ABSTRACT
Objetivo: Evaluar la calidad de la biopsia del ganglio centinela en nuestro centro. Material y métodos: Se incluyeron de forma consecutiva y prospectiva 460 pacientes diagnosticadas de carcinoma infiltrante de mama en el Hospital Universitario Mútua de Terrassa. Se analizaron los resultados de la prestación de acuerdo con los estándares de calidad del la Sociedad Española de Senología y Patología Mamaria (SESPM). Resultados: Hemos objetivado una mejoría en el 20% de los estándares, independientemente si se producía o no un cambio de nivel. La autoevaluación continuada nos ha permitido mejorar estándares tan importantes como es la eficacia técnica de detección en un 8%, el número de reconversiones a linfadenectomías diferidas en un 3%. La tasa de ganglios extra- axilares se ha incrementado un 5%, así como la tasa de micrometástasis o células tumorales aisladas ha pasado del 9 al 11%. Conclusiones: La autoevaluación continuada nos permite mejorar nuestra práctica clínica diaria y utilizando los estándares de calidad podemos homogenizar todas las series(AU)
Objective: To assess procedural quality of sentinel node biopsy in our centre. Material and method: 460 consecutive patients with invasive breast cancer were prospectively included in our SN Data Base, at the University Hospital Mútua Terrassa. Results from SND biopsy were analysed according to the quality standards set by the Sociedad Española de Senología y Patología Mamaria (SESPM). Results: We have been able to show improvement in up to 20% of the standards, regardless of quality level changes. Continued self-evalution of our results has allowed for improvements in such important standards as the SN detection rate (8%), or conversion rate to axillary lymph-node dissection after definitive SN histology (3%). Extra-axillary SN rate has increased (5%), and also the rate of SN micrometastases or isolated cancer cells has increased form 9 to 22%. Conclusions: Continued self-evaluation using the SESPM standards resulted in significant opportunity for improvement in our daily clinical practice(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Sentinel Lymph Node Biopsy/methods , Sentinel Lymph Node Biopsy/statistics & numerical data , Breast Neoplasms/diagnosis , Lymphography/methods , Lymph Node Excision/trends , Sentinel Lymph Node Biopsy/instrumentation , Sentinel Lymph Node Biopsy , Prospective Studies , Breast Neoplasms/epidemiologyABSTRACT
Eighty foetuses from some of the main cattle-producing regions in Spain were analysed to investigate the participation of Neospora caninum in cases of bovine abortion. Diagnosis of the infection was determined by histopathological analysis complemented with immunohistochemistry, serology (IFAT and ELISA) and PCR tests. A total of 38.8% of the bovine foetuses analysed were considered to be infected by at least one of the diagnostic techniques used. Microscopic lesions consistent with Neospora infection in brain were identified in 31.3% of the samples, whereas only 10.7 and 15.3% were positive using serological and PCR analysis, respectively. Perfect agreement was shown between IFAT and ELISA, although there was little agreement among results of the other diagnostic techniques. Gestational age of aborted foetuses checked ranged from <3 to 9 months, with a mean of 5.9 months, and no difference in age was found between infected and non-infected foetuses (P>0.05). This study confirms the importance of N. caninum as a cause of abortion in Spain and underlines the need to use different diagnostic techniques to increase the chance to detect the infection in aborted foetuses.
