Evaluación del tratamiento sustitutivo del enfisema por déficit de alfa-1-antitripsina
Assessment of α1-antitrypsin replacement therapy for emphysema
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Bofill, J. de Gracia" "autores" => array:5 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Miravitlles" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Vidal" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Torrella" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Bofill" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "de Gracia" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología. Hospital General Universitario Vall d’Hebron. Barcelona" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Servicio de Neumología. Hospital General Universitario Vall d’Hebron. P.° Vall d’Hebron, 119-129. 08035 Barcelona." ] ] ] 1 => array:3 [ "autoresLista" => "M. Cotrina" "autores" => array:1 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Cotrina" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Bioquímica. Hospital General Universitario Vall d’Hebron. Barcelona" "etiqueta" => "*" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Assessment of α<span class="elsevierStyleInf">1</span>-antitrypsin replacement therapy for emphysema" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1994-01-13" "fechaAceptado" => "1994-04-26" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabra clave" "identificador" => "xpalclavsec569879" "palabras" => array:2 [ 0 => "Enfisema" 1 => "Alfa-1-antitripsina" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec569878" "palabras" => array:2 [ 0 => "Enphysema" 1 => "α<span class="elsevierStyleInf">1</span>-antitrypsin" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluación del tratamiento sustitutivo en pacientes con enfisema por déficit de alfa-1 antitripsina (AAT). Se valoran las características de los pacientes, los posibles efectos secundarios del tratamiento y su eficacia para mantener valores de AAT adecuados en plasma. También se estudia la evolución funcional de los pacientes.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El protocolo se inicia con 4 dosis semanales de 60 mg/kg de AAT (Prolastin<span class="elsevierStyleSup">®</span>) intravenosas, seguidas de dosis mensuales de 240 mg/kg. Previamente a cada administración se determinan valores de AAT en plasma. Cada 6 meses se realiza un estudio funcional respiratorio con espirometría, pletismografía y prueba de transferencia del CO.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Desde 1988 han iniciado el tratamiento 13 pacientes con una edad media de 46 años, el FEV<span class="elsevierStyleInf">1</span>, promedio al inicio era de 0,79 1. Se han infundido más de 250 dosis sin advertir ninguna reacción adversa de importancia. En 3 pacientes los valores de AAT antes de la siguiente infusión eran inferiores a los considerados protectores de 50 mg/dl. La evolución funcional muestra en algunos casos una estabilización de los valores espirométricos.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Existe un retraso importante en el diagnóstico del déficit de AAT que provoca que los pacientes alcancen una alteración funcional importante antes de iniciar tratamiento sustitutivo. No se observan efectos secundarios con el tratamiento. Hasta conseguir establecer el intervalo adecuado entre dosis, es necesario monitorizar los valores de AAT en cada paciente.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Assessment of α<span class="elsevierStyleInf">1</span>-antitrypsin replacement therapy (AAT) for emphysema. Patient characteristics were analyzed along with the possible side effects of the treatment and its efficacy in maintaining appropriate AAT blood levels. Lung function changes were also studied.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The treatment protocol began with 4 weekly intravenous doses of 60 mg/kg AAT (Prolastin<span class="elsevierStyleSup">®</span>) and continued with monthly doses of 240 mg/kg. AAT serum levels were measured before each dose. Every 6 months pulmonary function tests (spirometry, pletismography and CO transfer) were performed.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Thirteen patients (mean age 46 yr) have been studied since 1988. Mean initial FEV<span class="elsevierStyleInf">1</span>, was 0.79 1. Over 250 doses have been infused with no significant side effects reported. AAT levels before treatment in 3 patients were lower than that considered protective (50 mg/dl). Function tests results indicated stabilization of spirometric values in most cases.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Diagnosis of AAT deficiency is delayed considerably, meaning that significant functional deterioration takes place before replacement therapy begins. No side effects of treatment have been observed. Until an appropriate interval between doses has been established, each patient's AAT levels must be monitored.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antielastases of the human alveolar structures: Implications for the protease-antiprotease theory of emphysema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.E. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 1 | 3 |
| 2024 October | 40 | 8 | 48 |
| 2024 September | 42 | 20 | 62 |
| 2024 August | 54 | 30 | 84 |
| 2024 July | 31 | 27 | 58 |
| 2024 June | 45 | 22 | 67 |
| 2024 May | 51 | 40 | 91 |
| 2024 April | 26 | 24 | 50 |
| 2024 March | 39 | 20 | 59 |
| 2024 February | 35 | 36 | 71 |
| 2024 January | 0 | 4 | 4 |
| 2023 December | 0 | 1 | 1 |
| 2023 November | 0 | 1 | 1 |
| 2023 October | 0 | 3 | 3 |
| 2023 September | 0 | 2 | 2 |
| 2023 July | 0 | 17 | 17 |
| 2023 June | 0 | 4 | 4 |
| 2023 May | 0 | 3 | 3 |
| 2023 March | 3 | 2 | 5 |
| 2023 February | 26 | 23 | 49 |
| 2023 January | 27 | 29 | 56 |
| 2022 December | 30 | 27 | 57 |
| 2022 November | 37 | 32 | 69 |
| 2022 October | 30 | 34 | 64 |
| 2022 September | 26 | 30 | 56 |
| 2022 August | 35 | 41 | 76 |
| 2022 July | 29 | 37 | 66 |
| 2022 June | 25 | 25 | 50 |
| 2022 May | 28 | 26 | 54 |
| 2022 April | 36 | 41 | 77 |
| 2022 March | 39 | 46 | 85 |
| 2022 February | 39 | 34 | 73 |
| 2022 January | 26 | 36 | 62 |
| 2021 December | 18 | 37 | 55 |
| 2021 November | 26 | 38 | 64 |
| 2021 October | 19 | 45 | 64 |
| 2021 September | 19 | 32 | 51 |
| 2021 August | 18 | 29 | 47 |
| 2021 July | 19 | 35 | 54 |
| 2021 June | 23 | 40 | 63 |
| 2021 May | 24 | 25 | 49 |
| 2021 April | 48 | 55 | 103 |
| 2021 March | 26 | 19 | 45 |
| 2021 February | 25 | 10 | 35 |
| 2021 January | 32 | 18 | 50 |
| 2020 December | 17 | 19 | 36 |
| 2020 November | 13 | 12 | 25 |
| 2020 October | 18 | 12 | 30 |
| 2020 September | 22 | 9 | 31 |
| 2020 August | 25 | 9 | 34 |
| 2020 July | 26 | 14 | 40 |
| 2020 June | 15 | 11 | 26 |
| 2020 May | 27 | 13 | 40 |
| 2020 April | 22 | 6 | 28 |
| 2020 March | 42 | 19 | 61 |
| 2020 February | 27 | 13 | 40 |
| 2020 January | 47 | 14 | 61 |
| 2019 December | 43 | 23 | 66 |
| 2019 November | 23 | 4 | 27 |
| 2019 October | 12 | 19 | 31 |
| 2019 September | 18 | 20 | 38 |
| 2019 August | 18 | 9 | 27 |
| 2019 July | 20 | 22 | 42 |
| 2019 June | 11 | 26 | 37 |
| 2019 May | 20 | 25 | 45 |
| 2019 April | 24 | 18 | 42 |
| 2019 March | 16 | 15 | 31 |
| 2019 February | 18 | 10 | 28 |
| 2019 January | 15 | 9 | 24 |
| 2018 December | 10 | 15 | 25 |
| 2018 November | 28 | 16 | 44 |
| 2018 October | 33 | 13 | 46 |
| 2018 September | 32 | 6 | 38 |
| 2018 May | 9 | 1 | 10 |
| 2018 April | 6 | 5 | 11 |
| 2018 March | 18 | 8 | 26 |
| 2018 February | 7 | 6 | 13 |
| 2018 January | 13 | 9 | 22 |
| 2017 December | 17 | 13 | 30 |
| 2017 November | 7 | 9 | 16 |
| 2017 October | 17 | 13 | 30 |
| 2017 September | 14 | 4 | 18 |
| 2017 August | 16 | 14 | 30 |
| 2017 July | 16 | 15 | 31 |
| 2017 June | 23 | 21 | 44 |
| 2017 May | 12 | 10 | 22 |
| 2017 April | 16 | 6 | 22 |
| 2017 March | 10 | 21 | 31 |
| 2017 February | 6 | 11 | 17 |
| 2017 January | 12 | 8 | 20 |
| 2016 December | 27 | 11 | 38 |
| 2016 November | 74 | 35 | 109 |
| 2016 October | 52 | 29 | 81 |
| 2016 September | 46 | 11 | 57 |
| 2016 August | 32 | 4 | 36 |
| 2016 July | 34 | 6 | 40 |
| 2016 June | 43 | 12 | 55 |
| 2016 May | 44 | 3 | 47 |
| 2016 April | 38 | 0 | 38 |
| 2016 March | 28 | 0 | 28 |
| 2016 February | 32 | 4 | 36 |
| 2016 January | 38 | 9 | 47 |
| 2015 December | 46 | 20 | 66 |
| 2015 November | 50 | 11 | 61 |
| 2015 October | 15 | 1 | 16 |
| 2015 September | 2 | 0 | 2 |
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