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Objetivo: Conocer la supervivencia, control o recidiva dela enfermedad, y calidad de vida de las pacientes con micrometástasisen el ganglio centinela no sometidas a vaciamientoaxilar.Pacientes y método: Un ensayo clínico prospectivo aleatorizadoen dos brazos, uno con pacientes con micrometástasis enel ganglio centinela que serían sometidas a observación clínica yotro brazo similar pero con linfadenectomía en un segundotiempo quirúrgico. Las pacientes serían seguidas detalladamentedurante cinco años. La muestra constaría de 176 pacientes porbrazo (total 352) para conseguir solidez estadística.Resultados: Hasta el momento se han incluido 120 pacientes(cabe decir que el estudio se mantiene activo). Descontandolos abandonos (7 en el grupo control y 2 en el experimental)permanecen en el estudio 54 en la rama control y 57en la experimental. En el grupo control se encontraron 8 vaciadospositivos (7 de ellos presentaban únicamente un segundoganglio afectado), mientras que en el grupo experimentalapareció una recidiva axilar local (por palpación, siendo el únicoganglio afectado en la linfadenectomía). La paciente se encuentraen la actualidad libre de enfermedad.El estudio no ha terminado. El tiempo máximo de seguimientoes de 47 meses, insuficiente para concluir. Queda sinembargo, abierto, pues consideramos que la pregunta planteadasigue siendo todavía de actualidad

Objective: To asses the impact of SN technique on thewellbeing and performance status of breast cancer patients,specifically targeting the finding of axillary micrometastatic disease.Patients and method: To achieve such objective, a randomizedprospective clinical trial was devised with two arms. Inone arm, patients with SN micrometastases are the subject ofplain clinical follow-up (experimental arm). In the other arm, patientsare submited for second-sugery completion ALND (controlarm). All patients are intended for a five-year follow-up period,and the accrual goal is 176 patients per arm (352 overall).Results: The study is still in the accrual phase. Up untilnow, 120 patients have been entered. There have been 7withdrawals in the control group and 2 in the experimentalgroup. 54 patients are being followed in the control arm, and57 in the study arm. In the control arm, 8 completion ALNDturned out positive, in seven only with one additional (non-sentinel)lymph-node metastasis. In the study arm, one axillary recurrencehas been observed in a single lymph-node, one yearafter primary surgery. Two years after completion ALND, thepatient is free of disease. This is a still ongoing study. A maximum follow-up periodof 47 months is obviously not enough to draw solid conclusions.It will be open for further accrual as the proposed questionis still in need of a definite answer

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INTRODUCTION: Several studies have found neuropsychological and behavioral disorders in children with attention deficit/hyperactivity disorder (ADHD), which have been explained as an executive dysfunction. OBJECTIVE: To describe and compare children with ADHD and a control group. PATIENTS AND METHODS: 79 seven to eleven-year-old children were selected and grouped according to ADHD DSM IV criteria and the T scores on a ADHD checklist. They were classified as predominantly inattentive (n=19), combined (n=24) and control (n=36) groups. Age, gender, socio economic status and intellectual quotient (>85) were statistically controlled. Neuropsychological functions were assessed with a child neuropsychological battery, and the behavioral dimensions were evaluated with the BASC's questionnaires, Conner's parents (CPRS) and teachers (CTRS) rating scales, and with a questionnaire for oppositional defiant (ODD) and conduct (CD) disorders. RESULTS: Statistically significant differences were found (P<0.01) in neuropsychological variables of mental control, continuous auditory performance, Rey's complex figure evocation and the Stroop's test. There were significant differences in the most BASC's internalizing and externalizing dimensions, so for the parents as for the teachers and self report questionnaire, and in the dimensions of CPRS, CTRS, ODD and CD questionnaires. CONCLUSION: Children with ADHD showed difficulties in sustained and selective attention, visual memory, inhibitory control, and they had behavioral disorders similar to those informed by previous studies.

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Introducción. Diversos estudios han revelado la existencia de alteraciones neuropsicológicas y de comportamiento en el trastorno por déficit de atención/hiperactividad (TDAH). Objetivo. Describir y comparar el desempeño de un grupo de niños con diagnóstico de TDAH y un grupo de control. Pacientes y métodos. Se seleccionaron 79 niños de 8 a 11 años, agrupados según los criterios del DSM-IV y las puntuaciones T de una lista de síntomas para TDAH; se clasificaron como inatentos ( n = 19), mixtos (n = 24) y en el grupo control (n= 36). Se controlaron la edad, el sexo, el estrato socioeconómico y el coeficiente intelectual (CI > 85). Se evaluaron las funciones neuropsicológicas con una batería para niños, y las dimensiones de la conducta con el BASC, un cuestionario para trastorno negativista desafiante (TND), otro para trastorno de conducta (TC) y las escalas de Conners para padres (ECP) y maestros (ECM). Resultados. Se encontraron diferencias significativas (p < 0,01) en control mental, ejecución continua auditiva, evocación de la figura de Rey y el test de Stroop. También hubo diferencias significativas en la mayoría de las dimensiones de conducta externalizante e internalizante del BASC en los formatos padres, maestros y autoinforme, al igual que en las dimensiones de los cuestionarios de TND, TC, ECP y ECM. Conclusiones. Los niños con TDA presentan déficit en atención sostenida y selectiva, memoria visual y control inhibitorio, así como alteraciones en las dimensiones de la conducta similar a lo informado en otros estudios (AU)

Introduction. Several studies have found neuropsychological and behavioral disorders in children with attention deficit/ hyperactivity disorder (ADHD), which have been explained as a executive dysfunction. Objective. To describe and compare children with ADHD and a control group. Patients and methods. 79 seven to eleven year-old children were selected and grouped according to ADHD DSM IV criteria and the T scores on a ADHD checklist. They were classified as predominantly inattentive (n = 19), combined (n = 24) and control (n = 36) groups. Age, gender, socio economic status and intellectual quotient (> 85) were statistically controlled. Neuropsychological functions were assessed with a child neuropsychological battery, and the behavioral dimensions were evaluated with the BASC’s questionnaires, Conners’ parents (CPRS) and teachers (CTRS) rating scales, and with a questionnaire for oppositional defiant (ODD) and conduct (CD) disorders. Results. Statistically significant differences were found (p < 0.01) in neuropsychological variables of mental control, continuous auditory performance, Rey’s complex figure evocation and the Stroop’s test. There were significant differences in the most BASC’s internalizing and externalizing dimensions, so for the parents as for the teachers and self report questionnaire, and in the dimensions of CPRS, CTRS, ODD and CD questionnaires. Conclusion. Children with ADHD showed difficulties in sustained and selective attention, visual memory, inhibitory control, and they had behavioral disorders similar to those informed by previous studies (AU)

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A clinical study of 44 eyes in 22 patients with cortisone-induced glaucoma confirmed the importance of the duration of employ of the corticoid. Those patients who had instilled the medication for less than 8 weeks recovered normal ocular tension after discontinuation of the corticoid. On the contrary, those who had employed the corticoid for more than 4 years did not regain normal ocular tension, and medical treatment, or even surgical therapy in a large number of cases, had to be employed. The frequency of congenital anomalies of the angle has to be emphasized, particularly persistence of the pectinate ligament. Papilla asymmetry was noted in a large percentage of cases, and was related to the difference in the stage of evolution of the eyes. The appearance of the papilla has important prognostic value. Of the patients with abnormal papilla, 61.9 p. cent had normal ocular tension after stopping treatment, but normal tension did not appear in patients with anexcavated and apale papilla. The authors consider trabeculotomy to be the operation of choice in cortisone induced glaucoma, but this tends to be ineffective in young patients because of sclerous and/or conjunctival blocking.

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