Modelo de competencia docente del profesor de medicina en la UNAM

El estudio presenta un modelo de competencia docente del profesor de medicina. Fue generado a partir de un modelo conceptual preexistente: a) dicho modelo se sometió al juicio de expertos quienes seleccionaron las competencias de mayor impacto; b) se construyó un perfil de competencias; c) se generó un instrumento basado en la opinión de los estudiantes y otro de autoevaluación; d) ambos fueron validados por 18 expertos en evaluación; e) se aplicó a 2,281 estudiantes y 107 profesores, obteniendo un comportamiento psicométrico adecuado que permitió establecer un modelo acorde a las tendencias actuales en evaluación del desempeño docente

A pharmaco-economic analysis of second-line treatment with imatinib or sunitinib in patients with advanced gastrointestinal stromal tumours

Second-line treatments recommended by the National Cancer Center Network to manage advanced-stage gastrointestinal stromal tumours (GIST) were evaluated to determine the cost and cost-effectiveness of each intervention in the Mexican insurance system, the Instituto Mexicano del Seguro Social (IMSS). Treatments examined over a 5-year temporal horizon to estimate long-term costs included 800 mg day−1 of imatinib mesylate, 50 mg day−1 of sunitinib malate (administered in a 4 week on/2 week rest schedule), and palliative care. The mean cost (MC), cost-effectiveness, and benefit of each intervention were compared to determine the best GIST treatment from the institutional perspective of the IMSS. As sunitinib was not reimbursed at the time of the study, a Markov model and sensitivity analysis were conducted to predict the MC and likelihood of reimbursement. Patients taking 800 mg day−1 of imatinib had the highest MC (±s.d.) of treatment at $35 225.61 USD (±1253.65 USD); while sunitinib incurred a median MC of$17 805.87 USD (±694.83 USD); and palliative care had the least MC over treatment duration as the cost was $2071.86 USD (±472.88 USD). In comparison to palliative care, sunitinib is cost-effective for 38.9% of patients; however, sunitinib delivered the greatest survival benefit as 5.64 progression-free months (PFM) and 1.4 life-years gained (LYG) were obtained in the economic model. Conversely, patients on imatinib and palliative care saw a lower PFM of 5.28 months and 2.58 months and also fewer LYG (only 1.31 and 1.08 years, respectively). Therefore, economic modeling predicts that reimbursing sunitinib over high dose imatinib in the second-line GIST indication would deliver cost savings to the IMSS and greater survival benefits to patients

Model of teaching competence in teachers of medicine at UNAM]

El estudio presenta un modelo de competencia docente del profesor de medicina. Fue generado a partir de un modelo conceptual preexistente: a) dicho modelo se sometió al juicio de expertos quienes seleccionaron las competencias de mayor impacto; b) se construyó un perfil de competencias; c) se generó un instrumento basado en la opinión de los estudiantes y otro de autoevaluación; d) ambos fueron validados por 18 expertos en evaluación; e) se aplicó a 2,281 estudiantes y 107 profesores, obteniendo un comportamiento psicométrico adecuado que permitió establecer un modelo acorde a las tendencias actuales en evaluación del desempeño docente.The study presents a model of teaching competence in teachers of medicine. It was generated from an existing conceptual model: a) it was referred to the opinion of experts who selected the competencies of greater impact; b) a reference profile was constructed; c) an instrument was generated based on student opinion, and another for selfassessment; d) the instruments were validated by 18 experts in evaluation; e) they were applied to 2,281 students and 107 teachers, obtaining adequate psychometric characteristics, establishing a model according to current trends in teacher performance assessment

Chronic graft-versus-host disease could ameliorate the impact of adverse somatic mutations in patients with myelodysplastic syndromes and hematopoietic stem cell transplantation

Somatic mutations in patients with myelodysplastic syndromes (MDS) undergoing allogeneic hematopoietic stem cell transplantation (HSTC) are associated with adverse outcome, but the role of chronic graft-versus-host disease (cGVHD) in this subset of patients remains unknown. We analyzed bone marrow samples from 115 patients with MDS collected prior to HSCT using next-generation sequencing. Seventy-one patients (61%) had at least one mutated gene. We found that patients with a higher number of mutated genes (more than 2) had a worse outcome (2 years overall survival [OS] 54.8% vs. 31.1%, p = 0.035). The only two significant variables in the multivariate analysis for OS were TET2 mutations (p = 0.046) and the development of cGVHD, considered as a time-dependent variable (p < 0.001), correlated with a worse and a better outcome, respectively. TP53 mutations also demonstrated impact on the cumulative incidence of relapse (CIR) (1 year CIR 47.1% vs. 9.8%, p = 0.006) and were related with complex karyotype (p = 0.003). cGVHD improved the outcome even among patients with more than 2 mutated genes (1-year OS 88.9% at 1 year vs. 31.3%, p = 0.02) and patients with TP53 mutations (1-year CIR 20% vs. 42.9%, p = 0.553). These results confirm that cGVHD could ameliorate the adverse impact of somatic mutations in patients with MDS with HSCT.This work has been supported by Gerencia Regional de Salud de Castilla y León (GRS 1033/A/14), Instituto de Salud Carlos III - Fondo de investigación sanitaria (FIS PI17/01741), Instituto de Salud Carlos III - Contratos Río Hortega (CM17/0017), Instituto de Salud Carlos III & FEDER funds (PI16/01302), and CIBERONC Centro de Investigación Biomédica en Red Cáncer (CB16/12/00284)