{"id":27797,"date":"2018-03-09T09:20:13","date_gmt":"2018-03-09T09:20:13","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/toxicidad-y-adherencia-en-el-tratamiento-de-la-infeccion-latente-tuberculosa\/"},"modified":"2018-03-09T09:20:13","modified_gmt":"2018-03-09T09:20:13","slug":"toxicidad-y-adherencia-en-el-tratamiento-de-la-infeccion-latente-tuberculosa","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/toxicidad-y-adherencia-en-el-tratamiento-de-la-infeccion-latente-tuberculosa\/","title":{"rendered":"Toxicidad y adherencia en el tratamiento de la infecci\u00f3n latente tuberculosa"},"content":{"rendered":"<h2>Tesis doctoral de <strong>  Arriba M\u00e9ndez Jos\u00e9-javier De <\/strong><\/h2>\n<p>El tratamiento de la infecci\u00f3n latente tuberculosa plantea dos problemas: la toxicidad, fundamentalmente hep\u00e1tica, y el mal cumplimiento. Para estudiar estos dos aspectos, realizamos un estudio prospectivo de cohortes con 536 pacientes a los que se ofrece tratamiento con una de cuatro pautas: isoniazida y rifampicina 3 meses , isoniazida 6 meses, isoniazida 9 meses e isoniazida 12 meses. Quisimos saber si alguna de estas pautas o alguna caracter\u00edstica de los pacientes se asociaba a mayor frecuencia de toxicidad grave, hepatotoxicidad grave (definida por una elevaci\u00f3n de transaminasas superior a cinvo veces el valor normal) o abandono del tratamiento. S\u00f3lo la edad igual o superior a 35 a\u00f1os y la infecci\u00f3n por vih se asociaron a mayor toxicidad grave y hepatotoxicidad grave. La presencia de hepatopat\u00eda previa no se asoci\u00f3 a mayor toxicidad general o hep\u00e1tica, pero s\u00ed a presentaci\u00f3n m\u00e1s precoz de la hepatotoxicidad.  aunque se observ\u00f3 una tendencia a m\u00e1s toxicidad en la pauta de 12 meses, en el an\u00e1lisis multivariante no hubo diferencias estad\u00edsticamente significativas entre las pautas en cuanto a toxicidad o hepatotoxicidad.  respecto a la adherencia, la pauta de 12 meses se asoci\u00f3 a mayor porcentaje de p\u00e9rdidas o abandonos.  no hubo diferencias entre buenos cumplidores y abandonos o p\u00e9rdidas en ninguna de las caracter\u00edsticas estudiadas. Concluimos que debe realizarse un seguimiento estrecho, cl\u00ednico y anal\u00edtico, para detectar precozmente la toxicidad en pacientes con infecic\u00f3n vih, hepatopat\u00eda previa y edad igual o superior a 35 a\u00f1os, y que la pauta de 12 meses no deber\u00eda ser utilizada, por su peor cumplimiento y por la alternativa de otras m\u00e1s cortas, como la de isoniazida-rifampicina tres meses.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Toxicidad y adherencia en el tratamiento de la infecci\u00f3n latente tuberculosa<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Toxicidad y adherencia en el tratamiento de la infecci\u00f3n latente tuberculosa <\/li>\n<li><strong>Autor:<\/strong>\u00a0  Arriba M\u00e9ndez Jos\u00e9-javier De <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Aut\u00f3noma de Madrid<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 17\/12\/2003<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Rafael Herruzo Cabrera<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: angel Gil de Miguel <\/li>\n<li>  (vocal)<\/li>\n<li>  (vocal)<\/li>\n<li>  (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Arriba M\u00e9ndez Jos\u00e9-javier De El tratamiento de la infecci\u00f3n latente tuberculosa plantea dos problemas: la toxicidad, fundamentalmente [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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