Rediseño del proceso asistencial de una unidad multidisciplinaria de patología mamaria. Análisis de la repercusión en el consumo de recursos durante un periodo de 5 años / Redesign of the nursing process of a multi-disciplinary breast pathology unit. Analysis of the repercussions in the consumption of resources over a period of five years

El objetivo de este artículo es analizar el impacto en el consumo de recursos sanitarios del rediseño del proceso asistencial diagnóstico en una Unidad de Patología Mamaria. Con la introducción del nuevo sistema de gestión durante un periodo de cinco años, (en el que se han atendido 10.804 pacientes), se han evitado un total de 15.781 consultas, lo que ha supuesto una reducción de costes económicos estimados entre 333.218,58 € y 594.012,18 € en función del tipo de hospital al que se aplique. El modelo de gestión desarrollado es eficiente en cuanto a reducción de consumo de recursos sanitarios en el diagnóstico de patología mamaria (AU)

No disponible

Reingeniería del proceso asistencial de una unidad multidisciplinaria de patologia mamaria / Re-engineering the medical care process of a multi-disciplinary breast pathology unit

El incremento en la demanda de asistencia a las Unidades de Patología Mamaria, hace necesario el rediseño del proceso asistencial global. El objeto de este trabajo es presentar nuestra experiencia en el rediseño del proceso asistencial en una Unidad de Patología Mamaria mediante la aplicación de metodología de calidad. Se identifican y analizan los problemas de los sistemas de organización clásicos y se plantea un sistema alternativo orientado a disminuir el número de consultas necesarias en el proceso diagnóstico, reducir la sobreindicación de cirugía e integrar los Programas Poblacionales de Detección Precoz, sin menoscabo en la atención de pacientes sintomáticas (AU)

No disponible

Aumento de la tasa cruda de la incidencia del cáncer de próstata en nuestro medio / Increase of the crude rate of the incidence of prostate cancer un our population

El cáncer de próstata es uno de los cánceres más frecuentes en el sexo masculino, y su incidencia está aumentando progresivamente en una población que cada vez tiene una edad media más elevada. OBJETIVOS: Conocer la tasa cruda de la incidencia del cáncer de próstata en nuestra población y conocer si ésta progresa. MATERIAL Y MÉTODO: Conociendo el número de habitantes que cubre nuestra asistencia, se analiza el número de casos de cáncer de próstata diagnosticados según el archivo de Anatomía Patológica. RESULTADOS: La tasa cruda de la incidencia del cáncer de próstata en nuestro medio es de 28,7 casos/100.000 habitantes, y ésta crece progresivamente en torno a 3 casos/100.000 h/año. CONCLUSIONES: Existe un aumento de la tasa cruda de la incidencia del cáncer de próstata, influido probablemente por el aumento de la edad poblacional y la extensión de la medida de PSA en pacientes con sintomatología de afección prostática (AU)

[Crude rate increase of prostate cancer incidence in our setting]. / Aumento de la tasa cruda de la incidencia del cáncer de próstata en nuestro medio.

UNLABELLED: The prostate cancer is one of the most frequent cancers in the male sex and its incidence is increasing progresively in a population that every time has a more increased age. OBJECTIVE: To know the crude rate of prostate cancer in our population and if there is an increase. MATERIAL AND METHODS: Knowing the number of habitants under our assistance, we analyze the cases diagnosed of prostate cancer. RESULTS: The crude rate of the incidence of prostate cancer in our medium is 28.7 cases/100.000 habitants/year and this increases progressively in 3 cases/100.000 habitants/year. CONCLUSIONS: There is an increase of the crude rate of the incidence of prostate cancer probably by the influence of the increase of the population's age and the generalization of the measure of PSA in simtomatic patients of prostatic disease.

[Epidermoid cyst of the testis. A case of difficult preoperative diagnosis]. / Quiste epidermoide de testículo. Un caso de diagnóstico preoperatorio difícil.

Epidermoid cysts os the testes have an incidence between 1-2% of total tumours in that organ. The embryonary origin of this benign neoplasia is unknown, although the most widely accepted theory is they are monodermal teratomas. Differential diagnosis with germinal cells is established through the characteristic dartboard-like ultrasound image, which allows testicular conservant surgery though only in the case of certainty about the lesion. Since that was not the case and given the ultrasound variability recorded in the literature, radical orchiectomy was performed to overcome the persistent doubt at staging the tumour's benignancy.

Leiomyomatous nodules and bundles of vascular origin in the fibrosarcomatous variant of dermatofibrosarcoma protuberans.

We report 5 cases of the fibrosarcomatous variant of dermatofibrosarcoma protuberans, 4 of which presented a morphologic change of intraneoplastic blood vessels not previously recognized. This change consisted of focal proliferation of smooth muscle cells, resulting in hypertrophy, generally eccentric, of vascular walls with reduction and collapsing of vascular lumina. In 3 cases the proliferation was so intense it formed leiomyomatous nodules and bundles. This proliferation may originate in the smooth muscle cells of the vessel walls either by means of a hyperplastic mechanism or in the pericytes via a line of differentiation leading to mature smooth muscle cells. In either case, we believe that it concerns a reactive process of the vessel walls very probably induced by adjacent neoplastic cells. The cases recently reported by Calonje and Fletcher as "myoid differentiation" of neoplastic cells in dermatofibrosarcoma protuberans (DFSP) may well be an expression of the same phenomenon, and therefore the presence of leiomyomatous areas in this tumor should not be used to support the theory of a fibroblastic/myofibroblastic line of differentiation for DFSP.

Retiform hemangioendothelioma. A new case in a child with diffuse endovascular papillary endothelial proliferation.

We present a new case of retiform hemangioendothelioma (RH), an entity first described by Calonje et al. in 1994. The tumor was intradermal and located on the toe of an 11-year-old boy. Histologically, in addition to the distinctive retiform pattern of proliferating vessels in RH there are intraluminal papillae with hyaline cores similar to those seen in malignant endovascular papillary angioendothelioma (Dabska's tumor), but usually they are infrequent, focal and poorly developed. In our case, these papillary structures were well formed and distributed in a diffuse way. They were most conspicuous in superficial areas where the blood vessels were dilated. In deep areas, where the pattern of neoplastic vessels was retiform, the papillae filled their lumina totally, resembling solid cords. Our case shares the clinical and morphologic features of both retiform hemangioendothelioma and Dabska's tumor, supporting a relationship between these two kinds of neoplasms. The benign behavior of this case, with no recurrence or metastases over a 4-year follow-up, corresponds to the low malignancy of this kind of vascular neoplasm.