{"id":19469,"date":"2018-03-09T09:08:27","date_gmt":"2018-03-09T09:08:27","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/obesidad-morbida-manejo-perioperatorio-y-valoracion-global-de-la-respuesta-inmune\/"},"modified":"2018-03-09T09:08:27","modified_gmt":"2018-03-09T09:08:27","slug":"obesidad-morbida-manejo-perioperatorio-y-valoracion-global-de-la-respuesta-inmune","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/obesidad-morbida-manejo-perioperatorio-y-valoracion-global-de-la-respuesta-inmune\/","title":{"rendered":"Obesidad m\u00f3rbida. manejo perioperatorio y valoraci\u00f3n global de la respuesta inmune"},"content":{"rendered":"<h2>Tesis doctoral de <strong>  Garc\u00eda Rey Luis Alberto <\/strong><\/h2>\n<p>La cirug\u00eda bari\u00e1trica se presenta como el recurso terap\u00e9utico ideal en el tratamiento de la obesidad m\u00f3rbida. El manejo anest\u00e9sico es complicado debido a la variedad pluripatolog\u00eda que se asocia a estos pacientes. El presente trabajo refleja la experiencia acumulada en el manejo perioperatorio de esta cirug\u00eda en el hospital do meixoeiro.  el prop\u00f3sito de esta tesis es adem\u00e1s, en el contexto de la patolog\u00eda infecciosa postoperatoria m\u00e1s frecuente de estos pacientes, analizar si nuestra muestra tiene una respuesta inmunol\u00f3gica global comparable a la de otro grupo control sano. Se analiza la respuesta inmune global y sist\u00e9mica perioperatoriamente, realizando recuento leucocitario y cuantificaci\u00f3n de elastasa neutrof\u00edlica, il-1, il-6, prote\u00edna c reactiva, el tnf alfa y el factor 3a del complemento. El grupo control escogido son pacientes sometidos a colecistectom\u00eda por laparotom\u00eda y a histerectom\u00edas, ante la imposibilidad de comparar con otro acto quir\u00fargico semejante en duraci\u00f3n y en condici\u00f3n basal preoperatoria.  conclusiones  1,- el comportamiento hemodin\u00e1mico y respiratorio perioperatorio en nuestros pacientes ha seguido un patr\u00f3n similar a lo referido en la bibliograf\u00eda. queremos enfatizar la acusada repercusi\u00f3n de la intervenci\u00f3n sobre el sistema respiratorio, evidenciada por la disminuci\u00f3n de la movilidad diafragmatica y las alteraciones espirom\u00e9tricas postoperatorias.  2,- basalmente hemos constatado en el grupo de los obesos m\u00f3rbidos, respecto al grupo control, valores elevados en el recuento leucocitario (a expensas de los neutr\u00f3filos), en elastasa neutrof\u00edlica, il-1, il-6, factor c3 del complemento y pcr, por lo que podr\u00edamos definir que existe un estado basal proinflamatorio en estos pacientes.  3,- en ambos grupos se produce una respuesta inflamatoria cualitativamente similar frente al insulto quir\u00fargico, con un pico postoperatorio de elevaci\u00f3n de las variables analizadas que en el caso de<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Obesidad m\u00f3rbida. manejo perioperatorio y valoraci\u00f3n global de la respuesta inmune<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Obesidad m\u00f3rbida. manejo perioperatorio y valoraci\u00f3n global de la respuesta inmune <\/li>\n<li><strong>Autor:<\/strong>\u00a0  Garc\u00eda Rey Luis Alberto <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Santiago de compostela<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 14\/10\/2002<\/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>Julian \u00e1lvarez Escudero<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Miguel angel Ca\u00ednzos fern\u00e1ndez <\/li>\n<li>Francisco Carrascosa moreno (vocal)<\/li>\n<li>felipe Casanuevas freijo (vocal)<\/li>\n<li> Rueda chimeno Juan  Carlos (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Garc\u00eda Rey Luis Alberto La cirug\u00eda bari\u00e1trica se presenta como el recurso terap\u00e9utico ideal en el tratamiento [&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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