Four-Month High-Dose Rifampicin Regimens for Pulmonary Tuberculosis.

BACKGROUND: Shorter but effective tuberculosis treatment regimens would be of value to the tuberculosis treatment community. High-dose rifampicin has been associated with more rapid and secure lung sterilization and may enable shorter tuberculosis treatment regimens. METHODS: We randomly assigned adults who were given a diagnosis of rifampicin-susceptible pulmonary tuberculosis to a 6-month control regimen, a similar 4-month regimen of rifampicin at 1200 mg/d (study regimen 1 [SR1]), or a 4-month regimen of rifampicin at 1800 mg/d (study regimen 2 [SR2]). Sputum specimens were collected at regular intervals. The primary end point was a composite of treatment failure and relapse in participants who were sputum smear positive at baseline. The noninferiority margin was 8 percentage points. Using a sequence of ordered hypotheses, noninferiority of SR2 was tested first. RESULTS: Between January 2017 and December 2020, 672 patients were enrolled in six countries, including 191 in the control group, 192 in the SR1 group, and 195 in the SR2 group. Noninferiority was not shown. Favorable responses rates were 93, 90, and 87% in the control, SR1, and SR2 groups, respectively, for a country-adjusted absolute risk difference of 6.3 percentage points (90% confidence interval, 1.1 to 11.5) comparing SR2 with the control group. The proportions of participants experiencing a grade 3 or 4 adverse event were 4.0, 4.5, and 4.4% in the control, SR1, and SR2 groups, respectively. CONCLUSIONS: Four-month high-dose rifampicin regimens did not have dose-limiting toxicities or side effects but failed to meet noninferiority criteria compared with the standard 6-month control regimen for treatment of pulmonary tuberculosis. (Funded by the MRC/Wellcome Trust/DFID Joint Global Health Trials Scheme; ClinicalTrials.gov number, NCT02581527.)

Características clínicas epidemiológicas de las cardiopatías congénitas en el Instituto Nacional de Salud del Niño en el periodo Julio-Diciembre 2009 / Clinical and epidemiological features of congenital heart disease at the National Institute of Child Health in the period July- December 2009

Objetivo: Identificar el comportamiento epidemiológico de las cardiopatías congénitas de los niños que acuden al Instituto Nacional de Salud del Niño - 2009. Método: Es un estudio Descriptivo, retrospectivo, de una sola Casilla, la población y muestra, fue todos los niños con cardiopatías congénitas que acudieron al Instituto Nacional de salud del niño, durante el periodo Julio-Diciembre 2009. Los datos se recopilaron de las historias clínicas. Resultados: La cardiopatía congénita más frecuente, fueron el CIV, Tetralogía de- Fallot, y la persistencia del conducto arterioso, con el 25.9 por ciento, 16.1 por ciento, 13.5 por ciento, respectivamente, todos ellas acompañadas de otras cardiopatías congénitas. El 30.1 por ciento fue operado antes de año de edad. El 31 por ciento de los cardiópatas eran niños con síndrome de Down. Conclusiones: La Comunicación Intraventricular, Persistencia del conducto arterioso y la Tetralogía de fallot, todas ellas acompañadas de otra cardiopatía congénita. La tercera parte de los niños, con cardiopatía congénita, que se sometieron a cirugía, pertenecen al grupo etario de menores de un año La quinta parte de los niños con cardiopatía congénita, tiene un trastorno genético, mayormente el Síndrome de Down La Cirugía más frecuente, practicada en las cardiopatías congénitas fue la Intervención correctiva. Las cardiopatías acianóticas, fueron las más intervenidas quirúrgica mente, con técnicas correctivas Hubo una mayor mortalidad en los niños con peso menor de 5 kilos

Objective: Identify the epidemiological pattern of congenital heart disease of children attending the National Institute of Child Health - 2009 Methods: It is a descriptive, retrospective study. The population and sample of study was all children with congenital heart disease who attended the National Institute of Child Health, during the period July to December 2009. Data was collected from medical records Results: The most common congenital heart diseases were ventricular septal defect (VSD), tetralogy of Fallot and patent ductus arteriosus, with 25.9 per cent, 16.1 per cent, and 13.5 per cent respectively, all of them accompanied by other conqeriital heart disease. 30.1 per cent underwent surgery before one year of age. 31 per cent of cardiac patients were children with Down syndrome Conclusions: Ventricular septal defect, patent ductus arteriosus and tetralogy of Fallot are all accompanied by other congenital heart disease. One third of children, with congenital heart disease, who underwent surgery belong to the age group under one year. One fifth of children with congenital heart disease has a genetic disorder, mainly Down syndrome. The most common surgery performed was the corrective intervention. Acyanotie heart disease was the most diagnosed and treated with corrective techniques. There was a higher mortality in children weighing less than 5 kilos