2023-07-17 04:50:10
One cold morning in June was the setting for a talk with Karina Miranda, a doctor specializing in Nuclear Medicine and medical manager of the Molecular Imaging Center, and with Vivian Pereyra, a doctor in Radiochemistry, head of Radiopharmacy.
The first question, what is nuclear medicine? It is a specialty of medicine that consists of administering a radiopharmaceutical (a small dose of radioactive material attached to a drug), in order to confirm a diagnosis or treat a disease.
In diagnostic procedures, the radiopharmaceutical is fixed in a specific organ and its presence is captured by a radiation detector called a gamma camera. In the molecular images obtained, functional abnormalities that precede anatomical changes are detected, so it is possible to diagnose various pathologies at a very early stage, before they are evident by other diagnostic methods, explained Miranda.
VALUATION
There are regarding 60 types of explorations in conventional nuclear medicine and they are used in the diagnosis and control of a series of diseases: cardiac, endocrinological, bone, oncological, urological, in the diagnosis of pathologies of the digestive system, respiratory, neurological disorders , infectious processes and peripheral vascular system, both in adults and children.
Among the main diagnostic studies are scintigraphies: bone, with ciprofloxacin, renal, parathyroid, myocardial perfusion, thyroid, salivary glands, for gastrointestinal bleeding, Meckel’s diverticulum, esophageal transit, brain, I-131 scanning and lymphography of upper and lower limbs.
TREATMENT
Regarding therapeutic procedures, radioiodine is available for the treatment of diseases of the thyroid gland, such as hyperthyroidism and thyroid cancer. This radioiodine is concentrated predominantly in thyroid tissue, stopping its function or destroying malignant cells, depending on the case.
Bone pain treatment is also available as a palliative alternative in very advanced cancers.
The fact that Bolivia does not have a nuclear reactor for the production of the material used by this technique makes the work more complex in its application. Complicated import procedures must be dealt with for the supply of such specialized and almost mysterious products for ordinary Bolivians.
EACH PATIENT IS UNIQUE
In the 14 years that the Molecular Imaging Center has had and with almost half a million dollars in investment, it has focused on the task of facilitating access to this technique, through more affordable costs and, above all, favoring access to Communication and coordination with treating physicians and patients.
Not all methods are suitable for all pathologies and not all pathologies need our services. For this reason, it is very important to use the correct tool in each case so that the patient benefits the most, both in terms of the investment to be made and the expected diagnostic and therapeutic results, explain Miranda and Pereyra, convinced that the work and the coordination of the treating health team can make a big difference in the life of the patient.
And that is what Bolivia has been working on, for several years now, creating communication bridges with the treating doctors so that they have the availability, the confidence to call and consult regarding their patient’s disease, complements Miranda, sure that it is the feeling of the three partners of the center.
“The patient has this problem, can this technique help me or not for a more timely diagnosis? What will be the best dose for my patient?” Pereyra notes. He says that providing information to patients, who often cannot reach their facilities, through the use of the current means of communication, to clear up their doubts and calm the anxiety that every disease brings with it, is another of the maxims that govern the work of the center.
Miranda explains that it is sad when a patient with an easily treatable pathology, if detected early, arrives late and is already in the terminal stage. “We work for that every day,” she says, very convinced that progress has been made in Bolivia, but that there is still a long way to go to fully exploit all the options of nuclear medicine.
It is important to have awareness, the capacity for analysis, teamwork and, above all, empathy with the patient and their suffering, especially in a post-pandemic world, where financial and moral crises are our daily bread.
THE SPECIALISTS
The professionals have a Radioisotope Manipulation License, issued by the national regulatory body, the Nuclear Electricity and Technology Supervisory Authority (AETN).
Karina Miranda Fernández, Medical Manager – Nuclear Doctor.
Medical specialist in Nuclear Medicine, trained at the José Joaquín Aguirre Hospital in Santiago de Chile and at the National Institute of Nuclear Medicine (INAMEN) in La Paz, Bolivia. He participated in an application scholarship in Nuclear Cardiology from the First Spanish Association of Mutual Aid in Montevideo, Uruguay. He has a Master’s Degree in Psychopedagogy, Planning, Evaluation and Management in Higher Education in Health from the Universidad Mayor de San Andrés (UMSA) La Paz, Bolivia.
Vivian Pereyra Molina, Head of Radiopharmacy – Head of Radiological Protection.
Graduated in Biochemistry and Pharmacy from the Universidad Mayor de San Simón de Cochabamba with a Master’s Degree in Radiochemistry and Nuclear Chemistry from the National Atomic Energy Commission in Buenos Aires, Argentina. She has 25 years of work experience in Nuclear Medicine, working for state and academic entities in La Paz and Cochabamba.
Eduardo Scott Blacud, Technical Manager.
Electronic Engineer from the Universidad Mayor de San Andrés de La Paz. He has 19 years of experience in installation, corrective and preventive maintenance, and quality control of nuclear medicine instruments. He has been co-responsible for the installation of three SPECT gamma camera systems and a nuclear medical image acquisition and processing system.
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