{"id":35342,"date":"1998-01-01T00:00:00","date_gmt":"1998-01-01T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/sistema-de-valoracion-pronostica-del-sindrome-de-shock-septico-infantil-asociado-con-purpura-cutanea\/"},"modified":"1998-01-01T00:00:00","modified_gmt":"1998-01-01T00:00:00","slug":"sistema-de-valoracion-pronostica-del-sindrome-de-shock-septico-infantil-asociado-con-purpura-cutanea","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/sistema-de-valoracion-pronostica-del-sindrome-de-shock-septico-infantil-asociado-con-purpura-cutanea\/","title":{"rendered":"Sistema de valoracion pronostica del sindrome de shock septico infantil asociado con purpura cutanea."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Alvaro Castellanos Ortega <\/strong><\/h2>\n<p>Introducci\u00f3n: la asociaci\u00f3n de p\u00farpura cut\u00e1nea y shock s\u00e9ptico constituye un s\u00edndrome generalmente producido por el germen neisseria meningitidis. Afecta con mayor frecuencia a ni\u00f1os menores de 10 a\u00f1os y se caracteriza por un comienzo hiperagudo y una evoluci\u00f3n r\u00e1pidamente progresiva hacia la disfunci\u00f3n multiorg\u00e1nica y la muerte que puede sobrevenir en pocas horas hasta en un 45% de los casos, siendo necesario establecer un pron\u00f3stico precoz con la finalidad de racionalizar la asignaci\u00f3n de recursos y la selecci\u00f3n de posibles beneficiarios de tratamientos de riesgo o en fase de experimetaci\u00f3n.  objetivos: desarrollar un sistema pron\u00f3stico r\u00e1pido, sencillo y reproducible para determinar el riesgo de muerte en el momento del ingreso en la ucip del ni\u00f1o afecto de un s\u00edndrome de shock s\u00e9ptico asociado con p\u00farpura cut\u00e1nea y comparar su capacidad predictiva con la de otros seis sistemas pron\u00f3sticos existentes.  m\u00e9todos: estudio de cohortes retrospectivo de factores pron\u00f3sticos sobre una serie de 219 casos consecutivos de shock s\u00e9ptico infantil asociado con p\u00farpura que ingresaron en las ucips de cuatro hospitales espa\u00f1oles de tercer nivel durante el per\u00edodo comprendido entre enero de 1983 y junio de 1995. Se realiz\u00f3 un an\u00e1lisis univariante de cuarenta variables registradas al ingreso y un an\u00e1lisis de regresi\u00f3n log\u00edstica para seleccionar los predictores independientes. Se efectu\u00f3 una validaci\u00f3n interna del sistema resultante (jackkniffe). La exactitud predictiva se compar\u00f3 con la de otros sistemas mediante un an\u00e1lisis de curvas roc. La calibraci\u00f3n se analiz\u00f3 mediante la prueba de bondad de ajuste de hosmer y lemeshow.  resultados: edad media: 35 +- 40 m (25d-18a). Mortalidad:  36%. Se cultiv\u00f3 neisseria meningitidis en el 65% de los casos y otros g\u00e9rmenes en el 4%. La nueva escala est\u00e1 formada por ocho predictores independientes: sexo masculino =1p, cianosis=2p, coma (ecg&lt;8)=2p, hipotensi\u00f3<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Sistema de valoracion pronostica del sindrome de shock septico infantil asociado con purpura cutanea.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Sistema de valoracion pronostica del sindrome de shock septico infantil asociado con purpura cutanea. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Alvaro Castellanos Ortega <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Cantabria<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 01\/01\/1998<\/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>Miguel Delgado Rodriguez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Juan  Jes\u00fas Gestal Otero <\/li>\n<li> Lozano De La Torre M. Jos\u00e9 (vocal)<\/li>\n<li>Francisco Ruza Tarrio (vocal)<\/li>\n<li>Juan Casado Flores (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Alvaro Castellanos Ortega Introducci\u00f3n: la asociaci\u00f3n de p\u00farpura cut\u00e1nea y shock s\u00e9ptico constituye un s\u00edndrome generalmente producido [&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 center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[10518,155,9,1086,161],"tags":[55752,15376,23649,2686,13260,3745],"class_list":["post-35342","post","type-post","status-publish","format-standard","hentry","category-cantabria","category-ciencias-clinicas","category-ciencias-medicas","category-epidemiologia","category-pediatria","tag-alvaro-castellanos-ortega","tag-francisco-ruza-tarrio","tag-juan-casado-flores","tag-juan-jesus-gestal-otero","tag-lozano-de-la-torre-m-jose","tag-miguel-delgado-rodriguez"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/35342","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=35342"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/35342\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=35342"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=35342"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=35342"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}