{"id":11460,"date":"2018-03-09T08:56:50","date_gmt":"2018-03-09T08:56:50","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/utilidad-de-la-microbiologa%c2%ada-en-el-diagnostico-y-tratamiento-de-los-derrames-paraneumonicos-estudios-prospectivo-aleatorizado\/"},"modified":"2018-03-09T08:56:50","modified_gmt":"2018-03-09T08:56:50","slug":"utilidad-de-la-microbiologa%c2%ada-en-el-diagnostico-y-tratamiento-de-los-derrames-paraneumonicos-estudios-prospectivo-aleatorizado","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/utilidad-de-la-microbiologa%c2%ada-en-el-diagnostico-y-tratamiento-de-los-derrames-paraneumonicos-estudios-prospectivo-aleatorizado\/","title":{"rendered":"Utilidad de la microbiolog\u00eda en el diagn\u00f3stico y tratamiento de los derrames paraneum\u00f3nicos: estudios prospectivo aleatorizado"},"content":{"rendered":"<h2>Tesis doctoral de <strong> David Jim\u00e9nez Castro <\/strong><\/h2>\n<p>1,- el estudio microbiol\u00f3gico de los derrames pleurales paraneum\u00f3nicos no aporta informaci\u00f3n relevante que modifique la supervivencia de los pacientes con infecci\u00f3n del espacio pleural. Nuestra experiencia no apoya la realizaci\u00f3n inicial de estudios microbiol\u00f3gicos de los derrames pleurales. \u00faNicamente en aquellos casos de mala evoluci\u00f3n de los pacientes con infecci\u00f3n pleural recomendamos una nueva toracocentesis para valorar la evoluci\u00f3n de los par\u00e1metros bioqu\u00edmicos y buscar la filiaci\u00f3n de microorganismo responsable.  2,- el estudio microbiol\u00f3gico de los derrames pleurales paraneum\u00f3nicos aumenta e n\u00famero de d\u00edas de tratamiento antibi\u00f3tico, no disminuye la estancia hospitalaria de los pacientes y no ahorra la necesidad de tratamientos invasivos.  3,- ninguna de las variables analizadas permite predecir la mortalidad a 6 meses de los pacientes con derrame paraneum\u00f3nico. Los pacientes con leucocitos y puntuaci\u00f3n de fine de las clases iv y v presentar\u00e1n con m\u00e1s probabilidad engrosameinto pleural residual a 6 meses.  4,- el estudio microbiol\u00f3gico de los derrames pleurales paraneum\u00f3nicos supone un gasto excesivo en el manejo cl\u00ednico de los pacientes con infecci\u00f3n pleural. \u00faNicamente en centros de referencia, y con car\u00e1cter peri\u00f3dico, ser\u00eda recomendable estudiar el espectro de microorganismos responsables de las infecciones pleurales y sus resistencias antibi\u00f3ticas.  5,- los criterios de light contin\u00faan siendo excelentes par\u00e1metros para diferenciar exudados y trasudados. La modificaci\u00f3n de los puntos de corte para los criterios de light no aumenta significativamente su rendimiento. las combinaciones de 2 par\u00e1metros pueden ofrecer rendimiento similar al empleo de 3 de ellos. Recomendamos el empleo de colesterol mayor de 47 mg\/dl y ldh mayor de 222 ui\/l por ofrecer el mismo rendimiento que la combinaci\u00f3n de 3 par\u00e1metros, por su menor coste y porque evita la necesidad de determinaciones s\u00e9ricas.  6,- el<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Utilidad de la microbiolog\u00eda en el diagn\u00f3stico y tratamiento de los derrames paraneum\u00f3nicos: estudios prospectivo aleatorizado<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Utilidad de la microbiolog\u00eda en el diagn\u00f3stico y tratamiento de los derrames paraneum\u00f3nicos: estudios prospectivo aleatorizado <\/li>\n<li><strong>Autor:<\/strong>\u00a0 David Jim\u00e9nez Castro <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Alcal\u00e1<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 20\/06\/2001<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Esteban P\u00e9rez Rodr\u00edguez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: melchor Alvarez de mon soto <\/li>\n<li>Jos\u00e9 Luis Alvarez sala walther (vocal)<\/li>\n<li> G\u00f3mez de terreros Francisco Javier (vocal)<\/li>\n<li>  (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de David Jim\u00e9nez Castro 1,- el estudio microbiol\u00f3gico de los derrames pleurales paraneum\u00f3nicos no aporta informaci\u00f3n relevante que [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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