RESUMO
Los tumores estromales gastrointestinales son poco comunes. Representan neoplasias de células intersticiales de Cajal; especialmente, por mutaciones del receptor CD117 (c-Kit), cuya detección inmunohistoquímica confirma el diagnóstico, y para el cual existen inhibidores específicos (imatinib, sunitinib). Se describen las características clínicas, el diagnóstico, el tratamiento y el seguimiento de 6 casos (1 esofágico, 2 gástricos, 1 duodenal, 1 yeyunal y 1 colónico), de los cuales 4 son mujeres, y donde las edades oscilaron entre los 38 y los 78 años (promedio: 52). según cada caso, se evidencian manifestaciones (síndrome anémico, dolor y masa abdominal, etc.), las características operativas de los estudios imagenológicos y endoscópicos, y la histopatología. Hubo resección mínimamente invasiva en 2 pacientes, 1 sincronía con adenocarcinoma colorrectal y 2 casos de recurrencia. Los hallazgos son acordes con la literatura. Existen controversias respecto al pronóstico y la experiencia médica es limitada, por la escasa frecuencia, dado lo cual son necesarias las evidencias en torno a esta enfermedad. © 2012 Instituto Nacional de Cancerología. publicado por elsevier españa, S.L. todos los derechos reservados.
Gastrointestinal stromal tumors (GIST ) are uncommon. They are neoplasms of interstitial cells of Cajal, mainly due to receptor mutations CD117 (c-Kit), with their diagnosis being confirmed by immunohistochemical methods, and for which there are specific inhibitors (imatinib, sunitinib). We describe the clinical features, diagnosis, treatment, and follow-up of 6 cases (1 esophageal, two gastric, one duodenal, one jejunal and one colon), of which 4 were women, with an age range between 38 and 78 years (mean: 52). The signs and symptoms of each case are presented (anemic syndrome, abdominal pain and mass, etc.), as well as the operating characteristics of the imaging and endoscopic tests, and the histopathology. Minimally invasive resection was performed in 2 patients, 1 synchronous with colorectal adenocarcinoma and 2 cases of recurrence. The findings are consistent with the literature. There are controversies in prognosis, and medical expertise is limited by the low frequency, therefore, more evidence is needed about this disease.
Gastrointestinal stromal tumor, GIST.
Gastrointestinal neoplasia.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Tumores do Estroma Gastrointestinal , Literatura , Prognóstico , Terapêutica , OncologiaRESUMO
In higher education, learning variables are critical for professional activity and they should be properly assessed. Therefore, adequacy of evaluation instruments is very important. Consistency of an exam is one characteristic frequently studied to determine exam reliability. The subject of this study is a Pharmacology test of 70 items, taken by 849 medical students during a Pharmacology course at Medical School in the National University of Mexico in 2008. It explores whether students have been exposed to the same knowledge domain and if consistent execution in all parts of the exam is seen. Exam items were analyzed as independent items and as grouped items (by topic) and tested for consistency with Cronbach's test. Data were processed with the JMP statistical program (SAS Institute Inc.). The coefficient alpha was greater for independent items. We consider that grouping of items into topics tests integration of knowledge; a reasonable degree of consistency found when items are grouped, might favor this conclusion. Information obtained from the analysis of consistency of the exam, should provide elements for feedback during a course. Long term goals of this study include: to develop test instruments useful in formative evaluation and knowledge integration, to characterize the specificity of a Pharmacology exam, to determine degrees of knowledge acquisition and to get feedback about the quality of courses and exams.
Assuntos
Avaliação Educacional , Farmacologia/educação , HumanosRESUMO
PURPOSE: To explore the degree of retention of pharmacologic knowledge of third-year medical students taught in a new pharmacology teaching program. METHOD: In 1997, the authors administered a retention test consisting of 100 multiple-choice questions, each with only one correct answer, to 457 third-year medical students at the National University of Mexico. Students were not told in advance about this diagnostic evaluation, which was given eight months after they completed the second-year pharmacology course. As a comparison, the authors also analyzed the results obtained by the same students in the three partial examinations taken during the second-year pharmacology course. The Kolmogorov-Smirnov procedure and Wilcoxon and chi-square tests were used to analyze data. RESULTS: The distribution of scores obtained in the partial exams well approximated a symmetrical bell-shaped curve, and the mean score was 59.9%. In contrast, in the retention test the distribution was negatively skewed, the mean score (69.8%) was significantly higher (p <.001), and the curve was clearly displaced to the right of that corresponding to the partial exams. The percentage of students obtaining at least a passing score (60%) was considerably higher for the retention test (82.5 versus 51.9). CONCLUSION: These findings, indicating that medical students taught in a new pharmacology program developed adequate basic pharmacologic knowledge, should encourage other medical schools to formally evaluate their teaching programs and continue efforts to improve pharmacologic education of medical students.
