RESUMO
Mexico is a mid-income North American country. It strives to materialize the right to health in accordance with its laws. But the health system faces various problems: fragmentation, segmentation, limited funding, insufficient coverage, and low quality of health care. Mexico's population is aging, which has led to an increasing prevalence of chronic conditions. To overcome this issue, the goals have shifted towards free universal health coverage under equality, effectivity, and quality criteria focused on primary health care. Consequently, the health system has moved towards Patient-Centered Care (PCC), and an opportunity to promote Shared Decision-Making (SDM) during the clinical encounter to enhance patient and family involvement in their own health care. PCC and SDM are relatively new ideas in Mexico. The research agenda has focused on initiatives attempting to bring these concepts to clinical practice. This paper seeks to describe the local headway and the state of the art of PCC- and SDM-related strategies in the Mexican health system.
Assuntos
Tomada de Decisões , Participação do Paciente , Alemanha , Humanos , México , Assistência Centrada no PacienteRESUMO
Ovarian small cell pulmonary type carcinoma is a rare and aggressive tumor with higher incidence in young women. Multidisciplinary treatment seems to increase survival in a small number of cases. We present the case of a woman diagnosed with this type of tumor of small cells, their clinical evolution and the treatment he received.
Assuntos
Carcinoma de Células Pequenas/patologia , Neoplasias Ovarianas/patologia , Adulto , Carcinoma de Células Pequenas/terapia , Feminino , Humanos , Comunicação Interdisciplinar , Neoplasias Ovarianas/terapiaRESUMO
BACKGROUND: Breast cancer occupies the chief place in incidence after the cervix. This gland sarcomas are rare with less than 1% at this location. Its diagnosis is difficult and its evolution is aggressive. Primary breast osteogenic sarcomas are a subset of lower frequency so that their behavior, evolution, prognosis ytratamiento no much experience and often are diagnosed as benign tumors. CASE REPORT: We report the case of a woman of 59 years which initially arose from a tumor in the right breast was performed with tru-cut biopsy with inconclusive results, using the tumor 7 months after the presence of a multilobulated solid tumor 20 cm, tumor compatible with mammography Phylodes (BIRADS 2). It was decided to perform right total mastectomy and pectoral muscle resection reconstruction with latissimus dorsi more and histochemical review pathology diagnosed with malignant mesenchymal neoplasm, osteosarcoma osteoblast osteoclast type and complemented the treatment with radiotherapy and chemotherapy. The prognosis is poor because the five-year survival is less than 40%. CONCLUSION: In the fast-growing breast tumors and large mammographic calcifications with signs and antecedentesde irradiation, trauma and Phyllodes tumor must be aware of this disease and that early diagnosis improves survival. In the surgical treatment of axillary dissection is not indicated and adjuvant treatment with radiotherapy and chemotherapy.
Assuntos
Neoplasias da Mama/diagnóstico , Sarcoma/diagnóstico , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Primary breast tuberculosis was diagnosed in a 47 year old female. The diagnosis was made based on result of histopathological examination of a tumor biopsy material. The The tumor was excised. Antituberculous therapy was begun. The authors discuss the Cooper A classification of mammary tuberculosis.
Assuntos
Doenças Mamárias/patologia , Tuberculose/patologia , Doenças Mamárias/diagnóstico , Doenças Mamárias/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Tuberculose/diagnóstico , Tuberculose/cirurgiaRESUMO
Adenoid cystic carcinoma of the mammary gland is considered a rare entity with a favourable prognosis, accounts for < 1% of the breast malignancies. We report herein the case of a 57 year old woman who presented a breast mass. A mastectomy with axillary lymph node dissection was performed. None of 15 axillary lymph nodes contained metastases, and the patient remains well and free from recurrence 12 months after her operation.
Assuntos
Neoplasias da Mama , Carcinoma Adenoide Cístico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/cirurgia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Cavernous hemangioma of the breast, are thin-walled, blood-filled vascular spaces, separated by fibrous septa, with extensive fibrosis and sometimes phleboliths. Clinical diagnosis is rather difficult. Generally they are coincidental microscopic findings. We report herein a case of 37 years old woman with cavernous hemangioma of the breast. Physical examination, mammography and ultrasonography were not enough for the diagnosis. Surgical excision of the lesion was performed. Histological sample showed a cavernous hemangioma without cellular atypia. The role of the single diagnostic examination is limited and complementary of all available techniques in the evaluation of the breast lesions.
Assuntos
Neoplasias da Mama , Hemangioma Cavernoso , Adulto , Neoplasias da Mama/diagnóstico , Feminino , Hemangioma Cavernoso/diagnóstico , HumanosRESUMO
Durante muchos años se ha utilizado la histerectomía total abdominal como tratamiento definitivo de la lesión intraepitelial escamosa del cuello uterino (LIE) de alto grado, debido a que se asocia con el índice más alto de curación desarrollando recidivas que van de 1 por ciento a 15 por ciento de las pacientes, como lesiones neoplásicas en el manguito vaginal o islotes. El objetivo del presente estudio es evaluar la histerectomía total abdominal extrafascial como un método terapéutico eficaz y definitivo para la lesión intraepitelial escamosa de alto riesgo por seguimiento colpocitológico anual. Material y método. En el Servicio de Ginecología del Centro Estatal de Cancerología (CECAN) "Dr. Miguel Dorantes Mesa" de la Secretaría de Salud de Xalapa, Veracruz, se realizó un estudio retrospectivo, de 41 pacientes operadas de histerectomía por LIE de alto grado con seguimiento mínimo de tres años, con el resultado de 7.3 por ciento de recurrencia en el manguito vaginal con las siguientes conclusiones: La histerectomía extrafascial como tratamiento definitivo de la LEI del cuello uterino disminuye su eficacia en la medida que se incrementa el grado de lesión; la evaluación colposcópica preoperatoria es de invaluable ayuda para valorar la extensión de la enfermedad y descartar lesiones similares en la vagina y vulva. Estas pacientes requieren seguimiento citológico anual de cinco años
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Colposcopia , Histerectomia , Recidiva Local de Neoplasia/diagnóstico , Reoperação , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgiaRESUMO
Establecer una definicón precisa sobre la paciente geriátrica resulta dificil, ya que los límites de edad cambian en forma constante y arbitraria, pero dada la cada vez mayor longevidad de la mujer, supone un automento de la cirugía giencológica en edd avanzada
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Displasia do Colo do Útero/cirurgiaRESUMO
Establecer una definicón precisa sobre la paciente geriátrica resulta dificil, ya que los límites de edad cambian en forma constante y arbitraria, pero dada la cada vez mayor longevidad de la mujer, supone un automento de la cirugía giencológica en edd avanzada(AU)