Red de Bibliotecas Virtuales de Ciencias Sociales en
América Latina y el Caribe

logo CLACSO

Por favor, use este identificador para citar o enlazar este ítem: https://biblioteca-repositorio.clacso.edu.ar/handle/CLACSO/22303
Registro completo de metadatos
Campo DC Valor Lengua/Idioma
dc.contributorTorres Dueñas, Diego-
dc.contributorNaranjo Junoy, Francisco Fernando-
dc.contributorMeléndez Flórez, Héctor Julio-
dc.contributorhttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000176095;https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000066885-
dc.contributorhttps://orcid.org/0000-0002-8006-7461-
dc.contributorhttps://www.scopus.com/authid/detail.uri?authorId=24282065800-
dc.contributorGrupo de Investigación en Ciencias y Educación en Salud-
dc.creatorSanabria Reyes, Marelbi Stella-
dc.creatorPuerto Chaparro, Ricardo Giovanni-
dc.date2020-06-26T19:59:27Z-
dc.date2020-06-26T19:59:27Z-
dc.date2017-
dc.date.accessioned2022-03-14T20:09:37Z-
dc.date.available2022-03-14T20:09:37Z-
dc.identifierhttp://hdl.handle.net/20.500.12749/1723-
dc.identifierinstname:Universidad Autónoma de Bucaramanga - UNAB-
dc.identifierreponame:Repositorio Institucional UNAB-
dc.identifier.urihttp://biblioteca-repositorio.clacso.edu.ar/handle/CLACSO/22303-
dc.descriptionIntroducción: la sepsis es un problema de salud pública que permanece con una alta incidencia y morbimortalidad, El uso de biomarcadores puede mejorar el diagnóstico e inicio de terapia tempranos y por lo tanto influir en el desenlace de morbilidad y mortalidad. En las últimas dos décadas, las Metaloproteinasas de matriz extracelular (MMPs)y sus inhibidores tisulares (TIMPs) han sido involucrados en diversas enfermedades de carácter inflamatorio, se perfilan como importantes biomarcadores para establecer el pronóstico del curso y desenlace de pacientes con sepsis o choque séptico. No obstante, es necesario aclarar controversias de su valor predictivo en este escenario. Objetivo General: Establecer la asociación entre las MMPs, los TIMPs y la mortalidad en pacientes sépticos. Metodología: se realizó un estudio de cohorte prospectivo de pacientes mayores de 18 años, captados en los proyectos G-SEPSIS Y MMACDyS en un grupo de pacientes hospitalizados en el servicio de urgencias y Unidades de Cuidados Intensivos adultos de 4 clínicas del área metropolitana de Bucaramanga, con diagnóstico de sepsis de acuerdo a la definición del tercer Consenso Internacional para sepsis y choque séptico (SEPSIS-3) de JAMA 2016. Se realizó análisis descriptivo, bivariado, capacidad discriminativa (curvas ROC) y modelo logístico multivariado. Resultados: de 289 pacientes con edades entre los 18 y 92 años, la incidencia de muerte fue de 28.4/100.000. En el análisis bivariado las concentraciones plasmáticas de TIMPs y MMP2 fueron mayores en los que fallecieron, en tanto que las de la MMP9 fueron mayores en los sobrevivientes. Los índices MMP/TIMPS, las actividades y las actividades ajustadas por concentración no presentaron diferencias estadísticamente significativas entre los pacientes que fallecieron y los sobrevivientes. En el modelo multivariado se encontró que los factores asociados a la mortalidad a 30 días eran el choque séptico, la edad, el BUN y el puntaje de Charlson. Conclusión: los factores encontrados que se asocian a la mortalidad a 30 días fueron el choque séptico, la edad, el BUN y el puntaje de Charlson. No se encontró asociación estadísticamente significativa para los índices MMP/TIMPS, las actividades de MMPs, y TIMPs y las actividades ajustadas por concentración y mortalidad en pacientes con sepsis y choque séptico.-
dc.descriptionINTRODUCCION 10 1. PLANTEAMIENTO Y JUSTIFICACION DEL PROBLEMA 11 2. PREGUNTA DE INVESTIGACION 14 3. MARCO TEÓRICO 15 3.1 DEFINICION DE SEPSIS 15 3.2 EPIDEMIOLOGÍA 17 3.3 CLASIFICACIÓN Y ESCALAS DE SEVERIDAD 18 3.4 FISIOPATOLOGÍA: INMUNOPATOGENESIS 20 3.5 METALOPROTEINASAS 21 3.6 DISFUNCIÓN CARDIOVASCULAR, DMF FMO 23 4. ESTADO DEL ARTE 24 5.1 OBJETIVOS 25 5.1 Objetivo general 25 5.2 Objetivos específicos 26 6. DISEÑO METODOLOGICO 27 6.1 DISEÑO DEL ESTUDIO 27 6.2 POBLACION 27 6.3 CRITERIOS DE INCLUSIÓN 27 6.4 CRITERIOS DE EXCLUSIÓN 27 6.5 MUESTREO 27 6.6 VARIABLES 28 6.7 PROCEDIMIENTOS PARA RECOLECCION DE INFORMACION 30 6.8 PROCESAMIENTO DE LOS DATOS 30 7. ANALISIS ESTADISTICO DE LAS VARIABLES 31 7.1 ANALISIS UNIVARIADO 31 7.2 ANALISIS BIVARIADO 32 8. CONSIDERACIONES ETICAS 32 9. RESULTADOS 34 9.1 CONSTRUCCION DE LA COHORTE 34 9.2 ANALISIS UNIVARIADO 34 9.3 ANALISIS BIVARIADO 37 9.4 REGRESION LOGISTICA BIVARIADA 37 9.5 REGRESION LOGISTICA MULTIVARIADA 38 9.6 EVALUACION DEL DESEMPEÑO 39 9.7 OBSERVACIONES INFLUYENTES 40 10. DISCUSION 40 11. CONCLUSIONES 44 12. BIBLIOGRAFIA 45-
dc.descriptionEspecialización-
dc.descriptionIntroduction: sepsis is a public health problem that remains with a high incidence and morbidity and mortality. The use of biomarkers can improve early diagnosis and initiation of therapy and therefore influence the outcome of morbidity and mortality. In the last two decades, extracellular matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) have been involved in various inflammatory diseases, they are emerging as important biomarkers to establish the prognosis of the course and outcome of patients with sepsis or shock septic. However, it is necessary to clarify controversies of its predictive value in this scenario. General Objective: To establish the association between MMPs, TIMPs and mortality in septic patients. Methodology: a prospective cohort study of patients over 18 years of age was carried out, captured in the G-SEPSIS and MMACDyS projects in a group of hospitalized patients in the emergency department and adult Intensive Care Units of 4 clinics in the metropolitan area of ​​Bucaramanga , with a diagnosis of sepsis according to the definition of the third International Consensus for sepsis and septic shock (SEPSIS-3) of JAMA 2016. Descriptive, bivariate analysis, discriminative capacity (ROC curves) and multivariate logistic model were performed. Results: of 289 patients aged between 18 and 92 years, the incidence of death was 28.4 / 100,000. In the bivariate analysis, the plasma concentrations of TIMPs and MMP2 were higher in those who died, while those of MMP9 were higher in the survivors. The MMP / TIMPS indices, activities, and concentration-adjusted activities did not show statistically significant differences between patients who died and survivors. In the multivariate model, it was found that the factors associated with 30-day mortality were septic shock, age, BUN, and the Charlson score. Conclusion: the factors found associated with 30-day mortality were septic shock, age, BUN, and the Charlson score. No statistically significant association was found for MMP / TIMPS indices, activities of MMPs, and TIMPs, and activities adjusted for concentration and mortality in patients with sepsis and septic shock.-
dc.formatapplication/pdf-
dc.formatapplication/pdf-
dc.formatapplication/pdf-
dc.languagespa-
dc.publisherUniversidad Autónoma de Bucaramanga UNAB-
dc.publisherFacultad Ciencias de la Salud-
dc.publisherEspecialización en Medicina Crítica y Cuidado Intensivo del Adulto-
dc.relationSanabria Reyes, Marelbi Stella, Puerto Chaparro, Ricardo Giovanni (2017). Asociación entre la mortalidad y las metaloproteinasas y sus inhibidores en pacientes sépticos. Bucaramanga (Santander, Colombia) : Universidad Autónoma de Bucaramanga UNAB-
dc.relation1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA [Internet]. 2016 Feb 23 [cited 2017 Apr 28];315(8):801–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26903338-
dc.relation2. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med [Internet]. 2003 Apr 17 [cited 2017 Apr 28];348(16):1546–54. Available from: http://www.nejm.org/doi/abs/10.1056/NEJMoa022139-
dc.relation3. Kawai T, Akira S. TLR signaling. Semin Immunol [Internet]. 2007 Feb [cited 2017 Apr 28];19(1):24–32. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1044532306001242-
dc.relation4. Nagase H, Woessner JF. Matrix metalloproteinases. J Biol Chem [Internet]. 1999 Jul 30 [cited 2017 Apr 28];274(31):21491–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10419448-
dc.relation5. Creemers EE, Cleutjens JP, Smits JF, Daemen MJ. Matrix metalloproteinase inhibition after myocardial infarction: a new approach to prevent heart failure? Circ Res [Internet]. 2001 Aug 3 [cited 2017 Apr 28];89(3):201–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11485970-
dc.relation6. Pennanen H, Kuittinen O, Turpeenniemi-Hujanen T. Plasma MMP-2-TIMP-2 complex levels measured during follow-up predict a risk of relapse in patients with malignant lymphoma. Eur J Haematol [Internet]. 2007 Nov 19 [cited 2017 Apr 28];0(0):071119202650001–??? Available from: http://www.ncbi.nlm.nih.gov/pubmed/18028436-
dc.relation7. Gadek JE, Pacht ER. The interdependence of lung antioxidants and antiprotease defense in ARDS. Chest [Internet]. 1996 Dec [cited 2017 Apr 28];110(6 Suppl):273S–277S. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8989164-
dc.relation8. Hoffmann U, Bertsch T, Dvortsak E, Liebetrau C, Lang S, Liebe V, et al. Matrix-metalloproteinases and their inhibitors are elevated in severe sepsis: prognostic value of TIMP-1 in severe sepsis. Scand J Infect Dis [Internet]. 2006 Jan 8 [cited 2017 Apr 28];38(10):867–72. Available from: http://www.tandfonline.com/doi/full/10.1080/00365540600702058-
dc.relation9. Wang M, Zhang Q, Zhao X, Dong G, Li C. Diagnostic and prognostic value of neutrophil gelatinase-associated lipocalin, matrix metalloproteinase-9, and tissue inhibitor of matrix metalloproteinases-1 for sepsis in the Emergency Department: an observational study. Crit Care [Internet]. 2014 Nov 19 [cited 2017 Apr 28];18(6):634. Available from: http://ccforum.biomedcentral.com/articles/10.1186/s13054-014-0634-6-
dc.relation10. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med [Internet]. 1992 Jun [cited 2017 Apr 28];20(6):864–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1597042-
dc.relation11. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med [Internet]. 2003 Apr [cited 2017 Apr 28];31(4):1250–6. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003246-200304000-00038-
dc.relation12. Alberti C, Brun-Buisson C, Burchardi H, Martin C, Goodman S, Artigas A, et al. Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med [Internet]. 2002 Feb 4 [cited 2017 Apr 28];28(2):108–21. Available from: http://link.springer.com/10.1007/s00134-001-1143-z-
dc.relation13. Jaimes F. A literature review of the epidemiology of sepsis in Latin America. Rev Panam Salud Publica [Internet]. 2005 Sep [cited 2017 Apr 28];18(3):163–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16269118-
dc.relation14. Ferdinandy P, Danial H, Ambrus I, Rothery RA, Schulz R. Peroxynitrite is a major contributor to cytokine-induced myocardial contractile failure. Circ Res [Internet]. 2000 Aug 4 [cited 2017 Apr 28];87(3):241–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10926876-
dc.relation15. Dellinger RP, Levy MM, Rhodes A, Bs MB, Annane D, Gerlach H, et al. Surviving Sepsis Campaign. Crit Care Med [Internet]. 2013;41(2):580–637. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003246-201302000-00024-
dc.relation16. Sriskandan S, Altmann DM. The immunology of sepsis. J Pathol [Internet]. 2008 Jan [cited 2017 Apr 28];214(2):211–23. Available from: http://doi.wiley.com/10.1002/path.2274-
dc.relation17. Dubois B, Starckx S, Pagenstecher A, Oord J van den, Arnold B, Opdenakker G. Gelatinase B deficiency protects against endotoxin shock. Eur J Immunol [Internet]. 2002 Aug [cited 2017 Apr 28];32(8):2163–71. Available from: http://doi.wiley.com/10.1002/1521-4141%28200208%2932%3A8%3C2163%3A%3AAID-IMMU2163%3E3.0.CO%3B2-Q-
dc.relation18. Lalu MM, Cena J, Chowdhury R, Lam A, Schulz R. Matrix metalloproteinases contribute to endotoxin and interleukin-1beta induced vascular dysfunction. Br J Pharmacol [Internet]. 2006 Sep [cited 2017 Apr 28];149(1):31–42. Available from: http://doi.wiley.com/10.1038/sj.bjp.0706823-
dc.relation19. Lalu MM, Gao CQ, Schulz R. Matrix metalloproteinase inhibitors attenuate endotoxemia induced cardiac dysfunction: a potential role for MMP-9. Mol Cell Biochem [Internet]. 2003 Sep [cited 2017 Apr 28];251(1–2):61–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14575305-
dc.relation20. Hoffmann U, Brueckmann M, Borggrefe M. Matrix metalloproteinases and their inhibitors: promising novel biomarkers in severe sepsis? Crit Care [Internet]. 2009 [cited 2017 Apr 28];13(6):1006. Available from: http://ccforum.biomedcentral.com/articles/10.1186/cc8156-
dc.relation21. Lorente L, Martín MM, Labarta L, Díaz C, Solé-Violán J, Blanquer J, et al. Matrix metalloproteinase-9, -10, and tissue inhibitor of matrix metalloproteinases-1 blood levels as biomarkers of severity and mortality in sepsis. Crit Care [Internet]. 2009 [cited 2017 Apr 28];13(5):R158. Available from: http://ccforum.biomedcentral.com/articles/10.1186/cc8115-
dc.relation22. Lorente L, Martín MM, Solé-Violán J, Blanquer J, Labarta L, Díaz C, et al. Association of sepsis-related mortality with early increase of TIMP-1/MMP-9 ratio. Alves-Filho JC, editor. PLoS One [Internet]. 2014 Apr 11 [cited 2017 Apr 28];9(4):e94318. Available from: http://dx.plos.org/10.1371/journal.pone.0094318-
dc.relation23. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med [Internet]. 2013 Feb [cited 2017 Apr 28];41(2):580–637. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003246-201302000-00024-
dc.relation24. Fridkin SK. Increasing prevalence of antimicrobial resistance in intensive care units. Crit Care Med [Internet]. 2001 Apr [cited 2017 Apr 29];29(4 Suppl):N64-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11292878-
dc.relation25. Fleischmann C, Scherag A, Adhikari NKJ, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med [Internet]. 2016 Feb [cited 2017 Apr 29];193(3):259–72. Available from: http://www.atsjournals.org/doi/10.1164/rccm.201504-0781OC-
dc.relation26. Mayr FB, Yende S, Angus DC. Epidemiology of severe sepsis. Virulence [Internet]. 2014 Jan 1 [cited 2017 Apr 29];5(1):4–11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24335434-
dc.relation27. Ortíz G, Dueñas C, Rodríguez F, Barrera L, De La Rosa G, Dennis R, et al. Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia. Biomédica [Internet]. 2013 Aug 2 [cited 2017 May 6];34(1):40. Available from: http://www.revistabiomedica.org/index.php/biomedica/article/view/1439-
dc.relation28. Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM, et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med [Internet]. 1998 Nov [cited 2017 May 6];26(11):1793–800. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9824069-
dc.relation29. Vosylius S, Sipylaite J, Ivaskevicius J. Sequential organ failure assessment score as the determinant of outcome for patients with severe sepsis. Croat Med J [Internet]. 2004 Dec [cited 2017 May 6];45(6):715–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15578805-
dc.relation30. Vincent J-L, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care [Internet]. 2010 [cited 2017 May 6];14(2):207. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20392287-
dc.relation31. Ganz T. Defensins: antimicrobial peptides of innate immunity. Nat Rev Immunol [Internet]. 2003 Sep [cited 2017 May 6];3(9):710–20. Available from: http://www.nature.com/doifinder/10.1038/nri1180-
dc.relation32. GASQUE P. Complement: a unique innate immune sensor for danger signals. Mol Immunol [Internet]. 2004 Nov [cited 2017 May 6];41(11):1089–98. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0161589004002184-
dc.relation33. Boes M, Prodeus AP, Schmidt T, Carroll MC, Chen J. A critical role of natural immunoglobulin M in immediate defense against systemic bacterial infection. J Exp Med [Internet]. 1998 Dec 21 [cited 2017 May 6];188(12):2381–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9858525-
dc.relation34. Haug R. Bacteremia due to viridans streptococci in neutropenic patients: A review. J Oral Maxillofac Surg [Internet]. 1995 Mar [cited 2017 May 6];53(3):349. Available from: http://linkinghub.elsevier.com/retrieve/pii/0278239195902570-
dc.relation35. Mitchell JA, Paul-Clark MJ, Clarke GW, McMaster SK, Cartwright N. Critical role of toll-like receptors and nucleotide oligomerisation domain in the regulation of health and disease. J Endocrinol [Internet]. 2007 Jun 1 [cited 2017 May 6];193(3):323–30. Available from: http://joe.endocrinology-journals.org/cgi/doi/10.1677/JOE-07-0067-
dc.relation36. Hehlgans T, Pfeffer K. The intriguing biology of the tumour necrosis factor/tumour necrosis factor receptor superfamily: players, rules and the games. Immunology [Internet]. 2005 May [cited 2017 May 6];115(1):1–20. Available from: http://doi.wiley.com/10.1111/j.1365-2567.2005.02143.x-
dc.relation37. Faulkner L, Altmann DM, Ellmerich S, Huhtaniemi I, Stamp G, Sriskandan S. Sexual Dimorphism in Superantigen Shock Involves Elevated TNF-α and TNF-α–induced Hepatic Apoptosis. Am J Respir Crit Care Med [Internet]. 2007 Sep [cited 2017 May 6];176(5):473–82. Available from: http://www.atsjournals.org/doi/abs/10.1164/rccm.200611-1712OC-
dc.relation38. Shelley O, Murphy T, Paterson H, Mannick JA, Lederer JA. Interaction Between the Innate and Adaptive Immune Systems is Required to Survive Sepsis and Control Inflammation After Injury. Shock [Internet]. 2003 Aug [cited 2017 May 6];20(2):123–9. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00024382-200308000-00004-
dc.relation39. Yazdan-Ashoori P, Liaw P, Toltl L, Webb B, Kilmer G, Carter DE, et al. Elevated plasma matrix metalloproteinases and their tissue inhibitors in patients with severe sepsis. J Crit Care [Internet]. 2011 Dec [cited 2017 May 6];26(6):556–65. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0883944111000700-
dc.relation40. Birkedal-Hansen H, Cobb CM, Taylor RE, Fullmer HM. Synthesis and release of procollagenase by cultured fibroblasts. J Biol Chem [Internet]. 1976 May 25 [cited 2017 May 7];251(10):3162–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/57961-
dc.relation41. Dollery CM, McEwan JR, Henney AM. Matrix Metalloproteinases and Cardiovascular Disease. Circ Res [Internet]. 1995 [cited 2017 May 7];77(5). Available from: http://circres.ahajournals.org/content/77/5/863.long-
dc.relation42. Maitra SR, Bhaduri S, Valane PD, Tervahartiala T, Sorsa T, Ramamurthy N. Inhibition of Matrix Metalloproteinases by Chemically Modified Tetracyclines in Sepsis. Shock [Internet]. 2003 Sep [cited 2017 May 6];20(3):280–5. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00024382-200309000-00014-
dc.relation43. Steinberg J,N Halter J, Schiller H, Gatto L, Carney D, Lee H-M, et al. CHEMICALLY MODIFIED TETRACYCLINE PREVENTS THE DEVELOPMENT OF SEPTIC SHOCK AND ACUTE RESPIRATORY DISTRESS SYNDROME IN A CLINICALLY APPLICABLE PORCINE MODEL. Shock [Internet]. 2005 Oct [cited 2017 May 6];24(4):348–56. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00024382-200510000-00009-
dc.relation44. Hirsh M, Carmel J, Kaplan V, Livne E, Krausz MM. Activity of lung neutrophils and matrix metalloproteinases in cyclophosphamide-treated mice with experimental sepsis. Int J Exp Pathol [Internet]. 2004 Jun 16 [cited 2017 May 7];85(3):147–57. Available from: http://doi.wiley.com/10.1111/j.0959-9673.2004.00385.x-
dc.relation45. Nakamura T, Ebihara I, Shimada N, Shoji H, Koide H. Modulation of plasma metalloproteinase-9 concentrations and peripheral blood monocyte mRNA levels in patients with septic shock: effect of fiber-immobilized polymyxin B treatment. Am J Med Sci [Internet]. 1998 Dec [cited 2017 May 7];316(6):355–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9856688-
dc.relation46. Niño M, Serrano S,Pazin-Filho A,Jaimes F,Cunha F,Schulz,Torres-Dueñas TIMP1 and MMP9 are predictors of mortalitiy in septic patients in the Emergency department and intensive care unit unlike MMP9/TIMP1 ratio: Multivariate model. One PLOS.2017 feb 13.-
dc.rightshttp://creativecommons.org/licenses/by-nc-nd/2.5/co/-
dc.rightsAbierto (Texto Completo)-
dc.rightsinfo:eu-repo/semantics/openAccess-
dc.rightshttp://purl.org/coar/access_right/c_abf2-
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia-
dc.subjectSeptic syndrome-
dc.subjectPublic health-
dc.subjectMortality-
dc.subjectMetalloproteinases-
dc.subjectMedicine-
dc.subjectCritical medicine-
dc.subjectAdult intensive care-
dc.subjectInvestigations-
dc.subjectRelationship with patients-
dc.subjectMetalloproteinases (MMPs)-
dc.subjectTissue metalloproteinase inhibitors (TIMPs)-
dc.subjectSíndrome séptico-
dc.subjectSalud pública-
dc.subjectMortalidad-
dc.subjectMetaloproteinasas-
dc.subjectMedicina-
dc.subjectMedicina crítica-
dc.subjectCuidado intensivo del adulto-
dc.subjectInvestigaciones-
dc.subjectRelación con los pacientes-
dc.subjectSepsis-
dc.subjectMetaloproteinasas (MMPs)-
dc.subjectInhibidores tisulares de metaloproteinasas (TIMPs)-
dc.titleAsociación entre la mortalidad y las metaloproteinasas y sus inhibidores en pacientes sépticos-
dc.titleAssociation between mortality and metalloproteinases and their inhibitors in septic patients-
dc.typeinfo:eu-repo/semantics/masterThesis-
dc.typeTesis-
dc.typehttp://purl.org/coar/resource_type/c_bdcc-
dc.typeinfo:eu-repo/semantics/acceptedVersion-
dc.typehttp://purl.org/redcol/resource_type/TM-
dc.coverageBucaramanga (Santander, Colombia)-
Aparece en las colecciones: Instituto de Estudios Políticos - IEP - Cosecha

Ficheros en este ítem:
No hay ficheros asociados a este ítem.


Los ítems de DSpace están protegidos por copyright, con todos los derechos reservados, a menos que se indique lo contrario.