ABSTRACT
Objetivo: comparar al capacidad del PET y del ganglio centinela (GC) para la detección de metástasis (MTS) axilares. Evaluar la sensibilidad, especificidad, valor de predicción positivo y negativo del PET/CT. Criterios de inclusión: cáncer de mama T1 T2 N0. Pacientes con axilas clínicamente dudosas. Criterios de exclusión: carcinoma ductal in situ, carcinoma inflamatorio, biopsia reciente de mama o axila, embarazo o lactancia, diabetes. Método: el 18-FDG PET/CT se realizó 15 días antes de la cirugía. La técnica de ganglio centinela se efectuó con el método combinado (radiosótopos y azul patente). Material: fueron evaluadas 44 pacientes. Edad promedio 58 años (37-79). T1: 29 pacientes (66%); T2: 15 pacientes (34%). Tamaño tumoral entre 5 y 40mm (promedio 19mm). Axila clínicamente negativa: 38 (86%); axila dudosa 6 (14%). Estadio I: 27 pacientes (61%); estadio II: 17 pacientes (39%). Once pacientes tuvieron tumores no palpables (25%). Nueve pacientes (20%) tuvieron biopsias previas. Resultados: treinta y siete (84%) tumores fueron carcinomas ductales infiltrantes; 5 (11%) lobulillares; y 2 (5%) ductolobulillares. Doce pacientes tuvieron MTS en el GC (27%), de éstas 2 casos eran micrometástasis (17%). En 2 pacientes el PET/CT cambió la estadificación, ya que fue positivo para metástasis óseas y pulmonares. Resultados PET en mama: once negativos (FN: 20%). Tres (33%) eran carcinomas lobulillares infiltrantes; 3 eran T1a (33%). Sensibilidad 79% VPP=100%. Resultados PET en axila: en 36 pacientes el PET fue negativo (82%); 4 de éstas presentaron MTS en el ganglio centinela; 2 de ellas eran micrometástasis. Falso negativo: 33%. Sensibilidad: 66%. En 8 pacientes el PET fue positivo (18%) y el ganglio centinela presentaba MTS en todos los casos. Especificidad: 100%. VPP=100%. En 6 pacientes la axila era dudosa, de éstas sólo en una paciente el PET y el GC fueron positivos.
Subject(s)
Breast Neoplasms , Ganglia , Neoplasm Metastasis , Positron-Emission TomographyABSTRACT
Nutritional habits and behavior are acquired and established during childhood and can remain through the whole life. Proper nutrition in childhood results in enhancing the child growth and development and hinders the risk of chronic diseases in adulthood. Regarding the significance of nutritional training of school children, this study was conducted with the aim of determining the effect of nutrition education on knowledge and nutritional practice of grade five elementary school children about junk food intake in Tabriz from 2004 to 2005. This experimental study was conducted on 487 students [from 16 schools] in two control and treatment groups. In this research two teaching styles [lecturing without teaching aids - and with teaching aids and group discussion] were performed for twelve sessions for the students. Data collecting tool was a questionnaire whose reliability and validity had been confirmed in advance. To investigate the effect of intervention of nutrition education in junk food consumption Solomon method was used. The results obtained from this study showed no significant difference between mean knowledge and practice of the students in control and education groups before intervention. However, after nutrition education there was a significant difference [P=0.005] between mean score of knowledge and practice in two groups and the mean score of practice in treatment group increased from 87.8 +/- 31.95 before intervention to 104.6 +/- 28.34 after intervention and the mean score of knowledge increased from 22.4 +/- 16.49 before intervention to 42.6 +/- 25.68 after intervention. In addition, knowledge and practice increased significantly in two groups [P=0.005]. The results were more favorable in girls than in boys [P=0.005]. Nutrition education plays a crucially important role in improvement of knowledge and practice, particularly in school. Replacement of junk food with nutritious, healthy food will reduce the complications posed by consumption of junk food. Parents, education also seems essential to reduce the consumption of junk food