array:22 [
  "pii" => "S0300289615323619"
  "issn" => "03002896"
  "doi" => "10.1016/S0300-2896(15)32361-9"
  "estado" => "S300"
  "fechaPublicacion" => "1982-05-01"
  "aid" => "72431"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica"
  "copyrightAnyo" => "1982"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 1982;18:119-23"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2037
    "formatos" => array:3 [
      "EPUB" => 81
      "HTML" => 572
      "PDF" => 1384
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0300289615323620"
    "issn" => "03002896"
    "doi" => "10.1016/S0300-2896(15)32362-0"
    "estado" => "S300"
    "fechaPublicacion" => "1982-05-01"
    "aid" => "72432"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 1982;18:124-31"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1096
      "formatos" => array:3 [
        "EPUB" => 52
        "HTML" => 580
        "PDF" => 464
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Seudomesoteliomas: diagnostico diferencial"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "124"
          "paginaFinal" => "131"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Pseudomesotheliomas: a differential diagnosis"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F. Rodriguez Panadero, J.A. Garcia Canton, J. Muñoz Gutierrez, E. Rodriguez Becerra, J. Lopez Mejias"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "F."
              "apellidos" => "Rodriguez Panadero"
            ]
            1 => array:2 [
              "nombre" => "J.A."
              "apellidos" => "Garcia Canton"
            ]
            2 => array:2 [
              "nombre" => "J."
              "apellidos" => "Muñoz Gutierrez"
            ]
            3 => array:2 [
              "nombre" => "E."
              "apellidos" => "Rodriguez Becerra"
            ]
            4 => array:2 [
              "nombre" => "J."
              "apellidos" => "Lopez Mejias"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615323620?idApp=UINPBA00003Z"
    "url" => "/03002896/0000001800000003/v1_201509151113/S0300289615323620/v1_201509151113/es/main.assets"
  ]
  "es" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Recaidas de la tuberculosis pulmonar. Valor del interrogatorio para la seleccion del esquema terapeutico adecuado"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "119"
        "paginaFinal" => "123"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "J.A. Pilheu, M.a C. De Salvo, V. Gnecco, J. Giannattasio, M. Hoffman"
        "autores" => array:5 [
          0 => array:2 [
            "nombre" => "J.A."
            "apellidos" => "Pilheu"
          ]
          1 => array:2 [
            "nombre" => "M.a C."
            "apellidos" => "De Salvo"
          ]
          2 => array:2 [
            "nombre" => "V."
            "apellidos" => "Gnecco"
          ]
          3 => array:2 [
            "nombre" => "J."
            "apellidos" => "Giannattasio"
          ]
          4 => array:2 [
            "nombre" => "M."
            "apellidos" => "Hoffman"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Hospital E. Tornú. Buenos Aires"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Pulmonary tuberculosis relapses. the value of detailed questioning of the patient for inclusion in an adecuate treatment regime"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "1981-10-20"
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="absec0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 200 pacientes con una reca&#237;da de su tuberculosis pulmonar y se relacionaron las caracter&#237;sticas de su primer tratamiento con la sensibilidad bacteriana en el momento de la reca&#237;da&#46; Fueron clasificados como regulares los pacientes que hab&#237;an recibido tratamientos asociados&#44; en dosis adecuadas al peso&#44; diario o intermitente&#44; continuo&#44; que lo terminaron espont&#225;neamente &#40;tratamiento incompleto&#41; o por indicaci&#243;n m&#233;dica &#40;tratamiento completo&#41; e interrumpieron todas las drogas simult&#225;neamente&#46; Se consideraron irregulares a quienes recibieron tratamientos asociados&#44; diarios o intermitentes&#44; completos o incompletos&#44; pero con dosis inadecuadas o con interrupciones o con abandono sucesivo de las drogas&#46; En el grupo desconocido se incluyeron los pacientes en quienes no fue posible obtener datos seguros sobre las drogas recibidas&#44; dosis&#44; duraci&#243;n&#44; forma de abandono&#46; Del total de los 200 pacientes&#44; 146 &#40;73 &#37;&#41; ten&#237;an <span class="elsevierStyleItalic">Mycobacte&#241;um tuberculosis</span> sensibles a isoniacida &#40;INH&#41;&#44; rifampicina &#40;RAMP&#41;&#44; estreptomicina &#40;SM&#41; y ethambutol &#40;EMB&#41;&#44; y los 54 restantes &#40;27 &#37;&#41; ten&#237;an g&#233;rmenes resistentes a una o m&#225;s drogas&#46; De los 154 regulares&#44; 139 &#40;90&#44;2&#41; presentaban g&#233;rmenes sensibles a INH&#44; RAMP&#44; SM y EMB&#44; mientras que de 26 irregulares y 20 desconocidos&#44; s&#243;lo dos &#40;7&#44;6 &#37;&#41; y cinco &#40;25 &#37;&#41; pacientes presentaban g&#233;rmenes sensibles a las cuatro drogas&#46; La diferencia es estad&#237;sticamente significativa &#40;p &#60; 0&#44;001&#41;&#46; Entre los pacientes con g&#233;rmenes resistentes hab&#237;a 26 &#40;13 &#37;&#41; que lo eran a una sola droga &#40;con franco predominio de la INH&#41;&#44; 12 &#40;6 &#37;&#41; a dos drogas&#44; 12 &#40;6 &#37;&#41; a tres drogas y 4 &#40;2 &#37;&#41; a cuatro drogas&#46; La resistencia primaria&#44; estudiada en un grupo de 243 pacientes con tuberculosis pulmonar&#44; no tratados que ingresaron al hospital simult&#225;neamente con los que presentaban reca&#237;das&#44; fue del 7 &#37; &#40;4&#44;5 &#37; a SM&#44; 1&#44;2 &#37; a INH&#44; &#40;1&#44;2 &#37; a SM e INH&#41;&#46; La resistencia adquirida &#40;27 &#37;&#41;&#44; menos la resistencia primaria &#40;7 &#37;&#41;&#44; indicaba la verdadera resistencia debida a la irregularidad de los tratamientos&#46; En el grupo regular&#44; esa diferencia result&#243; ser 2&#44;7 &#37; &#40;9&#44;7 &#37;- 7&#41;&#44; lo que permit&#237;a&#44; a los pacientes de este grupo iniciar su tratamiento con un esquema intensivo &#40;con 4 &#243; 5 drogas&#41; sin esperar el resultado del test de sensibilidad&#46; Aquellos pacientes incluidos en los grupos irregular y desconocido deb&#237;an&#44; por el contrario&#44; esperar el resultado del test y adecuar el esquema terap&#233;utico al mismo&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los resultados de este estudio sugieren que&#44; a los pacientes con reca&#237;da bacteriol&#243;gica de su tuberculosis pulmonar&#44; un interrogatorio detallado permite su agrupaci&#243;n en regulares&#44; irregulares y desconocidos&#44; y a los del primer grupo se les pueda iniciar un retratamiento con muchas posibilidades de &#233;xito sin esperar el resultado del test de sensibilidad&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<span id="absec0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The relapses of 200 tuberculous patients were studied and the caracteristics of their first treatment correlated with the bacteriological sensitivity in the relapse&#46; The patients that had received associated treatments&#44; in adec&#250;ate dosage to their weight&#44; daily or intermittent&#44; continu&#233;&#44; that had finished spontaneously &#40;incomplete treatment&#41; or by medical indication &#40;complete treatment&#41; and had withdrawn all the drugs simultaneously were classified as Regulars&#46; Those who received associate treatments&#44; daily or intermittent&#44; complete or incomplete&#44; but with inadecuate dosage or with interruptions or with succesive abandon of the drugs were considered Irregulars&#46; The patients without positive data about the given drugs&#44; dosage&#44; duration and form of abandon were included in the Unknown group&#46; Out of 200 patients&#44; 146 &#40;73 &#37;&#41; had sensitive <span class="elsevierStyleItalic">Mycybacteterium tuberculosis</span> to isoniazid &#40;INH&#41;&#44; rifampicin &#40;RAMP&#41;&#44; streptomycin &#40;SM&#41; and ethambutol &#40;EMB&#41; and the remaining 54 patients &#40;27 &#37;&#41; had resistant bacilli to one or more drugas&#46; From the 154 Regulars&#44; 139 &#40;90&#46;2 &#37;&#41; had sensitive germs to INH&#44; RAMP&#44; SM and EMB&#44; while from 26 Irregulars and 20 Unknowns&#44; only 2 &#40;7&#44;6 &#37;&#41; and 5 &#40;25 &#37;&#41; patients presented sensitive bacilli to the 4 drugs&#46; The difference is statistically significant &#40;p &#60; 0&#44;001&#41;&#46; Out of 54 patients with resistent germs&#44; 26 &#40;13 &#37;&#41; had resistance to one drug&#44; 12 to two drugs&#44; 12 to three drugs and four to four drugs&#46; The primary resistance&#44; studied in a group of 243 patients with pulmonary tuberculosis&#44; not treated&#44; that arrived to the hospital simultaneously with those who presented relapses&#44; was 7 &#37; &#40;4&#44;5 &#37; to SM&#44; 1&#44;2 &#37; to INH&#44; 1&#44;2 &#37; to SM and INH&#41;&#46; The secondary resistance &#40;27 &#37;&#41; minus the primary resistance &#40;7 &#37;&#41; indicated the true resistance due to the irregularity of the treatments&#46; In the Regular group that difference was 2&#44;7 &#37; &#40;9&#44;7 &#37;-7 &#37;&#41;&#44; and this permitted the patients from this group to start retreatment with an intensive therapeutic regimen &#40;with 4 or 5 drugs&#41; without waiting the result of the sensitivity test&#46; Those patients included in the Irregular and Unknown groups had on the contrary to wait the result of the tests in order to receive a favorable therapeutic regimen&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The results of this study suggest that the patients with bacteriological relapses of their pulmonary tuberculosis can be classified as Regulars&#44; Irregulars or Unknowns due to their history&#44; and to those of the first group a retreatment can be given&#44; with many possibilities of succes&#44; without waiting the result of the sensitivity test&#46;</p></span>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:21 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estado actual de la resistencia bacteriana en la Argentina"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46; Amad&#237;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Actas XV Cong Arg Tisiol Neum"
                        "fecha" => "1975"
                        "paginaInicial" => "65"
                        "paginaFinal" => "76"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Drug resistance among previously treated tuberculosis patients&#59; a brief report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Costello"
                            1 => "G&#46; Caras"
                            2 => "D&#46; Snider"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Amer Rev Respir Dis"
                        "fecha" => "1980"
                        "volumen" => "121"
                        "paginaInicial" => "313"
                        "paginaFinal" => "316"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controlled clinical trial of shortcourse &#40;6 month&#41; regimens of chemotherapy for treatment of pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "East African Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1972"
                        "volumen" => "1"
                        "paginaInicial" => "1079"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2566026"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controlled clinical trial of four short-course &#40;6 month&#41; regimens of chemotherapy for treatment of pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "East African&#47;Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1973"
                        "volumen" => "1"
                        "paginaInicial" => "1331"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2566860"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controlled clinical trial of four short-course &#40;6 month&#41; regimens of chemotherapy for treatment of pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "East African&#47;Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1974"
                        "volumen" => "2"
                        "paginaInicial" => "237"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2874275"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mesure de la sensibilit&#233;e du bacille tuberculeux aux drogues antibacillaires par la m&#233;thode des proportions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Canetti"
                            1 => "N&#46; Rist"
                            2 => "J&#46; Grosset"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Rev Tuberc Pneumol"
                        "fecha" => "1963"
                        "volumen" => "27"
                        "paginaInicial" => "217"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-course chemotherapy for pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46; Fox"
                            1 => "D&#46;A&#46; Mitchison"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Amer Rev Respir Dis"
                        "fecha" => "1975"
                        "volumen" => "111"
                        "paginaInicial" => "325"
                        "paginaFinal" => "353"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long term chemotherapy in the treatment of chronic pulmonary tuberculosis with cavitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Medical Peaearch Council&#47;Tuberc Chemoth Trial Com"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Tubercle"
                        "fecha" => "1962"
                        "volumen" => "43"
                        "paginaInicial" => "201"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Retreatment of drug sensitive relapses of pulmonary tuberculosis following chemotherapy with standard drugs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Santha"
                            1 => "S&#46; Radhakrishna"
                            2 => "C&#46;W&#46; Ramakrishna"
                            3 => "S&#46; Tripathy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Tubercle"
                        "fecha" => "1976"
                        "volumen" => "57"
                        "paginaInicial" => "177"
                        "paginaFinal" => "180"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/824775"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resultado del estudio de la sensibilidad bacteriana en pacientes tuberculosos retratados"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;R&#46; Secondi"
                            1 => "M&#46;C&#46; De Salvo"
                            2 => "S&#46;E&#46; Poggi"
                            3 => "B&#46;N&#46; Villar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "XVII Cong Arg-Tisiol Neumon&#46; Actas"
                        "fecha" => "1979"
                        "paginaInicial" => "632"
                        "paginaFinal" => "634"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "R&#233;sistance et survivance du bacille tuberculeux aux m&#233;dications antibacillaires"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46; Kreis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:5 [
                        "fecha" => "1966 p"
                        "paginaInicial" => "139"
                        "paginaFinal" => "143"
                        "editorial" => "Masson et Cie Ed"
                        "editorialLocalizacion" => "Par&#237;s"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A Service program of antituberculosis chemotherapy with five drugs for 4 months in the treatment of drug addicts and prisoners with pulmonary tuberculosis in Hong Kong"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Hong Kong Service&#47;Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Amer Rev Respir Dis"
                        "fecha" => "1980"
                        "volumen" => "122"
                        "paginaInicial" => "417"
                        "paginaFinal" => "424"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tol&#233;rance et toxicit&#233; des regimens &#171;lourds&#187; comportant le Pyrazinamide dans le traitement de la tuberculose pulmonaire commune"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Barbaoui"
                            1 => "Z&#46; Lamrani"
                            2 => "M&#46; Boulahbal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:5 [
                        "fecha" => "1979"
                        "paginaInicial" => "137"
                        "paginaFinal" => "145"
                        "editorial" => "Le Pyrazinamide 25 ans apres"
                        "editorialLocalizacion" => "Alger"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short duration treatment of pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;A&#46; Pilheu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1977"
                        "volumen" => "71"
                        "paginaInicial" => "583"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/852337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acci&#243;n de los esquemas con isoniacida y rifampicina sobre el h&#237;gado de enfermos tuberculosos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Pilheu"
                            1 => "M&#46;C&#46; De Salvo"
                            2 => "J&#46;A&#46; Barcat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicina &#40;Buenos Aires&#41;"
                        "fecha" => "1979"
                        "volumen" => "39"
                        "paginaInicial" => "298"
                        "paginaFinal" => "304"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esquemas terap&#233;uticos con pirazinamida&#46; Su acci&#243;n sobre el h&#237;gado"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Pilheu"
                            1 => "M&#46;C&#46; De Salvo"
                            2 => "O&#46; Koch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Arg Tisiol Neumon"
                        "fecha" => "1980"
                        "volumen" => "49"
                        "paginaInicial" => "11"
                        "paginaFinal" => "20"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controlled clinical trial of four six month regimens of chemotherapy for pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Second East Africa&#47;Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1976.114.3.471"
                      "Revista" => array:6 [
                        "tituloSerie" => "Amer Rev Resp Dis"
                        "fecha" => "1976"
                        "volumen" => "114"
                        "paginaInicial" => "471"
                        "paginaFinal" => "475"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/788570"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "First line chemotherapy in the treatment of bacteriological relapses of pulmonary tuberculosis following a syort-course regimen"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Hong Kong Tuberc Treat Serv&#47;East African&#47;Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1976"
                        "volumen" => "1"
                        "paginaInicial" => "162"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2563079"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cuarto estudio de la quimioterapia acortada de la tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "East African&#47;Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Bol Un Int Tuberc"
                        "fecha" => "1978"
                        "volumen" => "53"
                        "paginaInicial" => "248"
                        "paginaFinal" => "251"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical trial of six month and four month regimens of chemotherapy in the treatment of pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Singapore Tuberculosis Service&#47;Brit Med Res Counc"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1979.119.4.579"
                      "Revista" => array:6 [
                        "tituloSerie" => "Amer Rev Resp Dis"
                        "fecha" => "1979"
                        "volumen" => "119"
                        "paginaInicial" => "579"
                        "paginaFinal" => "585"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/375787"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resistencia primaria observada en 974 cepas de Mycobacterium tuberculosis aislados de enfermos pulmonares adultos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Porven"
                            1 => "R&#46; Piccolo"
                            2 => "L&#46; Padin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicina &#40;Buenos Aires&#41;"
                        "fecha" => "1978"
                        "volumen" => "38"
                        "paginaInicial" => "497"
                        "paginaFinal" => "501"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/03002896/0000001800000003/v1_201509151113/S0300289615323619/v1_201509151113/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9277"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03002896/0000001800000003/v1_201509151113/S0300289615323619/v1_201509151113/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615323619?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 18. Issue 3.
Pages 119-123 (May - June 1982)
Share
Share
Download PDF
More article options
Vol. 18. Issue 3.
Pages 119-123 (May - June 1982)
Full text access
Recaidas de la tuberculosis pulmonar. Valor del interrogatorio para la seleccion del esquema terapeutico adecuado
Pulmonary tuberculosis relapses. the value of detailed questioning of the patient for inclusion in an adecuate treatment regime
Visits
4680
J.A. Pilheu, M.a C. De Salvo, V. Gnecco, J. Giannattasio, M. Hoffman
Hospital E. Tornú. Buenos Aires
This item has received
Article information
Resumen

Se estudiaron 200 pacientes con una recaída de su tuberculosis pulmonar y se relacionaron las características de su primer tratamiento con la sensibilidad bacteriana en el momento de la recaída. Fueron clasificados como regulares los pacientes que habían recibido tratamientos asociados, en dosis adecuadas al peso, diario o intermitente, continuo, que lo terminaron espontáneamente (tratamiento incompleto) o por indicación médica (tratamiento completo) e interrumpieron todas las drogas simultáneamente. Se consideraron irregulares a quienes recibieron tratamientos asociados, diarios o intermitentes, completos o incompletos, pero con dosis inadecuadas o con interrupciones o con abandono sucesivo de las drogas. En el grupo desconocido se incluyeron los pacientes en quienes no fue posible obtener datos seguros sobre las drogas recibidas, dosis, duración, forma de abandono. Del total de los 200 pacientes, 146 (73 %) tenían Mycobacteñum tuberculosis sensibles a isoniacida (INH), rifampicina (RAMP), estreptomicina (SM) y ethambutol (EMB), y los 54 restantes (27 %) tenían gérmenes resistentes a una o más drogas. De los 154 regulares, 139 (90,2) presentaban gérmenes sensibles a INH, RAMP, SM y EMB, mientras que de 26 irregulares y 20 desconocidos, sólo dos (7,6 %) y cinco (25 %) pacientes presentaban gérmenes sensibles a las cuatro drogas. La diferencia es estadísticamente significativa (p < 0,001). Entre los pacientes con gérmenes resistentes había 26 (13 %) que lo eran a una sola droga (con franco predominio de la INH), 12 (6 %) a dos drogas, 12 (6 %) a tres drogas y 4 (2 %) a cuatro drogas. La resistencia primaria, estudiada en un grupo de 243 pacientes con tuberculosis pulmonar, no tratados que ingresaron al hospital simultáneamente con los que presentaban recaídas, fue del 7 % (4,5 % a SM, 1,2 % a INH, (1,2 % a SM e INH). La resistencia adquirida (27 %), menos la resistencia primaria (7 %), indicaba la verdadera resistencia debida a la irregularidad de los tratamientos. En el grupo regular, esa diferencia resultó ser 2,7 % (9,7 %- 7), lo que permitía, a los pacientes de este grupo iniciar su tratamiento con un esquema intensivo (con 4 ó 5 drogas) sin esperar el resultado del test de sensibilidad. Aquellos pacientes incluidos en los grupos irregular y desconocido debían, por el contrario, esperar el resultado del test y adecuar el esquema terapéutico al mismo.

Los resultados de este estudio sugieren que, a los pacientes con recaída bacteriológica de su tuberculosis pulmonar, un interrogatorio detallado permite su agrupación en regulares, irregulares y desconocidos, y a los del primer grupo se les pueda iniciar un retratamiento con muchas posibilidades de éxito sin esperar el resultado del test de sensibilidad.

Summary

The relapses of 200 tuberculous patients were studied and the caracteristics of their first treatment correlated with the bacteriological sensitivity in the relapse. The patients that had received associated treatments, in adecúate dosage to their weight, daily or intermittent, continué, that had finished spontaneously (incomplete treatment) or by medical indication (complete treatment) and had withdrawn all the drugs simultaneously were classified as Regulars. Those who received associate treatments, daily or intermittent, complete or incomplete, but with inadecuate dosage or with interruptions or with succesive abandon of the drugs were considered Irregulars. The patients without positive data about the given drugs, dosage, duration and form of abandon were included in the Unknown group. Out of 200 patients, 146 (73 %) had sensitive Mycybacteterium tuberculosis to isoniazid (INH), rifampicin (RAMP), streptomycin (SM) and ethambutol (EMB) and the remaining 54 patients (27 %) had resistant bacilli to one or more drugas. From the 154 Regulars, 139 (90.2 %) had sensitive germs to INH, RAMP, SM and EMB, while from 26 Irregulars and 20 Unknowns, only 2 (7,6 %) and 5 (25 %) patients presented sensitive bacilli to the 4 drugs. The difference is statistically significant (p < 0,001). Out of 54 patients with resistent germs, 26 (13 %) had resistance to one drug, 12 to two drugs, 12 to three drugs and four to four drugs. The primary resistance, studied in a group of 243 patients with pulmonary tuberculosis, not treated, that arrived to the hospital simultaneously with those who presented relapses, was 7 % (4,5 % to SM, 1,2 % to INH, 1,2 % to SM and INH). The secondary resistance (27 %) minus the primary resistance (7 %) indicated the true resistance due to the irregularity of the treatments. In the Regular group that difference was 2,7 % (9,7 %-7 %), and this permitted the patients from this group to start retreatment with an intensive therapeutic regimen (with 4 or 5 drugs) without waiting the result of the sensitivity test. Those patients included in the Irregular and Unknown groups had on the contrary to wait the result of the tests in order to receive a favorable therapeutic regimen.

The results of this study suggest that the patients with bacteriological relapses of their pulmonary tuberculosis can be classified as Regulars, Irregulars or Unknowns due to their history, and to those of the first group a retreatment can be given, with many possibilities of succes, without waiting the result of the sensitivity test.

Full text is only aviable in PDF
Bibliografia
[1.]
G. Amadío.
Estado actual de la resistencia bacteriana en la Argentina.
Actas XV Cong Arg Tisiol Neum, (1975), pp. 65-76
[2.]
H. Costello, G. Caras, D. Snider.
Drug resistance among previously treated tuberculosis patients; a brief report.
Amer Rev Respir Dis, 121 (1980), pp. 313-316
[3.]
East African Brit Med Res Counc.
Controlled clinical trial of shortcourse (6 month) regimens of chemotherapy for treatment of pulmonary tuberculosis.
Lancet, 1 (1972), pp. 1079
[4.]
East African/Brit Med Res Counc.
Controlled clinical trial of four short-course (6 month) regimens of chemotherapy for treatment of pulmonary tuberculosis.
Lancet, 1 (1973), pp. 1331
[5.]
East African/Brit Med Res Counc.
Controlled clinical trial of four short-course (6 month) regimens of chemotherapy for treatment of pulmonary tuberculosis.
Lancet, 2 (1974), pp. 237
[6.]
G. Canetti, N. Rist, J. Grosset.
Mesure de la sensibilitée du bacille tuberculeux aux drogues antibacillaires par la méthode des proportions.
Rev Tuberc Pneumol, 27 (1963), pp. 217
[7.]
W. Fox, D.A. Mitchison.
Short-course chemotherapy for pulmonary tuberculosis.
Amer Rev Respir Dis, 111 (1975), pp. 325-353
[8.]
Medical Peaearch Council/Tuberc Chemoth Trial Com.
Long term chemotherapy in the treatment of chronic pulmonary tuberculosis with cavitation.
Tubercle, 43 (1962), pp. 201
[9.]
T. Santha, S. Radhakrishna, C.W. Ramakrishna, S. Tripathy.
Retreatment of drug sensitive relapses of pulmonary tuberculosis following chemotherapy with standard drugs.
Tubercle, 57 (1976), pp. 177-180
[10.]
M.R. Secondi, M.C. De Salvo, S.E. Poggi, B.N. Villar.
Resultado del estudio de la sensibilidad bacteriana en pacientes tuberculosos retratados.
XVII Cong Arg-Tisiol Neumon. Actas, (1979), pp. 632-634
[11.]
B. Kreis.
Résistance et survivance du bacille tuberculeux aux médications antibacillaires.
Masson et Cie Ed, (1966 p), pp. 139-143
[12.]
Hong Kong Service/Brit Med Res Counc.
A Service program of antituberculosis chemotherapy with five drugs for 4 months in the treatment of drug addicts and prisoners with pulmonary tuberculosis in Hong Kong.
Amer Rev Respir Dis, 122 (1980), pp. 417-424
[13.]
D. Barbaoui, Z. Lamrani, M. Boulahbal, et al.
Tolérance et toxicité des regimens «lourds» comportant le Pyrazinamide dans le traitement de la tuberculose pulmonaire commune.
Le Pyrazinamide 25 ans apres, (1979), pp. 137-145
[14.]
J.A. Pilheu.
Short duration treatment of pulmonary tuberculosis.
Chest, 71 (1977), pp. 583
[15.]
J.A. Pilheu, M.C. De Salvo, J.A. Barcat.
Acción de los esquemas con isoniacida y rifampicina sobre el hígado de enfermos tuberculosos.
Medicina (Buenos Aires), 39 (1979), pp. 298-304
[16.]
J.A. Pilheu, M.C. De Salvo, O. Koch.
Esquemas terapéuticos con pirazinamida. Su acción sobre el hígado.
Arch Arg Tisiol Neumon, 49 (1980), pp. 11-20
[17.]
Second East Africa/Brit Med Res Counc.
Controlled clinical trial of four six month regimens of chemotherapy for pulmonary tuberculosis.
Amer Rev Resp Dis, 114 (1976), pp. 471-475
[18.]
Hong Kong Tuberc Treat Serv/East African/Brit Med Res Counc.
First line chemotherapy in the treatment of bacteriological relapses of pulmonary tuberculosis following a syort-course regimen.
Lancet, 1 (1976), pp. 162
[19.]
East African/Brit Med Res Counc.
Cuarto estudio de la quimioterapia acortada de la tuberculosis.
Bol Un Int Tuberc, 53 (1978), pp. 248-251
[20.]
Singapore Tuberculosis Service/Brit Med Res Counc.
Clinical trial of six month and four month regimens of chemotherapy in the treatment of pulmonary tuberculosis.
Amer Rev Resp Dis, 119 (1979), pp. 579-585
[21.]
G. Porven, R. Piccolo, L. Padin.
Resistencia primaria observada en 974 cepas de Mycobacterium tuberculosis aislados de enfermos pulmonares adultos.
Medicina (Buenos Aires), 38 (1978), pp. 497-501
Copyright © 1982. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?