RESUMO
Objective:To study the clinical value of combined indocyanine green fluorescence labeling method in sentinel lymph node biopsy on patients with thyroid carcinoma.Methods:Patients of thyroid tumor in our hospital from January 2016 to August 2017 were selected as the research,object 99 cases of thyroid benign tumor patients were randomly selected as the control group,99 cases of thyroid carcinoma patients were randomly selected as the observation group.According to the random number table method,patients in the group were randomly divided into A,B and C three groups,33 cases in each group.Group A were used 1.25mg/mL indocyanine green as a fluorescent tracer,group B were used 2.5mg/mL indocyanine green as a fluorescent tracer,group C were used 5mg/mL indocyanine green as fluorescent tracer to tracer for sentinel lymph node biopsy.The detection rate of sentinel lymph node and the average number of sentinel lymph nodes of each group were compared,and the false negative rate,sensitivity and accuracy of each group were also compared.Results:The detection rate of anterior sentinel lymph node in the group B was higher nan that in the group A and group C (P＜0.05).The average number of sentinel lymph nodes in the group B was significantly higher than that in the control group A and group C(P＜0.05).The false negative rate and sensitivity of the group B were significantly better than those of the group A and group C(P＜0.05).Conclusion:Indocyanine green fluorescent tracer method in sentinel lymph node biopsy has high detection rate of sentinel lymph node and detection range and high sensitivity advantage for patients with thyroid carcinoma,which has important clinical value for improving the operation methods,it is worth in clinical promotion.
RESUMO
OBJETIVO. Evaluar el conocimiento y la capacidad técnica de los médicos de primer nivel de atención en el manejo de los pacientes con diabetes mellitus e hipertensión arterial y de pacientes en riesgo de desarrollar enfermedad renal crónica (ERC) y utilizar la enfermedad terminal de esta última como trazador de la calidad de la atención primaria en el sistema de salud mexicano. MATERIAL Y MÉTODOS. Se realizó un estudio transversal en los servicios de salud de las secretarías de salud en 20 estados de junio a diciembre de 2008. Se construyó un cuestionario con dos casos clínicos. RESULTADOS. El promedio de calificación de los 149 médicos evaluados fue de 53.7 Los médicos que trabajan en las unidades de mayor tamaño tienden a tener mayor antigüedad y obtuvieron las calificaciones más bajas. CONCLUSIÓN. La utilización del diagnóstico de la ERC como un trazador permite detectar la capacidad de los médicos en el primer nivel de atención y el potencial del uso de esta metodología para evaluar procesos críticos en el sistema de salud.
OBJECTIVE. To assess knowledge and technical capacity of primary care physicians in the management of patients with diabetes mellitus and high blood pressure as well as patients at risk of developing chronic kidney disease, and to use the latter condition as a tracer of the quality of primary care of the Mexican health system. MATERIAL AND METHODS. A cross-sectional study included 149 primary health physicians in primary care units from state health care services in 20 states. An instrument with two clinical cases was applied. RESULTS. The average score of the physicians evaluated was 53.7 out of 100. Those physicians working in larger size units and graduated before the year 2000 tend to receive lower scores. CONCLUSIONS. The use of chronic kidney disease as a tracer of the technical capacity of the Mexican health care system is useful to understand the problems of primary care in the country´s public settings.