Hepatocellular carcinoma vascularization: from the most common to the lesser known arteries.

Hepatocellular carcinoma is the sixth most common cancer throughout the world. It is almost exclusively arterially vascularized, unlike the vascularization of the liver, which has a dual supply with a portal component of 75 to 80% and an arterial component of 20 to 25%. The reference treatment for intermediary stages of the Barcelona (B) classification is hepatic artery chemoembolization. The aim of chemoembolization is to inject the tumor chemotherapy into the artery and then to embolize the artery (or arteries), which supply the tumor. For this, knowledge of the anatomy of the hepatic artery is essential. Approximately 55% of the patients belong to the modal distribution, although numerous anatomical variants exist and must be recognized. In addition, primarily non-hepatic arteries may contribute to the vascularization of some hepatocellular carcinomas. Furthermore, new arterial supplies can be recruited by tumors after surgical or chemoembolization treatments. The aim of this article is to describe the different arteries, which may vascularize hepatocellular carcinomas. These arteries must be looked for, recognized, and reported by the radiologist on cross-section examinations in the pre-treatment assessment.

Protocolo de intervención en el trastorno de hiperactividad en una unidad de salud mental infanto-juvenil / Protocol of intervention in the attention hiperactivity deficit disorder in an infant-juvenile unit of mental health

El trastorno por déficit de atención/hiperactividad(TDAH) constituye una derivación frecuente en lasUnidades públicas de Salud Mental Infanto-Juvenil. Sinembargo, en muchas ocasiones esta derivación no esadecuada, magnificándose el número de casos incluidosbajo este epígrafe.El diagnóstico de TDAH debe hacerse atendiendo aunos criterios estrictos y siguiendo una metodologíaespecífica. La realización de evaluaciones eficaces seráclave a la hora de implementar tratamientos más efectivosa nivel cognitivo, emocional, comportamental, deaprendizaje social y escolar, generalizándose los resultadosa los dos contextos más habituales del niño: familiay escuela.Desde la Unidad de Salud Mental Infanto-Juvenil delInstituto Psiquiátrico José Germain, hemos detectado lanecesidad de establecer un protocolo de intervenciónmultiprofesional para nuestra zona que optimice la evaluacióne intervención en los casos de TDAH, presentándoseen este trabajo sus principales directrices

The Attention Hiperactivity Deficit Disorder (TDAH) constitutes a frequent derivation in the public Units ofInfant-Juvenile Mental Health. However, in many occasionsthis derivation is not accepted, being magnified thenumber of cases included under this epigraph.The diagnosis of TDAH should be made assisting tosome strict criteria and following a specific methodology.The realization of effective evaluations will be crucialto implement more effective treatments in theselevels: cognitive, emotional, comportamental, socialand school learning; being generalized the results to thetwo more habitual contexts of the children: family andschool.From the Infant-Juvenile Unit of Mental Health ofthe Psychiatric Institute José Germain, we have detectedthe necessity to establish a protocol of intervention withseveral proffesionals for our area that optimizes theevaluation and intervention in the TDAH cases, showingup in this work their main guidelines (AU)