{"id":348,"date":"2018-12-04T11:17:18","date_gmt":"2018-12-04T11:17:18","guid":{"rendered":"https:\/\/www.barnaclinic.com\/blog\/cirugia-de-tiroides\/ca\/?p=348"},"modified":"2018-12-04T11:17:18","modified_gmt":"2018-12-04T11:17:18","slug":"sistema-bethesda-nodul-tiroidal","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/cirugia-de-tiroides\/ca\/sistema-bethesda-nodul-tiroidal\/","title":{"rendered":"Sistema Bethesda per al diagn\u00f2stic del n\u00f2dul tiro\u00efdal, com treure-li partit"},"content":{"rendered":"

En l’anterior post vam explicar\u00a0en qu\u00e8 consisteix i com funciona el Sistema Bethesda<\/strong><\/a>\u00a0per al\u00a0diagn\u00f2stic del n\u00f2dul tiro\u00efdal<\/a>.<\/strong><\/span>\u00a0Vam veure que \u00e9s una pr\u00e0ctica eina, que ens permet classificar la probabilitat de malignitat i predir el tractament a seguir.<\/span>\u00a0No obstant aix\u00f2, \u00e9s un m\u00e8tode de “recomanaci\u00f3”, que t\u00e9 les seves limitacions.\u00a0<\/span>En aquest post tornem a abordar el tema, analitzant com utilitzar-lo correctament i explicant com treure-li partit per realitzar tractaments personalitzats, adaptats a cada pacient.<\/span><\/p>\n

EL SISTEMA BETHESDA SIMPLIFICA LA PRESA DE DECISI\u00d3<\/span><\/h2>\n

Quan un pacient s’ha fet la\u00a0punci\u00f3 PAAF\u00a0i obtenim un informe classificat segons el\u00a0Sistema Bethesda<\/strong>, coma\u00a0experts en el tractament de les\u00a0malalties de la tiroide<\/strong><\/a>,\u00a0hem de ser capa\u00e7os d’interpretar b\u00e9 la informaci\u00f3 que se’ns ha donat.<\/strong><\/span>\u00a0El\u00a0sistema Bethesda<\/a>\u00a0ens assigna un rang de probabilitat de malignitat i ens d\u00f3na una recomanaci\u00f3 sobre el tractament m\u00e9s adequat del\u00a0n\u00f2dul de tiroides<\/strong>\u00a0estudiat.<\/span>\u00a0De fet, simplifica tant la presa de decisi\u00f3 que ens assigna, per a cada caracter\u00edstica citol\u00f2gica, una probabilitat de malignitat i ens suggereix el tractament que hem de realitzar.<\/span><\/p>\n

\n

\"Oscar-Vidal\"<\/strong><\/em><\/h4>\n

“Com a experts en el tractament de les\u00a0malalties de la tiroide,<\/strong>\u00a0hem de ser capa\u00e7os d’interpretar b\u00e9 la informaci\u00f3 que se’ns d\u00f3na el Sistema Bethesda”<\/strong><\/span><\/h4>\n

Dr. Oscar Vidal<\/a><\/p><\/blockquote>\n

Per exemple, una citologia amb c\u00e8l\u00b7lules at\u00edpiques sospitosa, correspondria a una categoria de Bethesda V, correlacionant les troballes amb una probabilitat de malignitat d’un 60-75%, i establint com a recomanaci\u00f3 terap\u00e8utica una lobectom\u00eda tiro\u00efdal.<\/small><\/em><\/p>\n

EL SISTEMA BETHESDA COM A RECOMANACI\u00d3<\/strong><\/span><\/h2>\n

Alguns grups de professionals han utilitzat aquesta classificaci\u00f3 per justificar les seves indicacions i les pautes de tractament.<\/strong><\/span>\u00a0Hem de recordar que\u00a0el Sistema Bethesda<\/a>\u00a0\u00fanicament estableix recomanacions,\u00a0nom\u00e9s t\u00e9 en compte les caracter\u00edstiques citol\u00f2giques del teixit obtingut per punci\u00f3.<\/strong><\/span><\/p>\n

\n

\"Oscar-Vidal\"<\/strong><\/em><\/h4>\n

“El Sistema Bethesda \u00fanicament estableix recomanacions,\u00a0nom\u00e9s t\u00e9 en compte les caracter\u00edstiques citol\u00f2giques del teixit obtingut per punci\u00f3”<\/strong><\/span><\/h4>\n

Dr. Oscar Vidal<\/a><\/p><\/blockquote>\n

HEM D’OFERIR TRACTAMENTS INDIVIDUALITZATS<\/strong><\/span><\/h2>\n

La medicina actual ha d’estar basada en l’evid\u00e8ncia cient\u00edfica, per\u00f2 ha d’estar, sobretot, centrada en el pacient.<\/strong><\/span>\u00a0Aquests intents d’estratificar objectivament la pauta a seguir davant els\u00a0tumors del tiroide<\/strong>, han de ser utilitzats en el marc d’un equip multidisciplinari<\/a>, que inclogui els diferents actors implicats en el diagn\u00f2stic, tractament i seguiment del pacient.<\/span>\u00a0Cada pacient \u00e9s \u00fanic<\/strong>\u00a0i, si b\u00e9 \u00e9s imprescindible unificar els criteris diagn\u00f2stics a nivell mundial (i el Sistema Bethesda ho aconsegueix), hem de ser capa\u00e7os de realitzar\u00a0tractaments individualitzats per a cada un dels nostres pacients,<\/strong>\u00a0tenint en compte les seves caracter\u00edstiques, antecedents i context particular .<\/span><\/p>\n

\n

\"Oscar-Vidal\"<\/strong><\/em><\/h4>\n

“La medicina actual ha d’estar basada en l’evid\u00e8ncia cient\u00edfica, per\u00f2 ha d’estar, sobretot, centrada en el pacient”<\/span><\/h4>\n

Dr. Oscar Vidal<\/a><\/p><\/blockquote>\n

\n

\"BANNER-CITA-VIDAL\"<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

En l’anterior post vam explicar\u00a0en qu\u00e8 consisteix i com funciona el Sistema Bethesda\u00a0per al\u00a0diagn\u00f2stic del n\u00f2dul tiro\u00efdal.\u00a0Vam veure que \u00e9s una pr\u00e0ctica eina, que ens permet classificar la probabilitat de malignitat i predir el tractament a seguir.\u00a0No obstant aix\u00f2, \u00e9s un m\u00e8tode de “recomanaci\u00f3”, que t\u00e9 les seves limitacions.\u00a0En aquest post tornem a abordar el […]<\/p>\n","protected":false},"author":2,"featured_media":345,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[87,88],"tags":[146,134,135,136],"yoast_head":"\nSistema Bethesda per al diagn\u00f2stic del n\u00f2dul tiro\u00efdal, com treure-li partit<\/title>\n<meta name=\"description\" content=\"Com utilitzar correctament el Sistema Bethesda per el diagn\u00f3stic del n\u00f2dul tiro\u00efdal i com treure-li partit per realitzar tractaments personalitzats...\" 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