{"id":38303,"date":"2018-03-09T09:37:48","date_gmt":"2018-03-09T09:37:48","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/factores-de-riesgo-del-hepatocarcinoma-en-pacientes-cirroticos\/"},"modified":"2018-03-09T09:37:48","modified_gmt":"2018-03-09T09:37:48","slug":"factores-de-riesgo-del-hepatocarcinoma-en-pacientes-cirroticos","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/factores-de-riesgo-del-hepatocarcinoma-en-pacientes-cirroticos\/","title":{"rendered":"Factores de riesgo del hepatocarcinoma en pacientes cirroticos."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Manuel Macias Rodriguez <\/strong><\/h2>\n<p>Introducci\u00f3n: la aparici\u00f3n de un carcinoma hepatocelular (chc) es una de las principales complicaciones de la cirrosis. Su incidencia oscila entre el 2-11% anual. El tumor diagnosticado en fase sintom\u00e1tica es, generalmente, intratable, por lo que se han desarrollado programas de seguimiento en estos pacientes dirigidos a su diagn\u00f3stico precoz. Estos programas suponen un elevado coste asistencial y econ\u00f3mico, por lo que se hace necesario reconocer grupos de pacientes con un diferente riesgo de degeneraci\u00f3n tumoral.  objetivos: 1) establecer el riesgo de aparici\u00f3n del chc en pacientes cirr\u00f3ticos. 2) conocer las caracter\u00edsticas de los pacientes cirr\u00f3ticos con chc. 3) determinar la existencia de diferencias en el riesgo de presentar el tumor en dichos pacientes en funci\u00f3n de sus caracter\u00edsticas epidemiol\u00f3gicas, evoluci\u00f3n de la cirrosis y su etiolog\u00eda. 4) evaluar la utilidad de la alfa-fetoprote\u00edna en el seguimiento de los pacientes cirr\u00f3ticos.  pacientes y m\u00e9todo: estudio de cohortes con 512 pacientes cirr\u00f3ticos en grado a\/b de child-pugh, menores de 70 a\u00f1os, que fueron valorados peri\u00f3dicamente mediante ecograf\u00eda y determinaciones de alfa-fetoprote\u00edna (afp).  el 63% eran varones, la edad media ascendi\u00f3 a 55 a\u00f1os y el 70% se encontraban en el grado a de child al inicio.  el 52% ten\u00edan un antecedente et\u00edlico, el 42% presentaban anticuerpos contra el virus c y el 14% ten\u00edan el aghbs.  se determin\u00f3 el riesgo de aparici\u00f3n del tumor (curvas de kaplan-meier). Se sometieron a an\u00e1lisis univariante (prueba de log-rank) y multivariante (modelo de riesgos proporcionales de cox) la influencia en el riesgo de aparici\u00f3n del chc de edad, sexo, grado de child, duraci\u00f3n de la cirrosis, etiolog\u00eda y afp.  resultados: el seguimiento se prolong\u00f3, por t\u00e9rmino medio, 37 meses. Al final del estudio se hab\u00edan detectado 52 chc, que suponen un riesgo acumulado del 10% a los 3 a\u00f1os y 17% a los 5 a\u00f1os. El 73% de los pac<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Factores de riesgo del hepatocarcinoma en pacientes cirroticos.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Factores de riesgo del hepatocarcinoma en pacientes cirroticos. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Manuel Macias Rodriguez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 C\u00e1diz<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 22\/06\/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>Alipio Mangas Rojas<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Avelino Senra Varela <\/li>\n<li>Gonzalo Mi\u00f1o Fugarolas (vocal)<\/li>\n<li>Pedro Valdivieso Felices (vocal)<\/li>\n<li>Jes\u00fas Millan Nu\u00f1ez Cortes (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Manuel Macias Rodriguez Introducci\u00f3n: la aparici\u00f3n de un carcinoma hepatocelular (chc) es una de las principales complicaciones [&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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