Eficacia y tolerancia del tratamiento de la tuberculosis senil
Efficacy and tolerance in the treatment of tuberculosis in the elderly
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Morera" "autores" => array:5 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Teixidó" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Gallego" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Ribas" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Morera" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumologia. Hospital Universitari Germans Trias i Pujol. Badalona. Barcelona" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Servicio de Neumología. Hospital Universitari Germans Trias i Pujol. Ctra. del Canyet. s/n. 08916 Badalona. Barcelona." ] ] ] 1 => array:3 [ "autoresLista" => "X. Aguilar, J. Fernández-Muixí, C. Richart" "autores" => array:3 [ 0 => array:3 [ "nombre" => "X." "apellidos" => "Aguilar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Fernández-Muixí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Richart" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Unidad de Neumología y Servicio de Medicina Interna. Hospital Universitari Joan XXIII. Tarragona" "etiqueta" => "*" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Efficacy and tolerance in the treatment of tuberculosis in the elderly" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1995-06-05" "fechaAceptado" => "1995-10-24" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec546116" "palabras" => array:2 [ 0 => "Tuberculosis" 1 => "Población senil" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec546117" "palabras" => array:2 [ 0 => "Tuberculosis" 1 => "Elderly population" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizamos 55 casos de tuberculosis en enfermos mayores de 65 años con diagnóstico de certeza, que representan el 9% del total de pacientes controlados en nuestros dispensarios durante un período de 5 años. La edad media fue de 72.4 y la relación varón/mujer de 4/1. Las patologías asociadas más frecuentes fueron el tabaquismo (49%), EPOC (33%), enolismo crónico (25%) y tuberculosis previa (20%). La forma de presentación clínica más común fue la pulmonar (76%). seguida de la pleural (9%) y ósea (7%). El cuadro clínico fue inespecífico con un 13% de enfermos asintomáticos. El síntoma más constante fue la tos (45%). El dato radiológico más frecuente fue el infiltrado fibroulcerativo unilateral y apical. El derrame pleural y la cavitación se demostraron en el 14 y 22%, respectivamente. Un 44% de pacientes tenían alteraciones radiológicas de tipo cicatricial. La tuberculina fue positiva en el 88% de los casos en que se practicó. La media de retraso en el diagnóstico fue de 3,4 meses. El 62% de enfermos se diagnosticaron por baciloscopia, el 11% por cultivo y el 27% mediante histología. La mortalidad de la serie, debida a la propia tuberculosis, fue de un 4%. Tres pacientes abandonaron el tratamiento y se detectaron un fracaso y una recaída en el control terapéutico. Apreciamos reacciones adversas en el 33% de enfermos y al comparar los dos esquemas terapéuticos utilizados (2 meses rifampicina [R] más isoniacida [H] y etambutol [E] / 7 meses RH y 2 meses RHEZ [Z; pirazinamida] /4 meses RH) no observamos diferencias estadísticamente significativas.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La tuberculosis senil en nuestro medio tiene poca incidencia y clínicamente se comporta de forma muy similar al resto de población adulta. Tanto la eficacia como la tolerancia del tratamiento pueden considerarse óptimas.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We analyzed 55 confirmed cases of tuberculosis in patients over 65, a sample that amounted to 9% of all patients seen in our practice over a period of 5 years. Mean age was 72.4 and the male/female ratio was 4/1. The most frequently associated diseases were tobacco addiction (49%), chronic obstructive pulmonary disease (33%), alcoholism (25%) and prior diagnosis of tuberculosis (20%). Lung involvement was the most common clinical presentation (76%), followed by pleural (9%) and skeletal (7%) involvement. The clinical picture was non specific, with 13% remaining asymptomatic. Cough was the most frequent symptom (45%) and unilateral apical fibrosis with ulceration was the most frequent radiological finding. Pleural discharge and cavitation were demonstrated in 14 and 22%, respectively. Scarring was visible on <span class="elsevierStyleSmallCaps">X</span>-rays in 44%. The tuberculin test was positive in 88% of the cases in which it was performed. Mean delay in diagnosis was 3.4 months; 62% were diagnosed by sputum test, 11% by culture, and 27% histology. In 4% death was directly caused by tuberculosis. Three patients withdrew from treatment, in one case treatment failed, and there was one relapse detected at follow-up. We observed adverse side effects in 33%, and found no statistically significant differences between the 2 therapeutic protocols used (2 months RHS/7 months RH and 2 months RHZS/4 months RH).</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The incidence of tuberculosis among the elderly is low in our practice and the entity behaves much as it does in the rest of the adult population. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 1 | 3 |
| 2024 October | 37 | 9 | 46 |
| 2024 September | 43 | 14 | 57 |
| 2024 August | 43 | 42 | 85 |
| 2024 July | 39 | 33 | 72 |
| 2024 June | 57 | 21 | 78 |
| 2024 May | 64 | 28 | 92 |
| 2024 April | 31 | 25 | 56 |
| 2024 March | 41 | 35 | 76 |
| 2024 February | 37 | 34 | 71 |
| 2024 January | 0 | 2 | 2 |
| 2023 December | 0 | 1 | 1 |
| 2023 November | 0 | 6 | 6 |
| 2023 October | 0 | 16 | 16 |
| 2023 September | 0 | 3 | 3 |
| 2023 July | 0 | 24 | 24 |
| 2023 May | 0 | 1 | 1 |
| 2023 March | 1 | 2 | 3 |
| 2023 February | 35 | 22 | 57 |
| 2023 January | 22 | 28 | 50 |
| 2022 December | 26 | 26 | 52 |
| 2022 November | 36 | 17 | 53 |
| 2022 October | 28 | 27 | 55 |
| 2022 September | 18 | 19 | 37 |
| 2022 August | 33 | 41 | 74 |
| 2022 July | 34 | 32 | 66 |
| 2022 June | 22 | 30 | 52 |
| 2022 May | 24 | 31 | 55 |
| 2022 April | 35 | 29 | 64 |
| 2022 March | 34 | 31 | 65 |
| 2022 February | 25 | 29 | 54 |
| 2022 January | 24 | 26 | 50 |
| 2021 December | 22 | 34 | 56 |
| 2021 November | 22 | 35 | 57 |
| 2021 October | 22 | 41 | 63 |
| 2021 September | 19 | 39 | 58 |
| 2021 August | 14 | 33 | 47 |
| 2021 July | 21 | 35 | 56 |
| 2021 June | 22 | 39 | 61 |
| 2021 May | 13 | 22 | 35 |
| 2021 April | 32 | 48 | 80 |
| 2021 March | 44 | 42 | 86 |
| 2021 February | 18 | 35 | 53 |
| 2021 January | 12 | 20 | 32 |
| 2020 December | 24 | 23 | 47 |
| 2020 November | 5 | 12 | 17 |
| 2020 October | 9 | 6 | 15 |
| 2020 September | 11 | 5 | 16 |
| 2020 August | 18 | 11 | 29 |
| 2020 July | 20 | 11 | 31 |
| 2020 June | 14 | 7 | 21 |
| 2020 May | 10 | 11 | 21 |
| 2020 April | 17 | 10 | 27 |
| 2020 March | 17 | 22 | 39 |
| 2020 February | 22 | 18 | 40 |
| 2020 January | 27 | 23 | 50 |
| 2019 December | 16 | 25 | 41 |
| 2019 November | 15 | 2 | 17 |
| 2019 October | 21 | 14 | 35 |
| 2019 September | 17 | 19 | 36 |
| 2019 August | 18 | 10 | 28 |
| 2019 July | 14 | 25 | 39 |
| 2019 June | 8 | 21 | 29 |
| 2019 May | 14 | 42 | 56 |
| 2019 April | 11 | 36 | 47 |
| 2019 March | 9 | 22 | 31 |
| 2019 February | 7 | 9 | 16 |
| 2019 January | 5 | 11 | 16 |
| 2018 December | 8 | 20 | 28 |
| 2018 November | 12 | 13 | 25 |
| 2018 October | 26 | 13 | 39 |
| 2018 September | 10 | 10 | 20 |
| 2018 May | 6 | 1 | 7 |
| 2018 April | 11 | 10 | 21 |
| 2018 March | 5 | 12 | 17 |
| 2018 February | 5 | 20 | 25 |
| 2018 January | 9 | 16 | 25 |
| 2017 December | 9 | 13 | 22 |
| 2017 November | 5 | 18 | 23 |
| 2017 October | 10 | 16 | 26 |
| 2017 September | 4 | 6 | 10 |
| 2017 August | 7 | 7 | 14 |
| 2017 July | 5 | 7 | 12 |
| 2017 June | 12 | 19 | 31 |
| 2017 May | 9 | 8 | 17 |
| 2017 April | 7 | 7 | 14 |
| 2017 March | 8 | 21 | 29 |
| 2017 February | 3 | 10 | 13 |
| 2017 January | 2 | 7 | 9 |
| 2016 December | 14 | 15 | 29 |
| 2016 November | 16 | 18 | 34 |
| 2016 October | 20 | 18 | 38 |
| 2016 September | 23 | 14 | 37 |
| 2016 August | 16 | 4 | 20 |
| 2016 July | 24 | 6 | 30 |
| 2016 June | 24 | 11 | 35 |
| 2016 May | 11 | 4 | 15 |
| 2016 April | 12 | 0 | 12 |
| 2016 March | 10 | 0 | 10 |
| 2016 February | 10 | 1 | 11 |
| 2016 January | 15 | 7 | 22 |
| 2015 December | 18 | 11 | 29 |
| 2015 November | 33 | 11 | 44 |
| 2015 October | 7 | 1 | 8 |
| 2015 September | 3 | 0 | 3 |
| 2015 June | 1 | 0 | 1 |
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