples at the appropriate time.


2011 ◽  
Vol 102 (3) ◽  
pp. 261-266 ◽  
Author(s):  
R.A. King ◽  
J.S. Davey ◽  
J.R. Bell ◽  
D.S. Read ◽  
D.A. Bohan ◽  
...  

AbstractThe molecular detection of predation is a fast growing field, allowing highly specific and sensitive detection of prey DNA within the gut contents or faeces of a predator. Like all molecular methods, this technique is prone to potential sources of error that can result in both false positive and false negative results. Here, we test the hypothesis that the use of suction samplers to collect predators from the field for later molecular analysis of predation will lead to high numbers of false positive results. We show that, contrary to previous published work, the use of suction samplers resulted in previously starved predators testing positive for aphid and collembolan DNA, either as a results of ectopic contamination or active predation in the collecting cup/bag. The contradictory evidence for false positive results, across different sampling protocols, sampling devices and different predator-prey systems, highlights the need for experimentation prior to mass field collections of predators to find techniques that minimise the risk of false positives.


1991 ◽  
Vol 37 (4) ◽  
pp. 572-575 ◽  
Author(s):  
J G N de Jong ◽  
J J F Hasselman ◽  
A A J van Landeghem ◽  
H L Vader ◽  
R A Wevers

Abstract To check the reliability of the Ames MPS paper spot test, which is based on the Azure A dye, we sent a series of urine samples to three laboratories where the spot test is part of the metabolic screening for mucopolysaccharidoses. In these laboratories false-negative results ranged between 19% and 35% and false-positive results ranged between 12% and 29% of all samples submitted. In contrast, the quantitative dimethylmethylene blue test (Clin Chem 1989;35:1472-7) detected an increased glycosaminoglycan content in all urine samples from mucopolysaccharidosis patients and gave no false-positive results. In the latter procedure, glycosaminoglycan content is expressed per millimole of creatinine, and age-dependent reference values are used. We conclude that the Ames spot test and other spot tests are unreliable as a screening procedure for mucopolysaccharidoses and should not be used to screen for these diseases.


PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1065-1068 ◽  
Author(s):  
K. L. Tan ◽  
A. Loganath ◽  
A. C. Roy ◽  
H. H. Goh ◽  
S. M. Karim ◽  
...  

Umbilical cord plasma α-fetoprotein (AFP) values were determined in 127 infants with hyperbilirubinemia (56 glucose-6-phosphate dehydrogenase (G-6-PD) deficient and 71 G-6-PD normal) and 136 control subjects (73 G-6-PD deficient and 63 G-6-PD normal). The mean α-fetoprotein value of 173 ± 35.2 (SD) mg/L for the group of infants with hyperbilirubinemia was significantly greater than that (122 ± 21.7 mg/L) for the control infants (P < .001). G-6-PD status and sex did not significantly affect the α-fetoprotein values. Using an α-fetoprotein level of 130 mg/L as a "cut-off" value, the incidence of false-positive results was 25.5% and the incidence of false-negative results was 11.8%. This test can be used as a screening procedure to detect infants at high risk for hyperbilirubinemia.


1979 ◽  
Vol 9 (2) ◽  
pp. 170-174
Author(s):  
N Pyndiah ◽  
U Krech ◽  
P Price ◽  
J Wilhelm

The indirect immunofluorescent (IIF) antibody technique for the detection of Toxoplasma gondii immunoglobulin M (IgM) often gives false negative results, probably due to the competition between IgG and IgM. We therefore adapted a gel filtration procedure for the separation of IgG and IgM to a routine diagnostic test capable handling at least 10 sera per day and requiring only 50 microliters of serum. The results from 108 sera having positive complement fixation titers for Toxoplasma showed that 17 were IgM positive when the whole serum was tested by IIF compared with 55 positive when the IgM fraction was used. Sera with antideoxyribonucleic acid titers do not give false positive results after fractionation, and the removal of IgG eliminates false positive results due to rheumatoid factor. A prospective study showed that Toxoplasma IgM may persist up to 9 months.


1981 ◽  
Author(s):  
J J Rodzynek ◽  
P L Schoenfeld ◽  
T Martin ◽  
P Léautaud ◽  
P Wettendorff ◽  
...  

Citrated whole blood thrombo-elastogram (TEG) and its several parameters (r, k, am, IPT), Ethanol gel test (EGT), Fibrinogen degradation products (FDP) and Raby’s transfer test (RTT) were studied in 52 healthy volunteers acting as normal controls, in 211 consecutive patients admitted in a general hospital for non thrombotic pathologies (group 1), in 59 consecutive patients admitted for deep vein thrombosis (group 2) and in 45 consecutive patients addmitted for pulmonary thrombo embolism, confirmed at scintigraphy (group 3).In conclusion: l. TEG (r, k, am, IPT) offers little help in the early diagnosis of deep vein thrombosis as well as pulmonary thrombo embolism. 2. EGT although offering a high specificity (6.6% false positive), lacks of sensitivity for the diagnosis of deep vein thrombosis (56.6% false negative). 3. RTT appears as a highly sensitive detector of deep vein thrombosis (positive in 96.6% of cases) and of pulmonary embolism (positive in 97.7% of cases) as well as reasonably specific (12.3% false positive tests). 4. Negativity of FDP and RTT appears as a strong argument against the diagnosis of thrombotic disease.


Sign in / Sign up

Export Citation Format

Share Document