Tratamientos cortos en tuberculosis pulmonar. La evolucion conceptual de la terapeutica. 3 ensayos controlados
Short term treatments for pulmonary tuberculosis
F.J. Guerra Sanz, R. Rey Durán, J.J. Martínez Cuesta, F. Bachiller Cabezón, L. Muñoz Cabrera, R. Salama Benoliel, L. Lara Garcia, J.J. Fernández Luceño, P. Martínez Larriba
Servicio de Bronconeumologia Clínica Torácica Victoria Eugenia Madrid
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Peset" "autores" => array:1 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Peset" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615326107?idApp=UINPBA00003Z" "url" => "/03002896/0000001400000003/v1_201509151322/S0300289615326107/v1_201509151322/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Tratamientos cortos en tuberculosis pulmonar. La evolucion conceptual de la terapeutica. 3 ensayos controlados" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "105" "paginaFinal" => "117" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "F.J. Guerra Sanz, R. Rey Durán, J.J. Martínez Cuesta, F. Bachiller Cabezón, L. Muñoz Cabrera, R. Salama Benoliel, L. Lara Garcia, J.J. Fernández Luceño, P. Martínez Larriba" "autores" => array:9 [ 0 => array:2 [ "nombre" => "F.J." "apellidos" => "Guerra Sanz" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Rey Durán" ] 2 => array:2 [ "nombre" => "J.J." "apellidos" => "Martínez Cuesta" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Bachiller Cabezón" ] 4 => array:2 [ "nombre" => "L." "apellidos" => "Muñoz Cabrera" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Salama Benoliel" ] 6 => array:2 [ "nombre" => "L." "apellidos" => "Lara Garcia" ] 7 => array:2 [ "nombre" => "J.J." "apellidos" => "Fernández Luceño" ] 8 => array:2 [ "nombre" => "P." "apellidos" => "Martínez Larriba" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Bronconeumologia Clínica Torácica Victoria Eugenia Madrid" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Short term treatments for pulmonary tuberculosis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1978-02-08" "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En Tuberculosis, hoy se trata de utilizar un régimen terapéutico tan eficaz que sea capaz de curar al enfermo antes de <span class="elsevierStyleItalic">que se canse de tomar la medicación</span>. Los Tratamientos Cortos con Rifampicina e Hidracida, completados con una tercera droga, son el motivo de este trabajo. Se ha realizado un Estudio Controlado en 3 fases: 1.<span class="elsevierStyleSup">er</span><span class="elsevierStyleItalic">Estudio</span>, de «Aproximación a los Tratamientos Cortos» de 12 meses de duración, (99 casos) en donde se ha ido acortando el tiempo de ad ministración de la Rifampicina (12,9 y 6 <span class="elsevierStyleItalic">meses</span>), pero manteniendo en todos los casos la Hidracida hasta completar el año de tratamiento. 2.° <span class="elsevierStyleItalic">Estudio</span>, con pautas abreviadas de duración real de 12. 9 y 6 meses (133 pacientes) y 3.<span class="elsevierStyleSup">er</span> Estudio, todavía en fase de admisión de enfermos; donde se pretende conocer qué papel juega la Pirazinamida sobre la recidiva, y cual es su tolerancia. Hasta ahora cuenta con 157 casos.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En un régimen standar, que sirve como control la conversión del esputo se consigue al final del 6.° mes; en tanto que los que contienen R/AMP lo consiguen al 3.<span class="elsevierStyleSup">er</span> mes. Entre 245 enfermos ha habido 5 fracasos bacteriológicos en el transcurso del trata-miento (2%). 3 con el régimen standard (8,5%) y 2 con los regímenes que llevan R/AMP (1%). Hasta ahora no ha habido recidiva alguna, incluso en los regímenes de 6 meses de duración, bien es cierto que el número de casos es todavía reducido para poder extraer conclusiones que tengan valor estadístico. Todavía es temprano para valorar los datos del 3. <span class="elsevierStyleSup">er</span> Estudio; sólo es destacable la toxicidad a la PZ que no es despreciable, pero que podría aceptarse si esta droga fuera capaz de reducir las recidivas y recortar aún más el tratamiento.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se hacen unas consideraciones sobre los tres sectores que componen la población bacilar de una cavidad «no tratada»: La masa bacilar sensible, los gérmenes inicialmente resistentes, y los bacilos persistentes. Se concluye que los Tratamientos Cortos actúan con eficacia sobre estas 3 subpoblaciones bacilares.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Por publicarse este trabajo en una Revista de amplia difusión entre los neumólogos españoles, gran parte de los cuales viven alejados del problema de la Tuberculosis, se intercalan más comentarios de tipo práctico de los debidos.</p></span>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In Tuberculosis, today one tries to use a therapeutical regimen so effective <span class="elsevierStyleItalic">that it is capable of curing the patient before he tires of taking the medication</span>. Short term treatments with Rifampicine and Hidracide, completed with a third drug are the motive of this pa per. The authors have carried out a Controlled Study in 3 phases: <span class="elsevierStyleItalic">1st Study. of «Approximation to Short Term</span> Treatments: <span class="elsevierStyleItalic">12 months</span> long, (99 cases) where the length of time of administration of Rifampicine was shortened 12, 9 and 6 months), but maintaining in all the cases Hidracide until completing the year of treatment. <span class="elsevierStyleItalic">2nd Study</span>, with abbreviated guides of real duration of 12. 9 and <span class="elsevierStyleItalic">6 months</span> (133 patients). <span class="elsevierStyleItalic">3rd Study</span>, still in the phase of admission of patients; where the authors pretend to learn the role of Pirazinamide on relapse, and what is its tolerance. To date, the authors count with 157 cases.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In a standard regimen, that serves as control, the conversion of sputum was achieved at the end of the 6th month; whereas those that contain R/AMP achieve this conversion in the third month. Out of a group of 245 patients there were 5 bacteriological failures during the course of treatment (5%); 3 with the standard regimen (8,5%) and 2 with the regimens that include R/AMP (1%). Up to now there has been no relapse, including the regimens of 6 months of duration. However, it is true that the number of cases is still too small to be able to offer conclusions witha statistical value. It is still early to evaluate the data of the 3rd Study; although the toxicity of PZ is worthy of note, as it is not contemptible, but could be acepted if this drug were capable of reducing the nomber of relapses and shortening the treatment even more.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The authors then comment on the three sectors that compose the bacillary population of an «untreated» cavity: the sensitive bacillary mass, initially resistant germs, and persistent bacilli. The authors come to the conclusion that the Short Term Treatments act effectively on these 3 bacillary subpopulations.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Finally the author add appropriate commentaries of a practical type as this paper is published in a journal of wide distribution among Spanish pneumologists, many of whom do not live the problem of Tuberculosis closely.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Considerations generales sur le choix et maniement des regiments therapeutiques dans la Tuberculose Pulraonaire" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 1 | 3 |
| 2024 October | 42 | 11 | 53 |
| 2024 September | 46 | 21 | 67 |
| 2024 August | 55 | 42 | 97 |
| 2024 July | 44 | 27 | 71 |
| 2024 June | 43 | 50 | 93 |
| 2024 May | 42 | 26 | 68 |
| 2024 April | 44 | 22 | 66 |
| 2024 March | 52 | 24 | 76 |
| 2024 February | 46 | 36 | 82 |
| 2023 December | 0 | 5 | 5 |
| 2023 November | 0 | 7 | 7 |
| 2023 October | 0 | 2 | 2 |
| 2023 September | 0 | 2 | 2 |
| 2023 August | 0 | 4 | 4 |
| 2023 July | 0 | 12 | 12 |
| 2023 June | 0 | 1 | 1 |
| 2023 March | 7 | 2 | 9 |
| 2023 February | 18 | 18 | 36 |
| 2023 January | 22 | 35 | 57 |
| 2022 December | 29 | 53 | 82 |
| 2022 November | 29 | 18 | 47 |
| 2022 October | 21 | 36 | 57 |
| 2022 September | 31 | 24 | 55 |
| 2022 August | 21 | 41 | 62 |
| 2022 July | 21 | 33 | 54 |
| 2022 June | 23 | 41 | 64 |
| 2022 May | 25 | 25 | 50 |
| 2022 April | 31 | 28 | 59 |
| 2022 March | 33 | 36 | 69 |
| 2022 February | 25 | 27 | 52 |
| 2022 January | 23 | 36 | 59 |
| 2021 December | 22 | 42 | 64 |
| 2021 November | 11 | 42 | 53 |
| 2021 October | 14 | 33 | 47 |
| 2021 September | 21 | 38 | 59 |
| 2021 August | 12 | 34 | 46 |
| 2021 July | 11 | 23 | 34 |
| 2021 June | 21 | 30 | 51 |
| 2021 May | 9 | 16 | 25 |
| 2021 April | 11 | 40 | 51 |
| 2021 March | 34 | 19 | 53 |
| 2021 February | 31 | 10 | 41 |
| 2021 January | 17 | 8 | 25 |
| 2020 December | 13 | 7 | 20 |
| 2020 November | 9 | 18 | 27 |
| 2020 October | 9 | 13 | 22 |
| 2020 September | 4 | 5 | 9 |
| 2020 August | 12 | 11 | 23 |
| 2020 July | 17 | 14 | 31 |
| 2020 June | 10 | 15 | 25 |
| 2020 May | 5 | 16 | 21 |
| 2020 April | 9 | 17 | 26 |
| 2020 March | 8 | 20 | 28 |
| 2020 February | 13 | 26 | 39 |
| 2020 January | 19 | 16 | 35 |
| 2019 December | 25 | 34 | 59 |
| 2019 November | 10 | 16 | 26 |
| 2019 October | 9 | 14 | 23 |
| 2019 September | 7 | 18 | 25 |
| 2019 August | 11 | 9 | 20 |
| 2019 July | 10 | 23 | 33 |
| 2019 June | 13 | 16 | 29 |
| 2019 May | 9 | 15 | 24 |
| 2019 April | 34 | 17 | 51 |
| 2019 March | 6 | 20 | 26 |
| 2019 February | 5 | 4 | 9 |
| 2019 January | 6 | 17 | 23 |
| 2018 December | 6 | 8 | 14 |
| 2018 November | 6 | 10 | 16 |
| 2018 October | 17 | 7 | 24 |
| 2018 September | 7 | 8 | 15 |
| 2018 May | 5 | 1 | 6 |
| 2018 April | 11 | 7 | 18 |
| 2018 March | 7 | 4 | 11 |
| 2018 February | 8 | 11 | 19 |
| 2018 January | 8 | 7 | 15 |
| 2017 December | 7 | 10 | 17 |
| 2017 November | 11 | 5 | 16 |
| 2017 October | 9 | 7 | 16 |
| 2017 September | 9 | 4 | 13 |
| 2017 August | 12 | 16 | 28 |
| 2017 July | 6 | 11 | 17 |
| 2017 June | 8 | 11 | 19 |
| 2017 May | 12 | 17 | 29 |
| 2017 April | 4 | 4 | 8 |
| 2017 March | 3 | 7 | 10 |
| 2017 February | 5 | 6 | 11 |
| 2017 January | 2 | 2 | 4 |
| 2016 December | 13 | 10 | 23 |
| 2016 November | 16 | 12 | 28 |
| 2016 October | 23 | 13 | 36 |
| 2016 September | 10 | 4 | 14 |
| 2016 August | 11 | 4 | 15 |
| 2016 July | 23 | 5 | 28 |
| 2016 June | 20 | 8 | 28 |
| 2016 May | 24 | 10 | 34 |
| 2016 April | 15 | 0 | 15 |
| 2016 March | 15 | 0 | 15 |
| 2016 February | 3 | 0 | 3 |
| 2016 January | 16 | 6 | 22 |
| 2015 December | 31 | 15 | 46 |
| 2015 November | 20 | 4 | 24 |
| 2015 October | 4 | 1 | 5 |
| 2015 September | 2 | 0 | 2 |
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