Gestión por procesos en una Unidad de Diagnóstico por Imagen / Process management in an Imaging Diagnosis Unit

Se describen las características más relevantes de la gestión por proceso en una Unidad de Diagnóstico de Medicina Nuclear, describiendo procedimientos documentados de soporte y específicos de la Unidad y los medidores o indicadores de calidad. Asimismo se ha constar los beneficios en aspectos tan fundamentales como la gestión y la formación de personal, desarrollando un plan de acogida para los trabajadores y un procedimeinto de formacón para las contrataciones realizadas con carácter temporal en la Unidad. Los beneficios en la gestión por procesos engloba aspectos de índole asistencial, mediante la elaboración y revisión de procedimientos asistenciales, de calidad en los resultados, a través de la monitorización de los indicadores de calidad y en la formación personal, mediante los requiaitos específicos de contratación temporal. Todos los procedimientos y resultados son evaluables y cuantificables, permitiendo un seguimiento y revisión continua y, en caso de desviaciones, la adopción de no conformidades y, consecuentemente, acciones de tipo preventivo o correctivo. Todo ello redunda en una mejora de la calidad asistencial y un beneficio para el paciente

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[Chronic infections multifocal osteomyelitis vs chronic recurrent multifocal osteomyelitis: with reference to one case]. / Osteomielitis crónica multifocal séptica vs osteomielitis crónica multifocal recurrente: a propósito de un caso.

We present a rare case of chronic infectious multifocal osteomyelitis with affectation symmetric in the both femures in a patient with spondyarthropathic secondary Inflammatory Bowel Disease. The diagnosis was confirmed with culture of the bone biopsy. The aim of this work is the revision of the Chronic Infectious Multifocal Osteomyelitis and the Chronic Recurrent Multifocal Osteomyelitis into SAPHO syndrome that both were the possibilities diagnoses.

Osteomielitis crónica multifocal séptica vs osteomielitis crónica multifocal recurrente: a propósito de un caso / Chronic infections multifocal osteomyelitis vs chronic recurrent multifocal osteomyelitis: with reference to one case

Presentamos un caso raro de osteomielitis crónica multifocal de afectación simétrica en ambos fémures, confirmando con cultivo de la biopsia ósea, en una paciente previamente diagnosticada de espondidoloartropatía secundaria a Enfermedad Inflamatoria Intestinal. El objetivo de este trabajo es la revisión de la Osteomielitis Crónica Multifocal Séptica y la Osteomielitis Crónica Multifocal Recurrente dentro del Síndrome de SAPHO que fueron las dos posibilidades diagnósticas que se presentaron (AU)

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[Histological prediction of cerebral tumors using SPECT with 201T1]. / Predicción histológica de los tumores cerebrales mediante SPECT con 201T1.

INTRODUCTION AND OBJECTIVE: SPECT with 201Tl provides information regarding the degree of malignancy of cerebral tumours, their possible relapses, the differentiation of necrotic tissue in the tumours following chemotherapy or radiotherapy and permits differentiation into zones of various grades of histological malignancy. MATERIAL AND METHODS: We carried out a prospective analysis of the usefulness of SPECT with 201Tl for the histological prognosis of cerebral tumours. For one year 68 patients diagnosed (on CT and/or MR) as having an expansive cerebral lesion were studied. The early uptake (ICP) and retention (R) indices were calculated, and these results correlated with the morbid anatomy (AP) findings and the results obtained with surgery and stereotactic biopsy. Four patients were excluded due to lack of AP results. RESULTS: Significant differences were found between the ICP of grade I-II astrocytomas (1.34 +/- 0.52) and glioblastomas multiformes (2.56 +/- 0.57), between the ICP of meningiomas (4.53 +/- 1.68) and metastases (2.45 +/- 0.58) and between those of meningiomas and all glial tumours. With regard to IR, we saw significant differences between the figures for meningiomas (0.63 +/- 0.13) and meningiomas with malignant relapses (0.94 +/- 0.17) and between metastases (0.8 +/- 0.03) and all glial tumours. CONCLUSIONS: From our study, it may be concluded that rapid, high captation of 201Tl (high ICP) with a slow fall (high IR), is associated with a process showing malignancy on histological study (malignant relapse of meningioma, glioblastoma multiforme, metastasis), whilst high take-up (high ICP) with rapid elimination (low IR) corresponds to a benign hypervascularized tumour (meningioma).

The diagnostic value of Tc-99m human polyclonal immunoglobulin imaging compared to Tc-99m HMPAO labeled leukocytes in inflammatory bowel disease.

The aim of this study was to establish the usefulness of Tc-99m human polyclonal immunoglobulin (HIG) imaging in a group of patients who were suspected of having inflammatory bowel disease (IBD). The authors performed 30 scans (15 with Tc-99m HMPAO leukocytes and 15 with Tc-99m HIG) on 15 patients with IBD. Ten patients had Crohn's disease and five had ulcerative colitis. The sensitivity of Tc-99m HIG scintigraphy for detecting IBD was 33%, while the sensitivity of Tc-99m HMPAO leukocyte imaging was 100%. The Tc-99m HMPAO leukocyte imaging also detected a larger number of affected segments and provided better image quality of the extent of disease than Tc-99m HIG. On the basis of these results, the authors believe that Tc-99m HIG imaging is not a useful technique in the evaluation of patients with IBD, in the identification of location, or the extension or degree of disease activity.