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Biomedical subjects

R Steckel

Publications and source records attributed to R Steckel.

13 recordsLinked to original sources
PubMed2003

[Poststroke depression: risk factors and effects on the course of the stroke].

The incidence of poststroke depression (PSD) varies between 20% and 25% as a major variant and an additional 10% and 20% as a minor variant. Its prevalence peaks 3-6 months after stroke onset. In nearly a quarter of all PSD patients, depressive symptoms persist over at least 2 years.Several longitudinal studies have identified different factors which may increase the risk of PSD. Most probably, the severity of the neurological deficit, female gender, history of previous psychiatric disorders, and bad social living conditions increase the risk of PSD. It is uncertain whether lesion location or size modulate PSD risk. Increasing age is not associated with a higher PSD incidence. In contrast, it is obvious that PSD is associated with less favorable outcome and higher mortality. The degree of disability and quality of life are significantly reduced in PSD patients. In conclusion, PSD is presently a not predictable complication of ischemic stroke which is significantly associated with less favorable outcome.Early diagnosis and adequate therapy are still necessary in stroke rehabilitation.

Brain↗
PubMed2000

Improving the quality of care through routine teleradiology consultation.

RATIONALE AND OBJECTIVES: The hypotheses of this study were as follows: (a) University subspecialty radiologists can provide consultations effectively to general radiologists as part of routine clinical operations; (b) these consultations will improve the quality of the final radiologic report; and (c) the consultations will improve the care process and may save money, as well. MATERIALS AND METHODS: For 2,012 consecutive computed tomographic or magnetic resonance (MR) imaging studies, the initial interpretations provided by radiology generalists were subsequently reviewed by specialists, with a final consensus report available. "Truth" was established by final consensus reports. To control for potential bias, 150 adult MR imaging and 250 pediatric radiologic studies were interpreted initially by specialists and then by generalists. Again, truth was established by final consensus reports. RESULTS: There was disagreement between generalist and specialist radiologist interpretations in 427 (21.2%) of the cases reviewed. These disagreements were stratified further by independent specialists, who graded them as important, very important, or unimportant. Differences were considered important or very important in 99% of the cases reviewed. CONCLUSION: Consultations by subspecialty radiologists improved the quality of the radiology reports studied and, at least in some cases, improved the process of care by eliminating unnecessary procedures or suggesting more specific follow-up examinations. The consultation services can be provided cost-effectively from the payer's perspective and may save additional costs when unnecessary procedures can be eliminated.

Humans↗
PubMed1992

Imaging techniques in the evaluation of pulmonary parenchymal neoplasms.

Conventional PA and lateral chest radiographs continue to be the initial examination of choice to evaluate patients who are suspected of having a pulmonary parenchymal neoplasm. A lung lesion can be characterized as probably benign or malignant based on its radiographic appearance (size, shape, margins, presence of calcification, cavitation or air bronchograms, growth rate). A spiculated or lobulated lesion greater than 3 cm in size that is noncalcified is highly suspicious for malignancy. A lung lesion less than 3 cm in size with smooth borders that appears noncalcified on conventional radiographs should be examined by CT, including densitometry to detect calcification or fat, which indicates benignity. In patients with known lung cancer, CT can help to stage the tumor by indicating hilar or mediastinal involvement, or distant metastases. Currently, MR imaging has a limited role, but can be used as a "problem solving" modality for selected cases in evaluating pulmonary parenchymal neoplasms.

Diagnosis, Differential↗
PubMed1988

Diagnostic imaging techniques in mediastinal malignancies.

Mediastinal masses occur in both men and women of every age, and close to half of affected patients are asymptomatic. Screening of asymptomatic persons is not economically feasible. Symptomatic patients should be evaluated initially with posteroanterior and lateral chest radiographs. Additional imaging techniques may be required in patients suspected of having a mediastinal mass, when there is a questionable abnormality seen on chest radiographs or when local or systemic symptoms suggest a mediastinal mass. These techniques include oblique views, over-penetrated radiographs, and fluoroscopy of the chest. Computerized tomography of the chest is the imaging modality of choice for further assessment of a mediastinal mass. It can also be an important adjunct in radiotherapy portal planning. The use of other imaging modalities depends on the location of the tumor, the equipment available, and the expertise of local radiologists. In following up treated patients for disease recurrence, periodic chest radiographs are usually sufficient. Computerized tomography scans, because of their expense, should only be obtained as a baseline after completion of therapy or in patients with a suspected relapse.

Humans↗
PubMed1987

Diagnostic imaging techniques in lung carcinoma.

For the early detection of lung cancer at a stage when it is localized and hence resectable, persons in a high-risk group should be screened periodically with sputum cytologic studies and chest radiographs. For determination of the intrathoracic extent of a lesion, posteroanterior and lateral chest radiographs should be followed by computerized tomography to evaluate the hila, mediastinum, pleura, and chest wall. Computerized tomographic examination of the chest should be extended to include the upper abdomen. The adrenal glands can be evaluated by such examination, but adequate examination of the liver requires both precontrast and postcontrast computerized tomography scans. The radiologic workup for assessing distant metastases to the liver, brain, or bone should be performed only when clinical and biochemical findings suggest such metastases. For detection of recurrent carcinoma following treatment, computerized tomograms of the chest are more sensitive than routine radiographs. Magnetic resonance imaging may prove useful in the future for initial staging and for differentiating posttreatment fibrosis from recurrent bronchogenic carcinoma.

Adrenal Gland Neoplasms↗
PubMed1987

Nonpalpable breast cancer.

Although mammography is the most reliable method for the early detection of breast cancer in asymptomatic women and in women with equivocal signs or symptoms, this screening tool is still underutilized in the United States. Precise biopsy of suspicious nonpalpable findings is facilitated by mammographic localization.

Adult↗
PubMed1985

Diskospondylitis in five horses.

Diskospondylitis was diagnosed in 5 horses admitted to the Purdue University Large Animal Clinic during a 3-year period. Each horse had evidence of cervical pain. Clinical signs and radiography were useful for identifying the diskospondylitis. Cerebrospinal fluid was normal.

Animals↗
PubMed1978

Electromagnetic rheoangiometry: an extension of selective angiography.

A harmless magnetic field produced by an extracorporeal magnet induces in the blood vessels of a living subject electrical signals which carry information about regional blood flows. Loop probes of hairlike consistency equipped with fine electrodes can now be introduced percutaneously and selectively into the vasculature through angiographic catheters to pick up these magnetically induced signals at selected loci. In addition to a continuous record of phasic blood flow, the loop sensors provide signals which measure variations in vascular diameters, thus yielding a continuous record of active and passive vasomotion. Coupled with blood pressure recordings, these data will permit determination of the elastic constants of blood vessels in situ. The manifold capabilities of electromagnetic rheoangiometry for providing continuous records of these vascular parameters are illustrated in dogs with tracings using multichannel recorders which provide continuous information of arterial blood pressures, instantaneous and mean blood flows, and instantaneous and mean vascular diameter changes simultaneously in two nonadjacent arteries.

Animals↗