Mamografía "full digital" directa o en campo completo: experiencia preliminar / Direct or full-field "full digital" mammography: preliminary experience

Análisis de la introducción de una nueva tecnología en Chile llamada "mamografía full digital o campo completo" para la detección precoz del cáncer de mama no palpable. Esta tecnología se ha desarrollado en Europa, Estados Unidos y en algunos países de Sud América. Se describen las ventajas de la mamografía full digital en la detección de microcalcificaciones comparada con la mamografía convencional. La mamografía digital en campo total permite que se visualice toda la glándula mamaria, desde la piel hasta la pared torácica (1, 2, 3). Entre julio del 2001 y julio del 2002 se estudiaron con mamografía full digital 3.176 pacientes. Se utilizó un mamógrafo digital de campo completo, General Electric Senographe 2000 D. Solo 48 casos disponían de una mamografía convencional reciente. En 10 de las 48 pacientes la mamografía digital detectó microcalcificaciones sospechosas, no visualizadas en mamografía convencional. Estos hallazgos modificaron en algunos casos la conducta de tratamiento en éstas pacientes (3-4).

Introduction of a new technology called "full field digital mammography" (FFDM) for the detection of non palpables breast cancers. The GE Senographe 2000 D is the world`s first all digital mammography system and is installed in Europe, USA and some countries of LatinAmerica. Description of the advantages of full field digital mammography in comparison to conventional Film-Screen Mammography. (FSM) in the study and detection of microcalcifications. Full field digital mammography gives better visibility of the breast, particularly near the skin line , the chest wall and in women with dense breast tissue. Between july 2001 and july 2002, 3.176 patients were studied with full digital mammography with a GE Senographe 2000 D. Only 48 cases had a recently conventional mammography and in 10 of the 48 cases the full digital mammography detected suspicious microcalcifications not seen in conventional mammography. This results changed the patient treatment in some cases.

Promocion de la salud mental y prevencion de las dependencias quimicas entre escolares: evaluacion de una estrategia de intervencion / Promocion de la salud mental y prevencion de las dependencias quimicas entre escolares: evaluacion de una estrategia de intervencion

Este trabajo describe una estrategia educativa destinada a la prevencion primaria del abuso de sustancias quimicas entre los adolescentes. Fue aplicado en los establecimentos escolares de la comuna de La Reina (Region Metropolitana), y se centro en la aquisicion de habilidades de comunicacion, resolucion de problemas y mejoria de la autoestima de 100 estudiantes, a traves de un conjunto de talleres educativos, que a su vez aplicaron sus aprendizajes a 400 estudiantes. Ademas se capacitaron 26 educadores del Sistema Escolar de La Reina. Los autores concluyen que esta estrategia parece tener un efecto adecuado en el corto plazo, debiendo evaluarse despues su impacto sobre el consumo de alcohol en el mediano plazo.

Tumor mamario en adolescente. / Mammary tumor in adolescence

Se presenta un caso de cystosarcoma phyllodes en una adolescente.Este tipo de tumor mamario habitualmente se observa entre la cuarta y quinta decada de la vida. De manera que esta lesion es muy poco comun en mujeres jovenes y aun mas rara en una nina de trece anos que aun no presenta su menarquia, como es este caso. Este tumor es generalmente benigno. El estudio incluye mamografia y examen histopatologico. La terapia recomendada es extirpacion local incluyendo un pequeno margen de tejido sano. Dada la rareza de las lesiones mamaria en la pubertad o en la adolescencia es que nos ha parecido de interes descobrir este caso

Distal splenorenal shunt vs. portal-systemic shunt: current status of a controlled trial.

A prospective controlled comparison of portal-systemic (PSS) and distal splenorenal shunts (DSRS) in cirrhotic patients who had survived hemorrhage from esophagogastric varices was undertaken 5 yr ago at five hospitals by the Boston-New Haven Collaborative Liver Group. The clinical and endoscopic criteria for massive hemorrhage were satisfied in 155 patients. Thirty-four patients were excluded, primarily because of uncontrolled hemorrhage. Thirty-four were rejected because the were poor operative risks and 21 because they did not satisfy criteria. Thirteen patients refused to participate; the remaining 53 were randomized; 29 to receive PSS and 24, DSRS. The two groups were similar in clinical, laboratory, and manometric characteristics. The DSRS group was older and tended to have had more previous hemorrhages. Followup ranged from 1 to 56 months (mean 21). After PSS, which was performed by 10 different surgeons, 6 patients died during the hospital admission (21%) compared to 2 after DSRS (12%). There were 6 late deaths in the PSS group and 4 in the DSRS group. Portal-systemic encephalopathy occurred in 5 of the 23 survivors of PSS (23%), and in 6 of the 19 who survived DSRS (32%. Two patients in the PSS group bled (9%), 1 after thrombosis and 1 after stenosis of the shunt. Three patients in the DSRS group bled (16%) and all had thrombosis of the shunt. PSS was associated with an unexplained but inordinately high operative mortality. Although the DSRS was accomplished with an acceptably low operative mortality, it was associated with frequent portal-systemic encephalopathy, shunt occlusion, and recurrent hemorrhage. Similar incidences of portal-systemic encephalopathy, shunt occlusion, and recurrent hemorrhage were observed in the PSS group. More patients and longer followup are necessary to determine which of these portal decompressive procedures is superior.