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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.-
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dc.formatapplication/pdf-
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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-
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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

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