Evaluación de la calidad del procedimiento de biopsia selectiva de ganglio centinela en pacientes con cáncer de mama / Evaluation of the quality of the sentinel lymph node biopsy procedure in patients with breast cancer

La biopsia de ganglio centinela (BGC) ha demostrado ser una alternativa segura a la linfadenectomía axilar en la estadificación del cáncer de mama. El equipo multidisciplinar debe realizarlo con rigor y demostrando cumplir unos criterios esenciales. Objetivo. Evaluar la calidad del procedimiento en la Unidad de Patología Mamaria del Hospital Puerta del Mar, utilizando la guía de autoevaluación de la Sociedad Española de Senología y Patología Mamaria. Material y método. Dicha guía establece unos criterios de evaluación objetivos y medibles en los aspectos que intervienen en la BGC. Cada criterio se asocia a 4 niveles de estándares de calidad. Existen 3 criterios esenciales de obligado cumplimiento para implementar la BSCG en la práctica clínica. Se evalúan: experiencia asistencial (6 criterios), aspectos operativos (18 criterios, 3 esenciales) y actividad científica (8 indicadores). Material y método. La fase de validación incluyó 50 pacientes y la fase de aplicación 120 pacientes hasta febrero de 2009. Resultados. Se cumplen los 3 criterios esenciales relacionados con la detección del ganglio centinela (98%), sensibilidad acreditada (90%), promedio de ganglios axilares centinelas (2,1). Resultados. La aplicación de la guía de autoevaluación ha resultado una puntuación global de 39 sobre 71 puntos. Siendo el nivel II el nivel de calidad más prevalente. Conclusión. Nuestra Unidad cumplió durante la validación los criterios establecidos para implementar la técnica. Tras ella, la utilización de la guía acredita la buena práctica del procedimiento de BGC y permite identificar las áreas de mejora, en nuestro caso las relacionadas con actividades científicas y formativas de la Unidad(AU)

The Sentinel Lymph Node Biopsy (SLNB) has been demonstrated to be a safe alternative to axillary lymph node dissection in breast cancer staging. The multidisciplinary team must do it with rigor and demonstrate that they have fulfilled some essential criteria. Objective. To evaluate the quality of the procedure in the Breast Pathology Unit of Hospital Puerta del Mar, using the self-evaluation guidelines of the Spanish Society of Senology and Breast Pathology. Material and method. These guidelines establish some objective and measurable evaluation criteria related to the aspects that intervene in the SLNB. Each criterion is associated to 4 levels of quality standards. There are 3 essential criteria of mandatory fulfillment to implement SLNB in the clinical practice. They evaluate care experience (6 criteria), operative aspects (18 criteria, 3 essential) and scientific activity (8 indicators). The initial validation phase included 50 patients and the application phase 120 patients (February 2009). Results. Three essential criteria related to the detection of the sentinel node (98%), accredited sensitivity (90%), and mean number of axillary sentinel nodes (2.1) were fulfilled. The application of self-evaluation guidelines in our Unit obtained a global score of 39 out of 71 points, quality level II being the most prevalent. Conclusion. During the validation phase, our unit fulfilled the criteria established to implement the procedure. Following that, the use of this guideline accredits the good practice of the SLNB procedure and makes it possible to identify the areas of improvement, in our case, those related to the scientific and training activities(AU)

[Evaluation of the quality of the sentinel lymph node biopsy procedure in patients with breast cancer]. / Evaluación de la calidad del procedimiento de biopsia selectiva de ganglio centinela en pacientes con cáncer de mama.

UNLABELLED: The Sentinel Lymph Node Biopsy (SLNB) has been demonstrated to be a safe alternative to axillary lymph node dissection in breast cancer staging. The multidisciplinary team must do it with rigor and demonstrate that they have fulfilled some essential criteria. OBJECTIVE: To evaluate the quality of the procedure in the Breast Pathology Unit of Hospital Puerta del Mar, using the self-evaluation guidelines of the Spanish Society of Senology and Breast Pathology. MATERIAL AND METHOD: These guidelines establish some objective and measurable evaluation criteria related to the aspects that intervene in the SLNB. Each criterion is associated to 4 levels of quality standards. There are 3 essential criteria of mandatory fulfillment to implement SLNB in the clinical practice. They evaluate care experience (6 criteria), operative aspects (18 criteria, 3 essential) and scientific activity (8 indicators). The initial validation phase included 50 patients and the application phase 120 patients (February 2009). RESULTS: Three essential criteria related to the detection of the sentinel node (98%), accredited sensitivity (90%), and mean number of axillary sentinel nodes (2.1) were fulfilled. The application of self-evaluation guidelines in our Unit obtained a global score of 39 out of 71 points, quality level II being the most prevalent. CONCLUSION: During the validation phase, our unit fulfilled the criteria established to implement the procedure. Following that, the use of this guideline accredits the good practice of the SLNB procedure and makes it possible to identify the areas of improvement, in our case, those related to the scientific and training activities.

Cytochemical localization of K(+)-dependent p-nitrophenyl phosphatase and adenylate cyclase by using one-step method in human washed platelets.

Ultrastructural cytochemical localization of ouabain-sensitive, potassium dependent p-nitrophenyl phosphatase (K(+)-NPPase) of the Na(+)-/K(+)-ATPase complex and adenylate cyclase (cAMPase) activities, in washed inactivated human platelets, are described. The one-step lead-citrate method, under similar incubation conditions, was used to determine both activities. K(+)-NPPase appeared in both plasma membrane and the surface-connected canalicular system (SCCS) of the platelets. These data suggest a uniform distribution of the enzyme throughout membrane systems which are in contact with the external medium. cAMPase activity was strictly localized in tubules of the dense tubular system (DTS) when incubation medium contained prostaglandin E1, prostaglandin D2 or forskolin, at concentrations known to stimulate the enzyme in platelets that are intact. This fact and the inhibition of cytochemical reaction by thrombin confirm that the one-step lead-citrate method is a useful procedure in determining adenylate cyclase, abolishing the unfavorable conditions of previously reported methods.

Cytochemical Localization of ATPase Activity in Salt-Treated and Salt-Free Grown Lycopersicon esculentum Roots.

Adenosine-triphosphatase activity was localized by cytochemical methods in Lycopersicon esculentum Mill seedling roots. The identity of the enzyme was confirmed by its sensitivity to specific inhibitors. A differential distribution of ATPase activity was found depending on the region of the root. Under saline conditions, an increase of the tonoplast ATPase activity is observed, while the plasma membrane bound-ATPase activity decreases in the medial and basal regions of the root.