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Biomedical subjects

C Riedl

Publications and source records attributed to C Riedl.

12 recordsLinked to original sources
PubMed2003

Value of negative spiral CT angiography in patients with suspected acute PE: analysis of PE occurrence and outcome.

The aim of this study was to analyze pulmonary embolism (PE) occurrence and retrospective clinical outcome in patients with clinically suspected acute PE and a negative spiral CT angiography (SCTA) of the pulmonary arteries. Within a 35-month period, 485 consecutive patients with clinical symptoms of acute PE underwent SCTA of the pulmonary arteries. Patients with a negative SCTA and without anticoagulation treatment were followed-up and formed the study group. Patient outcome and recurrence of PE was evaluated retrospectively during a period of 6 months after the initial SCTA, and included a review of computerized patient records, and interviews with physicians and patients. Patients were asked to fill out a questionnaire concerning all relevant questions about their medical history and clinical course during the follow-up period. Special attention was focused on symptoms indicating recurrent PE, as well as later confirmation and therapy of PE. Of the 485 patients, 325 patients (67%) had a negative scan, 134 (27.6%) had radiological signs of PE, and 26 (5.4%) had an indeterminant result. Of 325 patients with a negative scan, 269 (83%) were available for follow-up. The main reasons for loss to follow-up were change of address, name, or phone number, or non-resident patients who left abroad. Of 269 patients available for follow-up, 49 patients (18.2% of 269) received anticoagulant treatment because of prior or recent deep venous thrombosis (32.6%) or a history of PE (34.7%), cardiovascular disease (18.4%), high clinical probability (8.2%), positive ventilation-perfusion scan (4.2%), and elevated D-dimer test (2%). The remaining 220 patients, who did not receive anticoagulant medication, formed the study group. Of this study group, 1 patient died from myocardial infarction 6 weeks after the initial SCTA, and the postmortem examination also detected multiple peripheral emboli in both lungs ( p=0.45%; 0.01-2.5, 95% confidence interval). The PE did not occur in any other patient. In patients with suspected PE and negative SCTA without anticoagulant therapy, the risk of recurrent PE in this study was less than 1% and similar to that in patients after a negative pulmonary angiogram. Therefore, we conclude that patients can be managed safely without anticoagulation therapy; however, this approach may not be appropriate for critically ill patients and those with persistent high clinical suspicion of acute PE.

Adolescent↗
PubMed2003

[Value of 14-gauge ultrasound-guided large-core needle biopsy of breast lesions: own results in comparison with the literature].

PURPOSE: To report the false-negative rate, sensitivity, and specificity of 14-gauge ultrasound-guided large-core needle biopsy (14-G USSB) performed on breast lesions at our institution and, furthermore, to compare and discuss our own results with those reported in the literature. MATERIALS AND METHODS: This study includes 399 lesions examined by 14-G USSB. The results of the 14-G USSB were compared with the results of the surgical biopsy or, in cases of benign histology, were followed clinically. A key word search in two medical databases was undertaken to compare our data with those reported in the literature. The search was limited to the period from January 1990 to February 2002 and only original investigations published in English and German were included in our comparison. RESULTS: At our institution, 238 (59.6 %) benign and 161 (40.4 %) malignant lesions were diagnosed by 14-G USSB. The 14-G USSB was false-negative in 5 (1.25 %) of 399 cases. It has a sensitivity of 95.7 %, and specificity 100%. The literature reports false-negative rates between 0 % and 1.26 %, sensitivities between 86% and 100%, and specificities between 99.7 % and 100 %. On the basis of 3880 results from seven selected original papers and our own study, the false-negative rate for 14-G USSB was calculated to be 0.4 % (16 of 3880). CONCLUSION: Based on our results and those reported in the literature, 14-G USSB can be considered safe and reliable in the assessment of breast lesions.

Adult↗
PubMed2002

[Electrical impedance scanning in the differentiation of suspicious breast lesions: comparison with mammography, ultrasound and histopathology].

PURPOSE: To assess the value of Electrical Impedance Scanning (EIS) in the differentiation of suspicious breast lesions in comparison to mammography (MG) and ultrasound (US). METHODS: In 95 female patients (median 53.1 ys) 95 suspicious breast lesions (BI-RADS TM III - V) in MG or US underwent targeted EIS (TransScan TS 2000(R); TransScan Medical, Israel; Siemens Elema, Sweden). Histopathologic proof (vacuum-assisted biopsy or surgical biopsy) was obtained in all cases. MG, US and EIS were independently assessed by two radiologists in consensus. Chi-square tests as well as variance-analysis for ROC-statistics were performed. RESULTS: Of 95 lesions, 44 were benign, 51 malignant. Sensitivity, specificity, positive and negative predictive values were, respectively for MG 95.3 %, 23.5 %, 51.3 % and 85.7 %, for US 86.5 %, 44.2 %, 57.1 % and 79.1 %, for EIS 77.3 %, 82.3 %, 79.1 % and 80.8 %. The ROC-analysis revealed a significant greater area under the curve for EIS than for MG and US. The sensitivity for EIS was higher in lesions < 10 mm (n = 26; 100 %) and in invasive cancers (n = 31; 80.6 %). The negative predictive value of EIS was higher in BI-RADS TM-IV-lesions (83.9 %) as well as in dense breast parenchyma on the mammogram (86.7 %). CONCLUSION: EIS shows potential adjunctive value to MG and US in the differentiation of suspicious breast lesions.

Adult↗
PubMed2000

Combination of signal intensity measurements of lesions in the peripheral zone of prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer.

The aim of this study was to predict the benign or malignant nature of a prostatic lesion by defining a threshold value of signal intensity ratio and a limiting value of serum prostate-specific antigen (PSA) in patients with elevated PSA level. Twenty-six patients with elevated PSA level and no hypoechogenic lesions at endosonography underwent MR imaging using an endorectal body phased-array coil at 1.5 T (Siemens Magnetom Symphony). A T2-weighted turbo-spin-echo (TSE) pulse sequence was applied in a transverse orientation. Two radiologists evaluated the images. In the presence of a pathological finding they defined regions of interest (ROI) in the suspicious pathological area of the peripheral zone and in muscle for reference. The quotient of the two ROIs was calculated and then correlated with the actual PSA level. Diagnosis was confirmed by prostate biopsy. Ten of 12 patients with quotients smaller than 4 showed cancer at histology. Nine of 12 men with cancer proven by biopsy had PSA levels higher than 10 ng/ml. A significant difference (p < 0.001) was found between the quotients of cancer and quotients of chronic prostatitis, fibrosis, or glandular atrophy. The accuracy of tumor differentiation of the method was 77%. Measurement of signal intensity quotients in the peripheral zone of the prostate in combination with knowledge of defined limits of PSA levels the technique could be helpful in detecting additional cancer areas for prostate biopsy. False-negative tumor results of standard sextant biopsy can be reduced. In men with high PSA values the method has a role in differentiating between patients who require prostate biopsy and those of clinical observation.

Adult↗
PubMed2000

Evaluation of bladder dysfunction.

A careful and detailed history and physical examination can give clues to a neurogenic bladder disturbance. Urine analysis should always be performed to exclude urinary tract infection. The most important basic investigation is ultrasound of the kidneys and of residual urine. If these investigations reveal suspicion of a dysfunction, elaborate urological investigation, including cystoscopy and urodynamic studies, is necessary for classification and appropriate therapy of a neurogeneous vesicourethral disorder.

Humans↗
PubMed2000

Non-bacterial cystitis.

The concept of non-bacterial cystitis (NBC) combines sterile urine and cystitic symptoms as well as inflammatory changes, in particular in the mucosa and submucosa of the bladder. It includes a multiplicity of vicious circles along the entire continence reflex. An understanding of NBC presupposes knowledge of the origin of the normal urinary urge and its successful control. Against the background of the steadily increasing incidence of interstitial cystitis (often irreversible end-stage NBC), it is suggested here that in the face of a failure of first-line therapeutics (anticholinergics, cyclic antidepressants or oestrogens), one must consider without delay the possible presence of NBC.

Cystitis↗
PubMed1995

The potential for malaria control with the biological larvicide Bacillus thuringiensis israelensis (Bti) in Peru and Ecuador.

A study on the efficacy of Bti spraying in mosquito breeding places was undertaken in the Pacific coast of Peru and Ecuador and in the Amazon area of Peru. It was shown that Bti is a powerful larvicide for Anopheles larvae, although it sinks quickly, whereas Anopheles larvae feed at the water surface. The duration of its effect was less than 7 days with the exception of the Amazon area of Peru, where it was approximately 10 days. In two study areas, Bti was sprayed weekly over periods of 10 and 7 weeks, respectively, and the adult mosquito densities were monitored. The Anopheles adult density (bites per person per hour on human baits) was reduced by an average of 70% in one area and by up to 50% in the other. This means that Bti spraying can potentially be an important component of a modified malaria control strategy.

Animals↗
PubMed1994

[The use of new turbo spin-echo pulse sequences with and without fat suppression in the diagnosis and staging of prostatic carcinoma].

MR studies using turbo spin-echo pulse sequences (TSE) were performed on 27 patients with histologically confirmed prostate cancer. A prospective study was conducted in 15 patients who underwent radical prostatectomy. Turbo SE pulse sequences generate strongly T2-weighted images of excellent quality with reduction of measurement time by a factor of 4-6. A comparison with standard T2-weighted spin-echo pulse sequences indicated an objective improvement in the contrast of pathological structures (p < 0.001). With respect to differentiation of stages T2 and T3 (TNM) during pathohistological correlation, sensitivity of 80%, specificity of 40% and an accuracy rate of 67% were obtained. Sensitivity of 71% and specificity of 75% were obtained when decoding cases of infiltration into the seminal vesicles, with an accuracy rate of 73%.

Adipose Tissue↗