RESUMO
Fluorine-18-fluorodeoxyglucose (F-18-FDG) is the most used positron emitter radiopharmaceutical worldwide. This glucose analogue allows to study the glucose metabolism which is often increased in many tumors. Nowadays the diagnostic performance of positron emission tomography/computed tomography (PET/CT) using F-18-FDG in different tumors is well known. On the other hand, to date, there is an increasing interest for the use of PET tracers other than F-18-FDG in oncology, because they allow to study different metabolic pathways or receptor expression. The aim of this review is to summarize the scientific literature about the diagnostic performance of PET/CT using tracers other than F-18-FDG in oncology through an evidence-based approach. In particular, the results of meta-analyses (representing the highest level of evidence) on the diagnostic performance of PET tracers other than F-18-FDG in different tumors are described. Furthermore, recommendations for the use of different PET tracers in oncology are provided based on existing literature data.
Assuntos
Oncologia/métodos , Neoplasias/diagnóstico , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X/métodos , Medicina Baseada em Evidências , Fluordesoxiglucose F18 , Humanos , Imagem Multimodal/métodos , Neoplasias/diagnóstico por imagemRESUMO
Este artigo traz reflexões sobre a gestão do trabalho em saúde com foco em categorias de análise, como a política de formação e educação permanente e a estruturação de parcerias entre gestores das Secretarias Municipais de Saúde e centros formadores para desenvolvimento de recursos humanos voltados para a Estratégia da Saúde da Família, cotejados com a política nacional de atenção básica.
Assuntos
Atenção Primária à Saúde , Sistema Único de Saúde , Pessoal de Saúde , Capacitação de Recursos Humanos em SaúdeRESUMO
This article describes and analyzes the structural principles of social health insurance in Germany and discusses their interrelations and current form. Focusing on salaried work, social security in Germany links rights and duties to the place occupied by workers in the production process and maintains a differentiation in their status. As a paradigm of social security, citizens' social rights in Germany are organized according to principles of equivalence, subsidiarity, and solidarity. The coexistence of these contradictory principles generates a constant field of tension and conditions their effect, thus mediating how each one is implemented. This tension, which has always existed in the underlying system, is reedited each time the political context changes. While subsidiarity and equivalence prevailed in the original social security system, the solution to the conflict tended towards solidarity during the expansion of welfare states and social health insurance. At present, however, there is a call for reediting subsidiarity and equivalence.