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array:22 [ "pii" => "S0025775300716496" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71649-6" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71649" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:641-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3446 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 3302 "PDF" => 138 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300716502" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71650-2" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71650" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:644-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3502 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 3287 "PDF" => 209 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Patrón de la distribución de colesterol total y cHDL en niños y adolescentes españoles: estudio RICARDIN" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "644" "paginaFinal" => "649" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Total cholesterol and HDL cholesterol distribution In Spanish children and adolescents: Ricardin Study" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Brotons Cuixart, Rafael Gabriel Sánchez, Javier Muñiz García, Aïda Ribera Solé, Serafín Málaga Guerrero, Pedro E. Sáenz Aranzubia, M. Teresa Díaz González-Blanco, Marciano Sánchez Bayle, Máximo Sandín Domínguez, Vicente Bosch Giménez, Esther Gorostiza Garai, Darwin R. Labarthe, Arturo Fernández-Cruzl" "autores" => array:14 [ 0 => array:2 [ "nombre" => "Carlos" "apellidos" => "Brotons Cuixart" ] 1 => array:2 [ "nombre" => "Rafael" "apellidos" => "Gabriel Sánchez" ] 2 => array:2 [ "nombre" => "Javier" "apellidos" => "Muñiz García" ] 3 => array:2 [ "nombre" => "Aïda" "apellidos" => "Ribera Solé" ] 4 => array:2 [ "nombre" => "Serafín" "apellidos" => "Málaga Guerrero" ] 5 => array:2 [ "nombre" => "Pedro E." "apellidos" => "Sáenz Aranzubia" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Teresa Díaz González-Blanco" ] 7 => array:2 [ "nombre" => "Marciano" "apellidos" => "Sánchez Bayle" ] 8 => array:2 [ "nombre" => "Máximo" "apellidos" => "Sandín Domínguez" ] 9 => array:2 [ "nombre" => "Vicente" "apellidos" => "Bosch Giménez" ] 10 => array:2 [ "nombre" => "Esther" "apellidos" => "Gorostiza Garai" ] 11 => array:2 [ "nombre" => "Darwin R." "apellidos" => "Labarthe" ] 12 => array:2 [ "nombre" => "Arturo" "apellidos" => "Fernández-Cruzl" ] 13 => array:1 [ "colaborador" => "por el Grupo Cooperativo Español de Estudio de los Factores de Riesgo Cardiovascular en la Infancia y Adolescencia, Proyecto Ricardin" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300716502?idApp=UINPBA00004N" "url" => "/00257753/0000011500000017/v1_201307291748/S0025775300716502/v1_201307291748/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Alto índice de erradicación de <span class="elsevierStyleItalic">Helicobacter pylori</span> en pacientes con úlcera duodenal tras fracaso de un tratamiento previo" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "641" "paginaFinal" => "643" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Beatriz Sicilia, Eva Sierra, Amelia Lago, Margarita Villar, Fernando Gomollón" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Sicilia" ] 1 => array:2 [ "nombre" => "Eva" "apellidos" => "Sierra" ] 2 => array:2 [ "nombre" => "Amelia" "apellidos" => "Lago" ] 3 => array:2 [ "nombre" => "Margarita" "apellidos" => "Villar" ] 4 => array:4 [ "nombre" => "Fernando" "apellidos" => "Gomollón" "email" => array:1 [ 0 => "fgomollong@meditex.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Aparato Digestivo. Hospital Universitario Miguel Servet. Zaragoza." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. F. Gomollón. Condes de Aragón, 18, 2. O B. 50009 Zaragoza." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "High eradication rates in <span class="elsevierStyleItalic">Helicobacter pylori</span> infection in patients with duodenal ulcer who failed previous eradication therapy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-05-10" "fechaAceptado" => "2000-09-05" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec223111" "palabras" => array:4 [ 0 => "Helicobacter pylori" 1 => "Erradicación" 2 => "Úlcera duodenal" 3 => "Fracaso del tratamiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar la efectividad de un segundo tratamiento en pacientes diagnosticados de úlcera duodenal en los que ha fracasado un primer intento de erradicación de Helicobacter pylori.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo, observacional, abierto y no aleatorizado pero protocolarizado. Se incluyeron 30 pacientes consecutivos con diagnóstico previo endoscópico de úlcera duodenal y fracaso de un intento de erradicación de Helicobacter pyloridefinido por un test del aliento positivo o confirmación en nueva endoscopia por test de la ureasa e histología de infección activa. Se asignaba el tratamiento de acuerdo con la pauta inicial. Si ésta había incluido claritromicina, se prescribía un tratamiento con omeprazol (20 mg/12 h), bismuto (120 mg/6 h), tetraciclina (500 mg/6 h), y metronidazol (500 mg/8 h) (OBTM); si por el contrario el tra-tamiento previo no había incluido claritromicina, la pauta incorporaba omeprazol (20 mg/12 h), claritromicina (500 mg/12 h) y amoxicilina (1g/12 h) (OCA). En ambos casos el tratamiento duraba 10 días. Se evaluaba la erradicación mediante un test del aliento a los 2 meses de la última dosis. Se exponen los datos con intervalos de confianza (IC) del 95%.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En un caso se suspendió el tratamiento por efectos adversos y 2 pacientes no acudieron al control del test del aliento (los 3 enfermos pertenecían al grupo OBTM). La erradica-ción fue eficaz en 25 de 27 pacientes (92,6%) en el análisis por protocolo y en 25 de 30 (83,3%) en el análisis por intención de tratamiento. Si se analizan por separado los dos grupos de tratamiento, la combinación OCA consiguió la erradicación en 5 de 6 pacientes (83,3%; IC del 95%, 35,9-99,6), mientras que con la opción OBTM se consiguió la erradicación en 20 de 21 pacientes evaluables (95,2%; IC del 95%, 76,2-99,9). En este caso, efectuamos el análisis según intención de tratamiento, y se erradicaron 20 de 24 casos (83,3%; IC del 95%, 62,6-95,3).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Mediante la prescripción de una segunda pauta de erradicación de H. pylorique incluye antibióticos no utilizados en la primera ocasión, sin cultivo previo, se obtiene una tasa de erradicación adecuada, lo que hace recomendable en esta situación.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To analyze the effectiveness of a second-line treatment of Helicobacter pyloriinfection in patients with duodenal ulcer based on previous antibiotic regimen.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Open, prospective, uncontrolled study, but guided by protocol including 30 consecutive patients with endoscopic diagnosis of active duodenal ulcer and failure of a first-line H. pylorieradication treatment diagnosed by urea breath test or a new endoscopy with histology and positive urease test. Treatment consisted in 10 days with omeprazole (20 mg/12 h), bismuth subcitrate (120 mg/6 h), tetracycline (500 mg/6 h) and metronidazole (500 mg/8 h) (OBTM) if previous regimen was with clarithromycin; or 10 days with omeprazole (20 mg/12 h), clarithromycin (500 mg/12 h) and amoxycillin (1g/12 h) (OCA) if previous regimen did not include clarithromycin; using metronidazole (500 mg/8 h) instead of amoxycillin (OCM) in case of allergy. Eradication was defined as a negative13 C-urea breath test 2 months after the end of therapy.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">One patient had to stop treatment due to the side effects and in 2 patients urea breath test was not performed (3 patients due to the OBTM group). Per protocol eradication was achie-ved in 25 out of 27 patients (92.6%) and by intention-to-treat eradication was attained in 25 out of 30 cases (83.3%). When both groups analyzed separaty, the OCA combination was successful in 5 from 6 patients (83.3%; 95% CI 35.9-99.6); while the OBTM combination was successful in 20 from 21 valuable patients (95.2%; 95% CI 76.2-99.9). In this second case we make an intention to treat analysis and eradication was achieved in 20 from 24 (83.3%; 95% CI 62.6-95.3).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The eradicative treatment for H. pylori based in different antibiotics used in subse-quent attempts get high eradication rates in patients with duodenal ulcer. Med Clin (Barc)2000; 115: 641-643</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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