Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women

2014 ◽  
Vol 30 (10) ◽  
pp. 706-713 ◽  
Author(s):  
MS Whiteley ◽  
SJ Dos Santos ◽  
CC Harrison ◽  
JM Holdstock ◽  
AJ Lopez
Keyword(s):  
False Positive ◽  
Gold Standard ◽  
False Negative ◽  
Duplex Ultrasonography ◽  
Coil Embolisation ◽  
Pelvic Vein ◽  
False Positive Diagnosis ◽  
Internal Iliac ◽  
Pre Treatment ◽  
Vein Reflux

Objectives To assess the suitability of transvaginal duplex ultrasonography to identify pathological reflux in the ovarian and internal iliac veins in women. Methods A retrospective study of patients treated in 2011 and 2012 was performed in a specialised vein clinic. Diagnostic transvaginal duplex ultrasonography in women presenting with symptoms or signs of pelvic vein reflux were compared with the outcomes of treatment from pelvic vein embolisation. A repeat transvaginal duplex ultrasonography was performed 6 weeks later by a blinded observer and any residual reflux was identified. Results Results from 100 sequential patients were analysed. Mean age 44.2 years (32–69) with mode average parity of 3 (0–5 deliveries). Pre-treatment, 289/400 veins were refluxing (ovarian – 29 right, 81 left; internal iliac – 93 right, 86 left). Coil embolisation was successful in 86/100 patients and failed partially in 14/100 – 5 due to failure to cannulate the target vein. One false-positive diagnosis was made. Conclusion Currently there is no accepted gold standard for pelvic vein incompetence. Comparing transvaginal duplex ultrasonography with the outcome from selectively treating the veins identified as having pathological reflux with coil embolisation, there were no false-negative diagnoses and only one false-positive. This study suggests that transvaginal duplex ultrasonography could be the gold standard in assessing pelvic vein reflux.

The effect of a subsequent pregnancy after transjugular coil embolisation for pelvic vein reflux

2016 ◽  
Vol 32 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Scott J Dos Santos ◽  
Judy M Holdstock ◽  
Charmaine C Harrison ◽  
Mark S Whiteley
Keyword(s):  
Varicose Veins ◽  
Iliac Vein ◽  
Subsequent Pregnancy ◽  
Duplex Ultrasonography ◽  
Venous Reflux ◽  
Coil Embolisation ◽  
Recurrent Reflux ◽  
Pelvic Vein ◽  
Internal Iliac ◽  
The Right

Background Pelvic venous reflux has been proven to contribute to the development of primary and recurrent varicose veins, vulval/labial varicose veins and pelvic congestion syndrome. It is associated with lower limb varicose veins in 20% of patients who have a history of at least one prior vaginal delivery. Pelvic vein embolisation is known to be a safe and effective treatment for the abolition of pelvic venous reflux. However, the effect of a subsequent pregnancy on a previously embolised patient remains largely unknown. This study aims to report the effect of pregnancy on patients that have undergone pelvic vein embolisation. Methods Patients that had previously undergone pelvic vein embolisation for pelvic venous reflux at our unit were sent a questionnaire asking if they had had a pregnancy and subsequently delivered post-embolisation. Patients responding positively were invited to attend our unit for transvaginal duplex ultrasonography of their pelvic veins. Post-pregnancy transvaginal duplex ultrasonography results were compared to pre-embolisation and 6-week post-embolisation scans. Results Eight women, aged 32–48 years (mean 38.8), were retrospectively analysed. Parity prior to embolisation ranged from 1 to 5 (mean 2.8). Initial outcomes at 6 weeks Pelvic venous reflux was completely eliminated in five patients, two patients achieved complete elimination of truncal reflux with very minor vulval reflux and one patient had persistent, mild reflux in the right internal iliac vein. Post-pregnancy outcomes Pelvic venous reflux was completely eliminated in three patients and five patients displayed pelvic venous reflux in at least one truncal vein, with or without concurrent vulval reflux. No patient showed any coil displacement or embolisation as a result of the pregnancy. Conclusions Pregnancy is associated with recurrent reflux in the pelvic veins in women who had previously been treated with coil embolisation. Following recovery from pregnancy, repeat embolisation can eliminate recurrent reflux. Pregnancy appears to be safe following coil embolisation of pelvic veins.

Pelvic venous reflux in males with varicose veins and recurrent varicose veins

2017 ◽  
Vol 33 (6) ◽  
pp. 382-387 ◽  
Author(s):  
Emma B Dabbs ◽  
Scott J Dos Santos ◽  
Irenie Shiangoli ◽  
Judith M Holdstock ◽  
David Beckett ◽  
...  
Keyword(s):  
Varicose Vein ◽  
Lower Limb ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Duplex Ultrasonography ◽  
Pelvic Vein ◽  
Male Cohort ◽  
Internal Iliac ◽  
Bilateral Lower Limb ◽  
Vein Reflux

Objectives To report on a male cohort with pelvic vein reflux and associated primary and recurrent lower limb varicose veins. Methods Full lower limb duplex ultrasonography revealed significant pelvic contribution in eight males presenting with bilateral lower limb varicose veins. Testicular and internal iliac veins were examined with either one or a combination of computed tomography, magnetic resonance venography, testicular, transabdominal or transrectal duplex ultrasonography. Subsequently, all patients received pelvic vein embolisation, prior to leg varicose vein treatment. Results Pelvic vein reflux was found in 23 of the 32 truncal pelvic veins and these were treated by pelvic vein embolisation. Four patients have since completed their leg varicose vein treatment and four are undergoing leg varicose vein treatments currently. Conclusion Pelvic vein reflux contributes towards lower limb venous insufficiency in some males with leg varicose veins. Despite the challenges, we suggest that pelvic vein reflux should probably be investigated and pelvic vein embolisation considered in such patients.

scholarly journals Reducing the risk of misdiagnosis of indirect ELISA by normalizing serum-specific background noise: The example of detecting anti-FGFR3 autoantibodies

2019 ◽  
Author(s):  
Christian Peter Moritz
Keyword(s):  
False Positive ◽  
Background Noise ◽  
Indirect Elisa ◽  
Solid Phase ◽  
False Negative ◽  
Rabbit Antiserum ◽  
Growth Factor Receptor ◽  
Normalization Method ◽  
Enzyme Linked Immunosorbent Assay ◽  
False Positive Diagnosis

Indirect enzyme-linked immunosorbent assay (ELISA) is an important diagnostic method as it enables the quantification of the presence of autoantibodies in human blood sera. However, unspecific binding of antibodies to the solid phase causes considerable serum-specific background noise (SSBN), involving the risk of false positive diagnosis. Therefore, we present a simple and concise, yet obvious proof-of-principle of a recently suggested normalization method. The method is based on subtracting SSBN by using non-coated ELISA wells as a control for each serum-of-interest. We performed ELISA to quantify anti-fibroblast growth factor receptor 3 (FGFR3) antibody levels in three positive controls (two anti-FGFR3-positive patients and a rabbit antiserum against FGFR3) and 58 negative controls (healthy blood donors). In all subjects, we found considerable unspecific reactivity which strongly varied among subjects. The conventional normalization method was not able to balance this strong SSBN, as demonstrated by 2/58 false positive healthy controls and one FGFR3-positive patient that was hidden in the noise (false negative). SSBN normalization reduced the frequency of false-positives to 0/58. Further, all three anti-FGFR3-positive sera were successfully detected and even doubled their z-score used to determine positivity. Albeit occupying more space on the ELISA plate, we strongly recommend considering this normalization method when working with blood sera. To better put the idea across to the community, we depict the SSBN issue and its solution in a graphic scheme. We conclude that SSBN normalization increases the sensitivity and specificity of indirect ELISA and thereby reduces the risk of false positive and false negative diagnosis.

Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux

2014 ◽  
Vol 30 (2) ◽  
pp. 133-139 ◽  
Author(s):  
JM Holdstock ◽  
SJ Dos Santos ◽  
CC Harrison ◽  
BA Price ◽  
MS Whiteley
Keyword(s):  
Varicose Veins ◽  
Strong Association ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Venous Reflux ◽  
Foam Sclerotherapy ◽  
Pelvic Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
Vein Reflux

Objectives: To determine the prevalence of haemorrhoids in women with pelvic vein reflux, identify which pelvic veins are associated with haemorrhoids and assess if extent of pelvic vein reflux influences the prevalence of haemorrhoids. Methods: Females presenting with leg varicose veins undergo duplex ultrasonography to assess all sources of venous reflux. Those with significant reflux arising from the pelvis are offered transvaginal duplex ultrasound (TVS) to evaluate reflux in the ovarian veins and internal Iliac veins and associated pelvic varices in the adnexa, vulvar/labial veins and haemorrhoids. Patterns and severity of reflux were evaluated. Results: Between January 2010 and December 2012, 419 female patients with leg or vulvar varicose vein patterns arising from the pelvis underwent TVS. Haemorrhoids were identified on TVS via direct tributaries from the internal Iliac veins in 152/419 patients (36.3%) and absent in 267/419 (63.7%). The prevalence of the condition increased with the number of pelvic trunks involved. Conclusion: There is a strong association between haemorrhoids and internal Iliac vein reflux. Untreated reflux may be a cause of subsequent symptomatic haemorrhoids. Treatment with methods proven to work in conditions caused by pelvic vein incompetence, such as pelvic vein embolisation and foam sclerotherapy, could be considered.

The doubtful value of tympanometry in the diagnosis of otosclerosis

1985 ◽  
Vol 99 (6) ◽  
pp. 545-547 ◽  
Author(s):  
G. G. Browning ◽  
I. R. C. Swan ◽  
S. Gatehouse
Keyword(s):  
False Positive ◽  
False Negative ◽  
Positive Diagnosis ◽  
False Positive Diagnosis ◽  
Practical Usefulness ◽  
The Mean ◽  
Mean Compliance ◽  
Range Of Values ◽  
Normal Controls ◽  
Made In

AbstractMany consider that the compliance of the middle ear as measured from the tympanogram can be helpful in diagnosing otosclerosis. To test this assertion, the compliance in 34 individuals with surgically proven otosclerosis was compared with the compliance in 34 age and sex matched, normal controls, randomly selected from the population. Though the mean compliance was different in the two groups, there was considerable overlap in the range of values which severely limits the practical usefulness of tympanometry.If the level of compliance is taken at which a false negative diagnosis would be made in 10 per cent of otosclerotic ears, a false positive diagnosis of otosclerosis would be made in 88 per cent of normal ears. If the level of compliance is taken at which a false positive diagnosis of otosclerosis would be made in 10 per cent of normal ears, 72 per cent of ears with otosclerosis would be considered normal.It is concluded that tympanometry will not help to arrive at a diagnosis of otosclerosis.

scholarly journals Color feature extraction of HER2 Score 2+ overexpression on breast cancer using Image Processing

2018 ◽  
Vol 154 ◽  
pp. 03016
Author(s):  
Izzati Muhimmah ◽  
Dadang Heksaputra ◽  
Indrayanti
Keyword(s):  
Image Segmentation ◽  
False Positive ◽  
Gold Standard ◽  
Image Acquisition ◽  
False Negative ◽  
Growth Factor Receptor ◽  
Her2 Status ◽  
Color Features ◽  
Color Deconvolution ◽  
Expert Validation

One of the major challenges in the development of early diagnosis to assess HER2 status is recognized in the form of Gold Standard. The accuracy, validity and refraction of the Gold Standard HER2 methods are widely used in laboratory (Perez, et al., 2014). Method determining the status of HER2 (human epidermal growth factor receptor 2) is affected by reproductive problems and not reliable in predicting the benefit from anti-HER2 therapy (Nuciforo, et al., 2016). We extracted color features by methods adopting Statistics-based segmentation using a continuous-scale naïve Bayes approach. In this study, there were three parts of the main groups, namely image acquisition, image segmentation, and image testing. The stages of image acquisition consisted of image data collection and color deconvolution. The stages of image segmentation consisted of color features, classifier training, classifier prediction, and skeletonization. The stages of image testing were image testing, expert validation, and expert validation results. Area segmentation of the membrane is false positive and false negative. False positive and false negative from area are called the area of system failure. The failure of the system can be validated by experts that the results of segmentation region is not membrane HER2 (noise) and the segmentation of the cytoplasm region. The average from 40 data of HER2 score 2+ membrane images show that 75.13% of the area is successfully recognized by the system.

scholarly journals Implications of False Negative and False Positive Diagnosis in Lymph Node Staging of NSCLC by Means of 18F-FDG PET/CT

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e78552 ◽  
Author(s):  
Shaolei Li ◽  
Qingfeng Zheng ◽  
Yuanyuan Ma ◽  
Yuzhao Wang ◽  
Yuan Feng ◽  
...  
Keyword(s):  
Lymph Node ◽  
False Positive ◽  
Fdg Pet ◽  
False Negative ◽  
Lymph Node Staging ◽  
Positive Diagnosis ◽  
False Positive Diagnosis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Investigation and treatment of pelvic vein reflux associated with varicose veins: Current views and practice of 100 UK vascular specialists

2019 ◽  
Vol 35 (1) ◽  
pp. 56-61
Author(s):  
Bruce Campbell ◽  
Stephen Goodyear ◽  
Ian Franklin ◽  
Isaac Nyamekye ◽  
Keith Poskitt
Keyword(s):  
Clinical Trial ◽  
Varicose Veins ◽  
Substantial Variation ◽  
Pelvic Vein ◽  
Clinical Trial Evidence ◽  
Internal Iliac ◽  
The Uk ◽  
Trial Evidence ◽  
Vein Reflux

Objective Management of pelvic vein disorders possibly contributing to leg varicose veins remains variable and controversial. This survey investigated practice in the UK. Methods Email questionnaire to 328 members of the Vascular Society. Results One hundred and four (32%) questionnaires were returned. Of 100 respondents treating varicose veins, 9% do not recognise pelvic vein reflux and 11% never investigate or treat it. Indications for investigation include labial (94%) and buttock/upper thigh (70%) varicose veins: 46% use magnetic resonance venography and only 16% transvaginal duplex. Treatments used are coil embolization (89%), sclerotherapy via thigh veins (47%) and transcatheter sclerotherapy (26%). Thirty-four per cent treat only ovarian veins (not internal iliac tributaries). Follow-up is by clinical response (100%): only 14% use duplex. Only 5% treat >10 patients annually. Conclusions There is substantial variation in the management of pelvic vein reflux in the UK. There is need for further consensus and good clinical trial evidence to guide practice.

scholarly journals How to Avoid False-Negative and False-Positive Diagnoses of Platelet Apoptosis: Illustrative Experimental and Clinically Relevant Cases

2018 ◽  
Vol 24 (7) ◽  
pp. 1009-1013
Author(s):  
Valery Leytin ◽  
Armen V. Gyulkhandanyan ◽  
John Freedman
Keyword(s):  
False Positive ◽  
Platelet Rich Plasma ◽  
False Negative ◽  
Shear Stresses ◽  
Optimal Conditions ◽  
False Positive Diagnosis ◽  
Current Review ◽  
Chemical Agents ◽  
Negative Controls ◽  
Stimulation Of

Platelets may selectively execute apoptosis (PL-Apo), activation (PL-Act), and both or no responses when exposed to different chemical agents, shear stresses, and stored under blood banking conditions. Appropriate diagnosis of PL-Apo is an important issue of platelet physiology investigations. However, in diagnosing PL-Apo, there is a risk of a false-negative or false-positive diagnosis. The goal of the current review is to present recommendations that may help to avoid incorrect PL-Apo diagnosis. Analyzing reported studies, we recommend (1) using platelet-rich plasma rather than isolated platelets to minimize artificial stimulation of PL-Apo during platelet isolation, (2) using established optimal conditions for stimulation of PL-Apo and/or PL-Act, (3) using a panel of PL-Apo and PL-Act markers, and (4) appropriate positive and negative controls for quantification of PL-Apo and PL-Act responses.

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