AP Barreiros

Universität Regensburg, Ratisbon, Bavaria, Germany

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Publications (97)325.86 Total impact

  • AP Barreiros · D Strand · PR Galle · S Strand
    Zeitschrift für Gastroenterologie 08/2015; 41(08). DOI:10.1055/s-0035-1555405 · 1.05 Impact Factor
  • Zeitschrift für Gastroenterologie 08/2015; 41(08). DOI:10.1055/s-0035-1555409 · 1.05 Impact Factor
  • AP Barreiros · TA Sagban · M Schuchmann · S Kanzler · PR Galle · G Otto · AW Lohse
    Zeitschrift für Gastroenterologie 08/2015; 41(08). DOI:10.1055/s-0035-1555388 · 1.05 Impact Factor
  • Ana Barreiros · Christoph Dietrich · Andre Ignee
    Gastroenterologie up2date 06/2015; 11(02):74-77. DOI:10.1055/s-0034-1391709
  • C Jenssen · A P Barreiros · U Will · E Burmester · I Schmidtmann · A J Eckardt
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    ABSTRACT: Purpose: To examine practice patterns of endosonographers in diagnosing and managing gastrointestinal stromal tumors (GISTs) in Germany. Materials and Methods: A modified published survey (Ha et al., Gastrointest Endosc 2009) was sent to endosonographic ultrasound (EUS) customers in Germany. The survey was also publicized on the homepage of an EUS interest group. To avoid duplicate opinions, participants were asked to return one survey per institution. Results: 142 centers of roughly 850 German EUS centers responded. 25 % were from University hospitals and 74 % from community hospitals. 61 % performed > 2 EUS scans for suspected subepithelial lesions/week. Although 97 % of respondents believed that tissue acquisition with CD117 immunohistochemistry best predicts a GIST, 11 % do not perform EUS-FNA when suspecting a GIST, 68 % perform it occasionally and 18 % perform it regularly. The main EUS criteria used for a suspected GIST are the typical layer (85 %), hypoechoic appearance (80 %) and gastric location (51 %). 69 % would diagnose a GIST with negative CD117 if the EUS criteria and spindle cells are present. FNA was rated helpful in < 50 % by 55 % of participants. Size was the primary criterion for suspecting malignancy. 95 % of respondents would perform surveillance ≥ 1x/year of GISTs that are not resected. Conclusion: There is significant variability in the diagnosis and management of GISTs in Germany. Diagnostic certainty of EUS-FNA is suboptimal in many centers and EUS is frequently used for guidance. The diagnosis of a GIST is often guided by a "gut feeling" rather than evidence. Efforts should be made to unify existing guidelines. © Georg Thieme Verlag KG Stuttgart · New York.
    Ultraschall in der Medizin 04/2015; DOI:10.1055/s-0034-1398970 · 4.92 Impact Factor
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    ABSTRACT: Purpose: To analyse the incidence of bleeding after percutaneous ultrasound guided diagnostic and therapeutic intraabdominal interventions in a prospective multicentre study (DEGUM percutaneous interventional ultrasound study). Materials and Methods: Within a time period of 2 years diagnostic and therapeutic intraabdominal interventions (with the exclusion of ascites paracentesis) performed percutaneously under continuous ultrasound (US) guidance were prospectively assessed using a pseudonymized standardized web site entry form. Number and type of intervention, operator experience, patient characteristics, medication, lab data as well as technical aspects of the procedure and bleeding complications were analysed according to the interventional radiology standards. Results: 8172 US-guided intraabdominal interventions (liver n = 5903; pancreas n = 501, kidney n = 434, lymph node = 272, biliary system n = 153, spleen n = 63, other abdominal organs and extra-organic targets n = 999) were analysed in 30 hospitals. The majority were diagnostic biopsies including 1780 liver parenchyma, 3400 focal liver lesions and 404 pancreatic lesions. 7525 interventions (92.1 %) were performed in hospitalized patients (mean age 62.6 years). Most operators were highly experienced in US-guided interventions (> 500 interventions prior to the study n = 5729; 70.1 %). Sedation was administered in 1131 patients (13.8 %). Needle diameter was ≥ 1 mm in 7162 punctures (87.9 %) with main focus on core needle biopsies (18 G, n = 4185). Clinically relevant bleeding complications with need of transfusion (0.4 %), surgical bleeding control (0.1 %) and radiological coiling (0.05 %) were very rare. Bleeding complications with fatal outcome occurred in four patients (0.05 %). The frequency of major bleeding complications was significantly higher in patients with an INR > 1.5 (p < 0.001) and patients taking a medication potentially interfering with platelet function or plasmatic coagulation (p < 0.0333). Conclusion: This prospective multicentre study confirms the broad spectrum of percutaneous US-guided intraabdominal interventions. However diagnostic liver biopsies dominate with the use of core needle biopsies (18 G). Percutaneous US-guided interventions performed by experienced sonographers are associated with a low bleeding risk. Major bleeding complications are very rare. A pre-interventional INR < 1.5 and individual medication risk assessment are recommended. © Georg Thieme Verlag KG Stuttgart · New York.
    Ultraschall in der Medizin 04/2015; 36(2):122-131. DOI:10.1055/s-0034-1399282 · 4.92 Impact Factor
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    C Jenssen · C Pietsch · U Gottschalk · A P Barreiros · A Teufel · X W Cui · C F Dietrich
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    ABSTRACT: In patients with diabetes mellitus, abdominal ultrasonography is the appropriate diagnostic technique to detect and to follow-up secondary and accompanying diseases of the liver, the kidneys, the pancreas, the gastrointestinal tract and of abdominal vessels. Moreover, pancreatic and hepatic diseases may be realized which are of etiological importance for diabetes mellitus. Based on a systematic survey of the published literature, this review in 3 parts will describe the value of abdominal ultrasonography in patients with diabetes mellitus. Part 1 deals with the diagnostic relevance and particular findings of ultrasonographic methods in hepatic manifestations and complications of diabetes mellitus. © Georg Thieme Verlag KG Stuttgart · New York.
    Zeitschrift für Gastroenterologie 04/2015; 53(4):306-319. DOI:10.1055/s-0034-1398949 · 1.05 Impact Factor
  • A P Barreiros · L Chiorean · B Braden · C F Dietrich
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    ABSTRACT: Ultrasound is often the first imaging procedure performed in the evaluation of individuals with suspected or known liver disease. Despite technical advances in ultrasound techniques, sonographic detection and evaluation of diffuse liver disease still remains difficult. This is due to the fact that diffuse liver disease does not always cause distortion of the liver parenchymal texture, internal liver architecture, or shape of the liver. On the other hand, the size of the liver, the echo pattern of the hepatic parenchyma, the analysis of intrahepatic vessels and alterations in perihepatic structures and lymph nodes can be helpful sonographic parameters of diffuse liver disease. Until now, the sonographic appearance of some rare diffuse liver diseases is not well known. However, there are some typical sonomorphological signs that, once identified, can facilitate the differentiation between various diseases. The aim of this paper is to highlight some typical ultrasound findings of liver parenchyma and perihepatic lymph node structures in rare diffuse liver diseases based on a review of published data.
    Zeitschrift für Gastroenterologie 11/2014; 52(11):1247-1256. DOI:10.1055/s-0034-1384996 · 1.05 Impact Factor
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    Ana Paula Barreiros · Gerd Otto · Bita Kahlen · Andreas Teufel · Peter R. Galle
    Journal of Hepatology 09/2014; 62(2). DOI:10.1016/j.jhep.2014.09.008 · 11.34 Impact Factor
  • D. Schacherer · M. Müller · A.P. Barreiros
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    ABSTRACT: Hintergrund und Fragestellung Zu den Pathologien im Bereich des Gastrointestinaltrakts, die gut sonographisch zu diagnostizieren sind, zählen insbesondere die beschriebenen funktionellen Störungen, die diffusen Wandverdickungen im Rahmen von entzündlichen Darmerkrankungen und die umschriebenen Wandverdickungen bei tumorösen Erkrankungen. Weniger gut lassen sich hingegen entzündliche oder ulzeröse Mukosaprozesse, Gefäßveränderungen im Sinne von Angiodysplasien, Blutungen oder kleine Polypen darstellen; insbesondere bei Letzteren fehlt der sonographischen Methode jeglicher Anspruch auf vollständige Darmbeurteilung. Schlussfolgerungen Da die von Darmgas überlagerten Regionen (insbesondere der linke Unterbauch) oftmals sonographisch nicht ausreichend beurteilbar sind und selten der gesamte Intestinaltrakt sonographisch darstellbar ist, spielt die Sonographie eine komplementäre Rolle zur Endoskopie und zur radiologischen Bildgebung – der Stellenwert der intestinalen Sonographie hat sich jedoch in den letzten 20 Jahren entscheidend verändert.
    Der Gastroenterologe 09/2014; 9(5):418-428. DOI:10.1007/s11377-014-0911-6
  • P Ploch · H Milera · R Tölken · T Itzel · M Hainz · A Teufel · PR Galle · AP Barreiros
    Zeitschrift für Gastroenterologie 08/2014; 52(08). DOI:10.1055/s-0034-1386282 · 1.05 Impact Factor
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    ABSTRACT: Background and aims: Despite increasingly sensitive and accurate blood tests to detect liver disease, liver biopsy remains very useful in patients with atypical clinical features and abnormal liver tests of unknown etiology. The aim was to determine those elevated laboratory liver parameters that cause the clinician to order a biopsy, and whether laboratory tests are associated with pathological findings on histology. Methods: 504 patients with unclear hepatopathy, admitted to the outpatient clinic of a university hospital between 2007 and 2010, were analyzed with respect to laboratory results, clinical data, and the results of liver biopsies. Results: Aspartate aminotransferase (AST) and glutamate dehydrogenase (GLDH) levels above the normal range significantly increased the likelihood of recommending a liver biopsy by 81% [OR with 95% CI 1.81 (1.21-2.71), p = 0.004] and 159% [OR with 95% CI 2.59 (1.70-3.93), p < 0.001], respectively. AST values above normal were associated with fibrosis (63 vs. 40% for normal AST, p = 0.010). Elevated ferritin levels pointed to a higher incidence of steatosis (48 vs. 10% for normal ferritin, p < 0.001) and inflammation (87 vs. 62% for normal ferritin, p = 0.004). Conclusions: Our results indicate that elevated AST and GLDH were associated with a greater likelihood of recommending liver biopsy. Elevated AST and ferritin levels were associated with steatosis, inflammation and fibrosis on liver biopsies. Thus, AST and ferritin may be useful non-invasive predictors of liver pathology in patients with unclear hepatopathy.
    Digestion 07/2014; 89(4):310-318. DOI:10.1159/000362404 · 2.10 Impact Factor
  • AP Barreiros · XW Cui · A Ignee · A Teufel · CF Dietrich
    Endoskopie heute 03/2014; 27(01). DOI:10.1055/s-0034-1371073 · 0.05 Impact Factor
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    A P Barreiros · X W Cui · A Ignee · C De Molo · C Pirri · C F Dietrich
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    ABSTRACT: Background and aims: The introduction of a new type of small handheld ultrasound device brings greater portability and affordability. The basic ultrasound approach with these handheld devices has been defined by European Federation of Societies of Ultrasound in Medicine and Biology (EFSUMB) as "EchoScopy". The current study aimed to assess the image quality, indications and limitations of a portable pocket "EchoScope" compared with a high-end ultrasound system in abdominal diseases. Methods: 231 consecutive patients were included in this study. Physician A performed ultrasound examinations with a high-end ultrasound system (HEUS), then physician B performed the same ultrasound examination using an EchoScope (Vscan™). In patients with focal lesions, physician B also measured the largest diameters and graded the vascularity by using colour Doppler imaging (CDI) within the lesion on the same plane with both ultrasound systems. Compared with the excellent image quality using HEUS, the image quality of the EchoScope was graded as good, sufficient or non-sufficient. Results: Out of all 231 patients, 167 had focal lesions, 19 patients were found with diffuse pathological findings, six with ascites, six after liver puncture and 33 without any pathological findings. The image quality of the pocket device was considered as being good or sufficient to delineate the pathology in 225/231 (97.4 %). The detection rate of the EchoScope for abdominal focal lesion was 162/167 (97 %), only five superficially located lesions could not be detected. Both systems showed agreement in determination of the best positioning to perform abdominal paracentesis and assessing complications after intervention. Conclusions: The investigated EchoScope displays a sufficient image quality, in some indications such as detection of focal lesions > 20 mm, detection of ascites, hydronephrosis and other pathological findings with comparable results to HEUS. We conclude that pocket sized EchoScopy devices have a promising future but the indications have to be determined by a prospective study.
    Zeitschrift für Gastroenterologie 03/2014; 52(3):269-275. DOI:10.1055/s-0033-1350114 · 1.05 Impact Factor
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    ABSTRACT: Splenic lesions are rare and characterization is difficult. Secondary spread is more frequent than primary malignant lesions. Thus clinical circumstances are important in the general work-up. Contrast enhanced ultrasound (CEUS) had high accuracy in recent studies but the positive predictive value is low. Biopsy is considered dangerous. Recent studies have brought back this method into focus showing an excellent efficacy and safety. The aim of this study was to estimate the rate of relevant biopsy results in patients with splenic lesions concerning the clinical circumstances. Patients with unclear splenic lesions which appeared progressively hypoenhancing in the late phase of CEUS with BR1 were included. Biopsy was performed with ultrasound guidance. Patients were sorted into 5 groups according to their clinical symptoms. 44 patients were enrolled, 59% had benign lesions. 73% were rated relevant. For the subgroups the rate was: patients with hints for hemato-oncological diseases 83%, patients without symptoms 38%, patients with infections of unknown origin 100%, patients with suspicion of metastases 33, immunocompromised patients 100%. One bleeding could be managed conservatively, another bleeding was detected incidentally 2 weeks later. Percutaneous biopsy of unclear splenic lesions which appear hypoenhancing in the late phase of CEUS with BR1 results in a high rate of relevant lesions. The results should be tested in larger numbers of patients.
    Clinical hemorheology and microcirculation 01/2014; 58(4). DOI:10.3233/CH-141813 · 2.24 Impact Factor
  • PS Ploch · H Milera · R Tölken · T Itzel · M Heinz · A Teufel · PR Galle · AP Barreiros
    Zeitschrift für Gastroenterologie 01/2014; 52(01). DOI:10.1055/s-0033-1360915 · 1.05 Impact Factor
  • Zeitschrift für Gastroenterologie 01/2014; 52(01). DOI:10.1055/s-0033-1360914 · 1.05 Impact Factor
  • AJ Eckardt · AP Barreiros · U Will · E Burmester · C Jenssen
    Ultraschall in der Medizin 10/2013; 34(S 01). DOI:10.1055/s-0033-1354909 · 4.92 Impact Factor
  • A Ignee · C Xinwu · AP Barreiros · G Schuessler · CF Dietrich
    Ultraschall in der Medizin 10/2013; 34(S 01). DOI:10.1055/s-0033-1354852 · 4.92 Impact Factor
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    AP Barreiros · XW Cui · A Ignee · C de Molo · C Pirri · CF Dietrich
    Ultraschall in der Medizin 10/2013; 34(S 01). DOI:10.1055/s-0033-1354888 · 4.92 Impact Factor

Publication Stats

571 Citations
325.86 Total Impact Points


  • 2014–2015
    • Universität Regensburg
      Ratisbon, Bavaria, Germany
    • University Hospital Regensburg
      Ratisbon, Bavaria, Germany
  • 1998–2014
    • Johannes Gutenberg-Universität Mainz
      • • I. Department of Medicine
      • • III. Department of Medicine
      Mayence, Rheinland-Pfalz, Germany
  • 2009
    • ISC Konstanz
      Constance, Baden-Württemberg, Germany
  • 2008–2009
    • Caritas Krankenhaus Bad Mergentheim
      Bad Mergentheim, Baden-Württemberg, Germany