Controversies in the Treatment of Extrapulmonary Tuberculosis

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Márquez-Martín, B. Valera-Bestard, R. Luque-Márquez, A. Alarcón-González" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Márquez-Martín" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Valera-Bestard" ] 2 => array:3 [ "preGrado" => "Dr." "nombre" => "R." "apellidos" => "Luque-Márquez" ] 3 => array:2 [ "nombre" => "A." 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Mediano, F. García-Río, C. Villasante" "autores" => array:3 [ 0 => array:3 [ "preGrado" => "Dra." "nombre" => "O." "apellidos" => "Mediano" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "García-Río" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Villasante" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906604412?idApp=UINPBA00003Z" "url" => "/15792129/0000004200000004/v1_201305150241/S1579212906604412/v1_201305150241/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Review Article" "titulo" => "Controversies in the Treatment of Extrapulmonary Tuberculosis" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "194" "paginaFinal" => "201" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Z.M. Fuentes, J.A. Caminero" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Z.M." "apellidos" => "Fuentes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 1 => array:4 [ "preGrado" => "Dr." "nombre" => "J.A." "apellidos" => "Caminero" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital General Dr. José Ignacio Baldó, El Algodonal, Caracas, Venezuela" "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital General de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain" "etiqueta" => "b" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J.A. Caminero. Servicio de Neumología. Hospital General de Gran Canaria Dr. Negrín. Barranco de la Ballena, s/n. 35010 Las Palmas de Gran Canaria. Las Palmas. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-05-02" "fechaAceptado" => "2005-05-31" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154315" "palabras" => array:4 [ 0 => "Extrapulmonary tuberculosis" 1 => "Treatment" 2 => "Surgery" 3 => "Steroids" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154314" "palabras" => array:4 [ 0 => "Tuberculosis extrapulmonar" 1 => "Tratamiento" 2 => "Cirugía" 3 => "Esteroides" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "Tuberculosis (TB) can spread to any tissue or organ of the body by way of hematogenous or lymphatic dissemination or contiguity. However, pulmonary TB is the most common presentation and the only form of the disease of epidemiologic importance. Consequently, the literature on the various forms of extrapulmonary TB (EPTB) is scant, and most of the published authors are specialists in specific extrapulmonary forms. As a result, in most of the major areas of study of EPTB, recommendations similar to those for pulmonary TB or others based on little or no evidence have been accepted. This lack of evidence is of particular concern in the case of treatment guidelines.The present article reviews important work that has given rise to current treatment guidelines. While most of these guidelines reveal the lack of evidence available on this subject, can, nevertheless, be concluded that a 6-month treatment regimen similar to that used in patients with pulmonary TB may be sufficient to treat all forms of EPTB, including meningeal disease. The role of steroids and surgery in the treatment of TB affecting different sites is also discussed. Other topics dealt with are the considerations that should be taken into account and the treatment modifications necessary in patients infected with the human immunodeficiency virus." ] "es" => array:1 [ "resumen" => "La tuberculosis (TB) puede afectar, por diseminación hematógena, linfática o contigüidad, a cualquier órgano o tejido del organismo. Sin embargo, la forma de presentación pulmonar es la más frecuente y la única epidemiológicamente importante. Esto ha motivado que las publicaciones sobre las diversas localizaciones de la TB extrapulmonar (TBE) hayan sido escasas, y casi siempre realizadas por especialistas de las diferentes presentaciones. Por tal motivo, en la mayoría de los grandes campos de estudio de la TBE se han aceptado recomendaciones similares a las efectuadas para la TB pulmonar, o se han seguido otras con escasa o nula evidencia; aspecto especialmente relevante en lo concerniente al tratamiento.En el presente artículo se revisan importantes publicaciones que han dado lugar a las actuales recomendaciones sobre el tratamiento, detrás de la mayoría de las cuales resalta la falta de evidencia existente. En cualquier caso, se concluye que un régimen de 6 meses, similar al de la TB pulmonar, puede ser suficiente para tratar todas las formas de TBE, incluida la meníngea. Se discute, igualmente, el papel que los esteroides y la cirugía pueden tener en las diversas localizaciones de la TB, así como las modificaciones y/o consideraciones que deben tenerse en cuenta en los pacientes infectados por el virus de la inmunodeficiencia humana." ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:119 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathogenesis of pulmonary tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ …2] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Pulmonary diseases and disorders" "paginaInicial" => "177" "paginaFinal" => "323" "serieFecha" => "1988" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Tuberculosis" "serieFecha" => "1992" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extrapulmonary tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ …2] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Textbook of respiratory medicine" "paginaInicial" => "878" "paginaFinal" => "889" "serieFecha" => "1988" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ …1] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Guía de la tuberculosis para médicos especialistas. 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Review Article

Controversies in the Treatment of Extrapulmonary Tuberculosis

Z.M. Fuentesa, J.A. Caminero*,b

a Servicio de Neumología, Hospital General Dr. José Ignacio Baldó, El Algodonal, Caracas, Venezuela

b Servicio de Neumología, Hospital General de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain

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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La tuberculosis &#40;TB&#41; puede afectar&#44; por diseminaci&#243;n hemat&#243;gena&#44; linf&#225;tica o contig&#252;idad&#44; a cualquier &#243;rgano o tejido del organismo&#46; Sin embargo&#44; la forma de presentaci&#243;n pulmonar es la m&#225;s frecuente y la &#250;nica epidemiol&#243;gicamente importante&#46; Esto ha motivado que las publicaciones sobre las diversas localizaciones de la TB extrapulmonar &#40;TBE&#41; hayan sido escasas&#44; y casi siempre realizadas por especialistas de las diferentes presentaciones&#46; Por tal motivo&#44; en la mayor&#237;a de los grandes campos de estudio de la TBE se han aceptado recomendaciones similares a las efectuadas para la TB pulmonar&#44; o se han seguido otras con escasa o nula evidencia&#59; aspecto especialmente relevante en lo concerniente al tratamiento&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">En el presente art&#237;culo se revisan importantes publicaciones que han dado lugar a las actuales recomendaciones sobre el tratamiento&#44; detr&#225;s de la mayor&#237;a de las cuales resalta la falta de evidencia existente&#46; En cualquier caso&#44; se concluye que un r&#233;gimen de 6 meses&#44; similar al de la TB pulmonar&#44; puede ser suficiente para tratar todas las formas de TBE&#44; incluida la men&#237;ngea&#46; Se discute&#44; igualmente&#44; el papel que los esteroides y la cirug&#237;a pueden tener en las diversas localizaciones de la TB&#44; as&#237; como las modificaciones y&#47;o consideraciones que deben tenerse en cuenta en los pacientes infectados por el virus de la inmunodeficiencia humana&#46;</p>"
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Article information

ISSN: 15792129
Original language: English

DOI:10.1016/S1579-2129(06)60442-4

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Year/Month	Html	Pdf	Total

2024 November	3	2	5
2024 October	27	16	43
2024 September	30	17	47
2024 August	38	49	87
2024 July	28	22	50
2024 June	28	19	47
2024 May	32	25	57
2024 April	21	18	39
2024 March	23	15	38
2024 February	23	15	38
2023 March	4	3	7
2023 February	14	12	26
2023 January	16	39	55
2022 December	19	23	42
2022 November	17	17	34
2022 October	19	30	49
2022 September	18	18	36
2022 August	15	30	45
2022 July	23	45	68
2022 June	16	28	44
2022 May	16	27	43
2022 April	16	30	46
2022 March	28	39	67
2022 February	21	29	50
2022 January	24	27	51
2021 December	13	39	52
2021 November	48	46	94
2021 October	47	44	91
2021 September	59	55	114
2021 August	24	34	58
2021 July	19	30	49
2021 June	37	36	73
2021 May	23	28	51
2021 April	25	43	68
2021 March	13	28	41
2021 February	11	17	28
2021 January	9	8	17
2020 December	15	17	32
2020 November	4	12	16
2020 October	6	6	12
2020 September	17	9	26
2020 August	35	16	51
2020 July	54	16	70
2020 June	6	8	14
2020 May	35	22	57
2020 April	46	11	57
2020 March	42	15	57
2020 February	63	19	82
2020 January	61	22	83
2019 December	36	12	48
2019 November	25	18	43
2019 October	6	12	18
2019 September	5	13	18
2019 August	14	8	22
2019 July	11	18	29
2019 June	10	8	18
2019 May	18	11	29
2019 April	21	21	42
2019 March	15	29	44
2019 February	8	9	17
2019 January	6	11	17
2018 December	10	16	26
2018 November	15	10	25
2018 October	11	13	24
2018 September	10	11	21
2018 May	8	0	8
2018 April	4	5	9
2018 March	2	0	2
2018 February	3	10	13
2018 January	5	12	17
2017 December	2	6	8
2017 November	6	7	13
2017 October	2	7	9
2017 September	3	6	9
2017 August	5	19	24
2017 July	6	5	11
2017 June	6	13	19
2017 May	6	15	21
2017 April	2	5	7
2017 March	3	27	30
2017 February	0	3	3
2017 January	3	4	7
2016 December	11	11	22
2016 November	16	9	25
2016 October	17	15	32
2016 September	12	15	27
2016 August	9	5	14
2016 July	9	8	17
2016 March	3	0	3
2015 December	3	0	3
2015 October	195	10	205
2015 September	216	10	226
2015 August	217	7	224
2015 July	253	16	269
2015 June	181	6	187
2015 May	195	13	208
2015 April	170	10	180
2015 March	211	11	222
2015 February	224	7	231
2015 January	236	13	249
2014 December	205	9	214
2014 November	273	17	290
2014 October	222	12	234
2014 September	201	10	211
2014 August	250	12	262
2014 July	229	9	238
2014 June	183	9	192
2014 May	164	6	170
2014 April	141	9	150
2014 March	123	12	135
2014 February	93	14	107
2014 January	58	10	68
2013 December	64	8	72
2013 November	48	10	58
2013 October	70	5	75
2013 September	65	13	78
2013 August	62	10	72
2013 July	67	14	81
2013 June	48	7	55
2013 May	39	7	46
2013 April	35	11	46
2013 March	10	1	11

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