Liderazgo en enfermería desde la perspectiva de sus seguidores / Care of the person with motor disabilities

Analizar el perfil de liderazgo de los directivos en enfermería desde la perspectiva de sus seguidores.

Primer caso en Uruguay de tuberculosis asociada a terapia con agentes biológicos: reporte de un caso clínico / Tuberculosis associated with biological therapeutic agents: first case in Uruguay

Las terapias biológicas con anticuerpos monoclonales antifactor de necrosis tumoral alfa (TNF- ) revolucionaron el tratamiento de la artritis reumatoide. Su uso implica un riesgo elevado para el desarrollo de tuberculosis pulmonar por lo que exige una evaluación exhaustiva, tanto al inicio del tratamiento como en el seguimiento del paciente, descartando infección latente o tuberculosis activa. Se presenta el primer caso clínico descripto en Uruguay de tuberculosis pulmonar asociada a terapia con agentes biológicos (adalimumab).

Biologic therapies with anti-tumor necrosis factor alpha (TNF- ) monoclonal antibodies were a revolution in the treatment of rheumatoid arthritis. The use of antibodies implies a high risk of developing pulmonary tuberculosisand thus a thorough assessment is necessary, both upon the initiation of treatment and during patient follow up, to rule out a latent infection or active tuberculosis. The study presents the first clinical case of pulmonary tuberculosis associated with biologic therapydescribed in Uruguay (adalimumab).

As terapias biológicas com anticorpos monoclonais antifator de necrose tumoral alfa (TNF- ) revolucionaramo tratamento da artrite reumatoide. Seu uso implica um risco elevado para o surgimento de tuberculose pulmonarrazão pela qual é imprecindível a avaliação exaustiva, tanto no inicio do tratamento como durante o seguimentodo paciente para descartar infecção latente ou tuberculose ativa. Apresentamos o primeiro caso clínicodescrito no Uruguai de tuberculose pulmonar associada à terapia com agentes biológicos (adalimumab).

Scintimammography in the evaluation of axillary lymph node invasion in patients with breast cancer

Purpose. To correlate axillary Technetium-99m-sestamibi uptake with the axillary histology in patients with proven breast cancer. Secondly, to correlate the breast scintimammography results with the tumor histology. Materials and methods. Fifty-one patients with operable breast cancer T1, T2 or T3 and N0 or N1 had a scintimammography before surgery. Images were interpreted directly from the computer screen by two specialists who did not have knowledge about clinical or radiological information concerning the patients. Surgical treatment included conservative surgery or mastectomy, both followed by axillary dissection for malignant tumors (45 patients) and only excision for benign lesions (6 patients). Statistical analysis correlated scintimammography and histologic results. Results. The sensitivity and specificity of Tc99m-sestamibi to assess histologic lymph node involvement in patients with operable breast cancer was 35 percent (95 percent CI:14-61 percent) and 57 percent (95 percent CI:37-75 percent) respectively. The positive predictive value was 33 percent (95 percent CI:13-58 percent) and the negative predictive value was 59 percent ( 95 percent CI: 38-77 percent). The sensitivity and specificity of Tc99-sestamibi to assess breast tumor malignancy was 97 percent (95 percent CI:88-99 percent) and 33 percent (95 percent CI: 4-77 percent) respectively, calculated in only six patients. The positive predictive value was 91 percent (95 percent CI: 80-97 percent) and the negative predictive value was 66 percent (95 percent CI:9-99 percent). Conclusion. Our findings regarding the preoperative axillary assessment with Tc99m-sestamibi do not support the use of this imaging modality for this purpose