¿Podemos mejorar la prevención de la tuberculosis? Análisis de la aplicación de la quimioprofilaxis
Can we improve tuberculosis prevention? Analysis of chemoprophylaxis compliance
Servicio de Neumología. Hospital Arnau de Vilanova. Valencia
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Análisis de la aplicación de la quimioprofilaxis" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "505" "paginaFinal" => "509" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "J. Franco Serrano, R. Blanquer Olivas, A. Domínguez Martínez" "autores" => array:3 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Franco Serrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Blanquer Olivas" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Domínguez Martínez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología. Hospital Arnau de Vilanova. Valencia" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Servicio de Neumología. Hospital Doctor Peset. Avda. Gaspar Aguilar. 90. 46017 Valencia." ] ] ] 1 => array:3 [ "autoresLista" => "J. Flores Cid, J.M. Nogueira Coito, C. Iñigo Zaera" "autores" => array:3 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Flores Cid" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "J.M." "apellidos" => "Nogueira Coito" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Iñigo Zaera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Hematología. Hospital Arnau de Vilanova. Valencia" "etiqueta" => "*" "identificador" => "aff0010" ] 1 => array:3 [ "entidad" => "Servicio de Microbiología. Hospital Doctor Peset. Valencia" "etiqueta" => "**" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Can we improve tuberculosis prevention? Analysis of chemoprophylaxis compliance" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1996-01-02" "fechaAceptado" => "1996-04-30" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec546174" "palabras" => array:3 [ 0 => "Tuberculosis" 1 => "Prevención" 2 => "Quimioprofilaxis" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec546175" "palabras" => array:3 [ 0 => "Tuberculosis" 1 => "Prevention" 2 => "Chemoprophylaxis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio ha sido analizar las situaciones que dificultan la aplicación de las indicaciones de la quimioprofilaxis antituberculosa.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 128 enfermos (106 VIH– y 22 VIH+) diagnosticados consecutivamente de tuberculosis (TB). Los pacientes fueron entrevistados personalmente mediante un cuestionario para identificar los diferentes grupos de riesgo y determinar las actuaciones que se habían realizado para prevenir la TB.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En el grupo VIH–, 63 individuos (57,8%) tuvieron al menos un factor de riesgo; los más frecuentes fueron: contacto con enfermos tuberculosos (31,1%), TB anterior (15,1%), pérdida rápida de peso o desnutrición crónica (13,2%) y residencia en instituciones cerradas (5,6%). En 51 de ellos (48,1%) había indicación de valoración para quimioprofilaxis y de éstos, 43 (84,3%) habían realizado alguna visita médica en los últimos 5 años. Sin embargo, sólo en 10 de los enfermos visitados (23,3%) se indicó la prueba de la tuberculina y en cuatro (9,3%) se prescribió isoniazida. En el grupo VIH+, 13 de los 18 individuos con indicación de valorar quimioprofilaxis (72,2%) habían sido visitados, en 12 (97,7%) se realizó la prueba de la tuberculina y en cuatro (30,7%) se indicó isoniazida. Ninguno de los pacientes de ambos grupos en que se indicó un curso completo de quimioprofilaxis tomó isoniazida durante un tiempo suficiente.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La mayoría de los pacientes VIH– con indicación de valorar quimioprofilaxis había realizado alguna visita médica en los 5 años previos a su enfermedad; sin embargo, menos de la cuarta parte fueron valorados en este sentido. Esta situación probablemente es consecuencia de la dispersión asistencial existente en nuestro país en materia de control de la tuberculosis. Por contra, en casi todos los pacientes VIH+ visitados se comprobó su estado tuberculínico, debido a que se beneficiaron de una asistencia protocolizada.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To analyze the situations that make chemoprophylaxis for tuberculosis difficult.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">One hundred twenty-eight patients consecutive (106 HIV negative and 22 HIV positive) diagnosed of tuberculosis (TB) were studied. The patients twre interviewed and a questionnaire was filled out in order to identify risk groups and determine what steps had been taken to prevent TB.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In the HIV negative group, 63 (57.8%) had at least one risk factor. The most common were contact with persons with active TB (31.1%), former TB (15.1%), rapid weight loss or chronic malnutrition (13.2%) and residence in closed institutions (5.6%). Of the 51 (48.1%) for whom evaluation of chemoprophylaxis was indicated, 43 (84.3%) had been examined by a physician within the past five years; only 10 (23.3%) of them, however, had been checked for TB and isoniazide had been prescribed for only 4 (9.3%). In the HIV positive group, 13 (72.2%) of those for whom evaluation of chemoprophylaxis was indicated had been seen by a physician; 12 (97.7%) of them were given tuberculin tests checked for TB and isoniazide was prescribed for 4 (30.7%). None of the patients in either group who were prescribed a full course of prophylaxis actually took the drug enough.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Most HIV negative patients for whom evaluation of chemoprophylaxis was indicated had been examined by a physician in the five years before disease was detected; less than a quarter of them were checked for TB, however. This situation is probably a consequence of the structure of health care in Spain as it affects TB control. Nearly all the HIV positive patients were checked for the disease, as they benefited from protocolozed health care.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 39 | 12 | 51 |
| 2024 September | 45 | 15 | 60 |
| 2024 August | 55 | 30 | 85 |
| 2024 July | 30 | 23 | 53 |
| 2024 June | 48 | 30 | 78 |
| 2024 May | 54 | 24 | 78 |
| 2024 April | 31 | 19 | 50 |
| 2024 March | 44 | 28 | 72 |
| 2024 February | 28 | 35 | 63 |
| 2024 January | 0 | 5 | 5 |
| 2023 December | 0 | 1 | 1 |
| 2023 November | 0 | 3 | 3 |
| 2023 October | 0 | 5 | 5 |
| 2023 September | 0 | 6 | 6 |
| 2023 August | 0 | 2 | 2 |
| 2023 July | 0 | 3 | 3 |
| 2023 June | 0 | 1 | 1 |
| 2023 March | 4 | 3 | 7 |
| 2023 February | 25 | 29 | 54 |
| 2023 January | 24 | 22 | 46 |
| 2022 December | 28 | 25 | 53 |
| 2022 November | 40 | 31 | 71 |
| 2022 October | 28 | 26 | 54 |
| 2022 September | 24 | 55 | 79 |
| 2022 August | 33 | 50 | 83 |
| 2022 July | 22 | 34 | 56 |
| 2022 June | 25 | 24 | 49 |
| 2022 May | 32 | 34 | 66 |
| 2022 April | 18 | 29 | 47 |
| 2022 March | 31 | 25 | 56 |
| 2022 February | 46 | 24 | 70 |
| 2022 January | 26 | 30 | 56 |
| 2021 December | 15 | 29 | 44 |
| 2021 November | 26 | 33 | 59 |
| 2021 October | 15 | 39 | 54 |
| 2021 September | 17 | 33 | 50 |
| 2021 August | 15 | 22 | 37 |
| 2021 July | 12 | 19 | 31 |
| 2021 June | 18 | 25 | 43 |
| 2021 May | 10 | 40 | 50 |
| 2021 April | 16 | 56 | 72 |
| 2021 March | 29 | 20 | 49 |
| 2021 February | 31 | 18 | 49 |
| 2021 January | 23 | 15 | 38 |
| 2020 December | 19 | 12 | 31 |
| 2020 November | 11 | 11 | 22 |
| 2020 October | 25 | 19 | 44 |
| 2020 September | 14 | 6 | 20 |
| 2020 August | 13 | 17 | 30 |
| 2020 July | 16 | 11 | 27 |
| 2020 June | 13 | 5 | 18 |
| 2020 May | 13 | 21 | 34 |
| 2020 April | 19 | 8 | 27 |
| 2020 March | 22 | 21 | 43 |
| 2020 February | 10 | 13 | 23 |
| 2020 January | 30 | 24 | 54 |
| 2019 December | 25 | 25 | 50 |
| 2019 November | 4 | 4 | 8 |
| 2019 October | 13 | 13 | 26 |
| 2019 September | 10 | 30 | 40 |
| 2019 August | 18 | 7 | 25 |
| 2019 July | 13 | 21 | 34 |
| 2019 June | 15 | 17 | 32 |
| 2019 May | 17 | 35 | 52 |
| 2019 April | 25 | 19 | 44 |
| 2019 March | 11 | 18 | 29 |
| 2019 February | 6 | 10 | 16 |
| 2019 January | 1 | 6 | 7 |
| 2018 December | 8 | 14 | 22 |
| 2018 November | 19 | 20 | 39 |
| 2018 October | 18 | 9 | 27 |
| 2018 September | 14 | 9 | 23 |
| 2018 May | 4 | 1 | 5 |
| 2018 April | 12 | 7 | 19 |
| 2018 March | 5 | 7 | 12 |
| 2018 February | 10 | 9 | 19 |
| 2018 January | 4 | 7 | 11 |
| 2017 December | 10 | 10 | 20 |
| 2017 November | 10 | 8 | 18 |
| 2017 October | 7 | 8 | 15 |
| 2017 September | 4 | 5 | 9 |
| 2017 August | 9 | 10 | 19 |
| 2017 July | 2 | 4 | 6 |
| 2017 June | 13 | 12 | 25 |
| 2017 May | 10 | 5 | 15 |
| 2017 April | 7 | 8 | 15 |
| 2017 March | 4 | 13 | 17 |
| 2017 February | 3 | 3 | 6 |
| 2017 January | 7 | 6 | 13 |
| 2016 December | 10 | 2 | 12 |
| 2016 November | 19 | 9 | 28 |
| 2016 October | 25 | 19 | 44 |
| 2016 September | 14 | 7 | 21 |
| 2016 August | 19 | 6 | 25 |
| 2016 July | 18 | 8 | 26 |
| 2016 June | 22 | 11 | 33 |
| 2016 May | 11 | 3 | 14 |
| 2016 April | 4 | 0 | 4 |
| 2016 March | 6 | 0 | 6 |
| 2016 February | 10 | 1 | 11 |
| 2016 January | 21 | 16 | 37 |
| 2015 December | 15 | 9 | 24 |
| 2015 November | 27 | 9 | 36 |
| 2015 October | 9 | 2 | 11 |
| 2015 September | 2 | 0 | 2 |
| 2015 July | 1 | 0 | 1 |
| 2015 June | 1 | 0 | 1 |
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