Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 10 de 10
Filtrar
Más filtros

Bases de datos
Tipo del documento
Intervalo de año de publicación
1.
Trop Med Int Health ; 16(4): 518-26, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21281407

RESUMEN

OBJECTIVE: To evaluate the role of prophylactic trimethoprim-sulfamethoxazole (co-trimoxazole) antibacterial prophylaxis in reducing morbidity and mortality in HIV-infected post-natal women in southern Africa. METHODS: Double-blind placebo-controlled trial. HIV-infected women with WHO stage 2 or 3 HIV disease who had recently delivered in the Department of Obstetrics and Gynaecology at the University Teaching Hospital, Lusaka, Zambia were randomised to receive daily co-trimoxazole (cotox) or matched placebo daily for the duration of the trial. Participants were followed up for a minimum of 1 year. Primary outcome measures were mortality from any cause or hospital admission and serious adverse events. RESULTS: Of 600 women randomised, follow-up information was available from 355 (180 cotox, 175 placebo) participants. Thirty-six (17 cotox, 19 placebo) women died during the trial, and another 11 (5 cotox, 6 placebo) were admitted to hospital. There was no significant difference in the combined event rates between the two treatment arms: HR = 0.82, 95% CI (0.46, 1.45), P = 0.49; morbidity was reduced over a range of symptoms. Secondary analyses of the outcome in babies indicated some evidence of reduced mortality in those whose mothers were allocated cotox. CONCLUSIONS: Follow-up rates were poor; there was no evidence that co-trimoxazole prophylaxis reduced mortality or hospital admission rates, although fewer symptoms were reported in the cotox arm. Cotox was safe and well tolerated.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/prevención & control , Antibacterianos/uso terapéutico , Profilaxis Antibiótica/métodos , Infecciones Bacterianas/prevención & control , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Adulto , Antibacterianos/efectos adversos , Profilaxis Antibiótica/efectos adversos , Infecciones Bacterianas/mortalidad , Métodos Epidemiológicos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Cumplimiento de la Medicación , Atención Posnatal/métodos , Resultado del Tratamiento , Combinación Trimetoprim y Sulfametoxazol/efectos adversos , Adulto Joven
2.
Antivir Ther ; 13(6): 761-70, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18839777

RESUMEN

BACKGROUND: Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulae are recommended for glomerular filtration rate (GFR) estimation, but neither has been validated or directly compared longitudinally in HIV-infected patients or in Africa. METHODS: We investigated differences between formulae in baseline GFR, GFR changes and incidence of impaired GFR after initiation of antiretroviral therapy (ART) in 3,316 HIV-infected adults in Africa, considering sex, age, body mass index and baseline laboratory parameters as predictors. RESULTS: Participants were 65% women, median age 36.8 years, median weight 56.7 kg. Baseline GFR was lower using CG (median 89 ml/min/1.73 m2, 7.4% <60 ml/min/1.73 m2) versus MDRD (103 ml/min/1.73 m2, 3.1% <60 ml/min/1.73 m2). At 36 weeks, median CG-GFR increased (92 ml/min/1.73 m2), whereas MDRD-GFR decreased (96 ml/min/1.73 m2). Weight (explicitly a factor in CG only) concurrently increased to 62.0 kg. GFR changes from weeks 36-96 (after weight stabilization) were similar across formulae. By 96 weeks, 56 patients developed severe GFR impairment (<30 ml/min/1.73 m2) using one or both formulae (both n=45, CG n=7, MDRD n=4) compared with only 24 by serum creatinine alone. Multivariate models identified different sets of predictors for each formula. CONCLUSIONS: Although severe GFR impairments are similarly classified by different formulae, moderate impairments were more frequently identified using CG-GFR versus MDRD-GFR (with Black ethnicity correction factor 1.21), and creatinine alone had low sensitivity. Given overestimation in underweight patients and sensitivity to weight changes, this MDRD formula might not necessarily be superior for monitoring ART in African HIV-infected adults.


Asunto(s)
Nefropatía Asociada a SIDA/fisiopatología , Algoritmos , Creatinina/sangre , Tasa de Filtración Glomerular , Nefropatía Asociada a SIDA/sangre , Nefropatía Asociada a SIDA/diagnóstico , Nefropatía Asociada a SIDA/tratamiento farmacológico , Adulto , Factores de Edad , Fármacos Anti-VIH/efectos adversos , Fármacos Anti-VIH/uso terapéutico , Terapia Antirretroviral Altamente Activa/efectos adversos , Estudios de Cohortes , Dieta , Carbohidratos de la Dieta/administración & dosificación , Femenino , Tasa de Filtración Glomerular/efectos de los fármacos , Humanos , Masculino , Selección de Paciente , Valor Predictivo de las Pruebas , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Factores Sexuales , Uganda , Zimbabwe
3.
N Engl J Med ; 352(9): 865-74, 2005 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-15745977

RESUMEN

BACKGROUND: Intrapleural fibrinolytic agents are used in the drainage of infected pleural-fluid collections. This use is based on small trials that did not have the statistical power to evaluate accurately important clinical outcomes, including safety. We conducted a trial to clarify the therapeutic role of intrapleural streptokinase. METHODS: In this double-blind trial, 454 patients with pleural infection (defined by the presence of purulent pleural fluid or pleural fluid with a pH below 7.2 with signs of infection or by proven bacterial invasion of the pleural space) were randomly assigned to receive either intrapleural streptokinase (250,000 IU twice daily for three days) or placebo. Patients received antibiotics and underwent chest-tube drainage, surgery, and other treatment as part of routine care. The number of patients in the two groups who had died or needed surgical drainage at three months was compared (the primary end point); secondary end points were the rates of death and of surgery (analyzed separately), the radiographic outcome, and the length of the hospital stay. RESULTS: The groups were well matched at baseline. Among the 427 patients who received streptokinase or placebo, there was no significant difference between the groups in the proportion of patients who died or needed surgery (with streptokinase: 64 of 206 patients [31 percent]; with placebo: 60 of 221 [27 percent]; relative risk, 1.14 [95 percent confidence interval, 0.85 to 1.54; P=0.43), a result that excluded a clinically significant benefit of streptokinase. There was no benefit to streptokinase in terms of mortality, rate of surgery, radiographic outcomes, or length of the hospital stay. Serious adverse events (chest pain, fever, or allergy) were more common with streptokinase (7 percent, vs. 3 percent with placebo; relative risk, 2.49 [95 percent confidence interval, 0.98 to 6.36]; P=0.08). CONCLUSIONS: The intrapleural administration of streptokinase does not improve mortality, the rate of surgery, or the length of the hospital stay among patients with pleural infection.


Asunto(s)
Infecciones Bacterianas/tratamiento farmacológico , Fibrinolíticos/uso terapéutico , Enfermedades Pleurales/tratamiento farmacológico , Estreptoquinasa/uso terapéutico , Antibacterianos/uso terapéutico , Infecciones Bacterianas/diagnóstico por imagen , Infecciones Bacterianas/mortalidad , Infecciones Bacterianas/cirugía , Terapia Combinada , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infección Hospitalaria/tratamiento farmacológico , Método Doble Ciego , Drenaje , Empiema Pleural/tratamiento farmacológico , Empiema Pleural/mortalidad , Empiema Pleural/cirugía , Femenino , Fibrinolíticos/efectos adversos , Humanos , Instilación de Medicamentos , Tiempo de Internación , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Enfermedades Pleurales/diagnóstico por imagen , Enfermedades Pleurales/mortalidad , Enfermedades Pleurales/cirugía , Neumonía/complicaciones , Radiografía , Estreptoquinasa/efectos adversos , Reino Unido
4.
Antivir Ther ; 12(1): 47-54, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17503747

RESUMEN

OBJECTIVE: To evaluate whether the addition of a fourth drug for up to 32 weeks to a standard three-drug antiretroviral combination decreases the risk of virological failure without increasing toxicity in treatment-naive patients. DESIGN: Induction/maintenance (IM) therapy [two nucleoside reverse transcriptase inhibitors (NRTIs) + one non-NRTI (NNRTI) + one protease inhibitor for 24-32 weeks until plasma HIV RNA viral load (VL) < or =50 copies/ml then two NRTIs + NNRTI] was compared with standard therapy (ST) (two NRTIs + NNRTI). The primary endpoint was virological failure: VL >50 copies/ml at 32 (and 24) weeks or subsequent rebound to >400 copies/ml. RESULTS: 122 (62 IM, 60 ST) participants were randomized and followed for a median of 81 weeks (IQR 64-145). 52% were asymptomatic; median CD4+ T-cell count was 160 x 10(6)/l (IQR 92-260) and median VL 98,830 copies/ml (IQR 37,500-241,290). In an intent-to-treat analysis, the proportion of participants with virological failure at or after 32 weeks was higher in the ST arm [26 (43%) versus 11 (18%), P = 0.002]. The mean decrease in VL at 48 weeks was 0.84 95% confidence interval (CI) (0.15, 1.53) log10 copies/ml greater in the IM arm (P = 0.02). There were no significant differences between the two arms in the change in CD4+ T-cell count from baseline to 48 weeks, the number of participants with adverse events or the frequency of progression to AIDS/death. Drug resistance at failure was detected less frequently in the IM arm. CONCLUSIONS: Starting antiretroviral therapy with an IM strategy improved virological outcomes compared with a three-drug regimen, without significantly increasing toxicity.


Asunto(s)
Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/uso terapéutico , VIH-1/genética , ARN Viral/sangre , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Adulto , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Didanosina/uso terapéutico , Progresión de la Enfermedad , Farmacorresistencia Viral Múltiple/genética , Femenino , Estudios de Seguimiento , Infecciones por VIH/inmunología , Infecciones por VIH/mortalidad , Infecciones por VIH/virología , Inhibidores de la Proteasa del VIH/efectos adversos , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Mutación , Nelfinavir/uso terapéutico , Nevirapina/uso terapéutico , Cooperación del Paciente , Inducción de Remisión , Inhibidores de la Transcriptasa Inversa/efectos adversos , Estavudina/uso terapéutico , Factores de Tiempo , Insuficiencia del Tratamiento , Reino Unido , Carga Viral
5.
Antivir Ther ; 11(6): 741-9, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17310818

RESUMEN

OBJECTIVE: To describe the prevalence, incidence and predictors of severe anaemia in previously untreated symptomatic HIV-infected adults with CD4+ T-cells <200 cells/mm(3) initiating zidovudine-containing regimens in Africa. DESIGN: DART is a randomized trial comparing two strategies for HIV/AIDS management in Uganda and Zimbabwe. METHODS: We analysed the occurrence of anaemia at weeks 4 and 12, and then every 12 weeks. We also evaluated sex, age, WHO stage, body mass index (BMI), baseline laboratory measurements and first regimen as predictors of developing grade 4 anaemia (<6.5 mg/dl) by week 48 using logistic regression. RESULTS: To May 2005, 3,314 participants (65% women, 23% at WHO stage 4, median age=37 years, baseline CD4+ T-cell=86 cells/mm(3) and median baseline haemoglobin=11.4 g/dl) had a median 72 weeks follow-up. Prevalence of grade 4 anaemia was 0.70, 2.0%, 0.5% and <0.5% at weeks 4, 12, 24 and > or =36, respectively. Overall, 219 (6.6%) participants developed grade 4 anaemia by week 48; women and those with lower haemoglobin, CD4+ T-cell count and BMI at baseline were at significantly higher risk (P<0.05), but not those with lower neutrophils or receiving cotrimoxazole at baseline. CONCLUSIONS: We observed a higher incidence of grade 4 anaemia than in studies from industrialized countries, which is likely to be due in part to population characteristics and in part to a higher rate of concurrent HIV-related clinical events. Clinical vigilance and haemoglobin measurements 4, 8 and 12 weeks after starting zidovudine could help to manage serious anaemia.


Asunto(s)
Anemia/epidemiología , Fármacos Anti-VIH/efectos adversos , Infecciones por VIH/complicaciones , Inhibidores de la Transcriptasa Inversa/efectos adversos , Zidovudina/efectos adversos , Adulto , Anemia/etiología , Anemia/mortalidad , Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/uso terapéutico , Quimioterapia Combinada , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , Hemoglobinas/análisis , Humanos , Incidencia , Masculino , Valor Predictivo de las Pruebas , Prevalencia , Inhibidores de la Transcriptasa Inversa/administración & dosificación , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Índice de Severidad de la Enfermedad , Uganda/epidemiología , Zidovudina/administración & dosificación , Zidovudina/uso terapéutico , Zimbabwe/epidemiología
6.
Antivir Ther ; 9(5): 641-8, 2004 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15535402

RESUMEN

OBJECTIVES: To assess the strength of evidence supporting the routine use of HIV drug resistance testing. DESIGN: A critical review of all studies relating to the clinical utility of HIV resistance testing, with a focus on randomized trials. RESULTS: Two cohort studies found no evidence of a difference in virological response in patients who had resistance testing compared with matched controls. We identified nine published randomized trials that were specifically designed to assess the clinical utility of drug resistance testing. In a meta-analysis of these trials, resistance testing increased the proportion of patients who achieved undetectable viral load by an average of 7% (95% confidence interval: 3-11%). However, this may be an over-estimate of the impact of resistance testing in clinical practice because of the idealized design and analytical approaches used in most of the studies. CONCLUSIONS: The available evidence does not clearly demonstrate that HIV drug resistance testing is clinically effective. To optimize their value for health decision-making, future trials of HIV resistance testing should be carefully designed to mimic the circumstances of routine clinical practice.


Asunto(s)
Fármacos Anti-VIH/farmacología , Farmacorresistencia Viral , VIH-1/efectos de los fármacos , Inhibidores de la Transcriptasa Inversa/farmacología , Fármacos Anti-VIH/uso terapéutico , Estudios de Cohortes , Farmacorresistencia Viral/genética , Infecciones por VIH/virología , Humanos , Pruebas de Sensibilidad Microbiana/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Inhibidores de la Transcriptasa Inversa/uso terapéutico
7.
BMJ ; 337: a257, 2008 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-18617486

RESUMEN

OBJECTIVE: To assess the impact of prophylactic oral co-trimoxazole in reducing mortality in HIV positive Zambian adults being treated for pulmonary tuberculosis. DESIGN: Double blind placebo controlled randomised clinical trial. PARTICIPANTS: Two groups of antiretroviral treatment naive adults with HIV infection: patients newly diagnosed as having tuberculosis and receiving tuberculosis treatment either for the first time or for retreatment after relapse; previously treated patients not receiving treatment. INTERVENTION: Oral co-trimoxazole or matching placebo daily. Primary outcome measures Time to death and occurrence of serious adverse events related to study drug. RESULTS: 1003 patients were randomised: 835 (416 co-trimoxazole, 419 placebo) were receiving treatment for tuberculosis, 762 (376 co-trimoxazole, 386 placebo) of them newly diagnosed previously untreated patients and 73 (40 co-trimoxazole, 33 placebo) receiving a retreatment regimen; 168 (84 co-trimoxazole, 84 placebo) were not on treatment but had received treatment in the past. Of 835 participants receiving tuberculosis treatment, follow-up information was available for 757, with a total of 1012.6 person years of follow-up. A total of 310 (147 co-trimoxazole, 163 placebo) participants died, corresponding to death rates of 27.3 and 34.4 per 100 person years. In the Cox regression analysis, the hazard ratio for death (co-trimoxazole:placebo) was 0.79 (95% confidence interval 0.63 to 0.99). The effect of co-trimoxazole waned with time, possibly owing to falling adherence levels; in a per protocol analysis based on patients who spent at least 90% of their time at risk supplied with study drug, the hazard ratio was 0.65 (0.45 to 0.93). CONCLUSIONS: Prophylaxis with co-trimoxazole reduces mortality in HIV infected adults with pulmonary tuberculosis. Co-trimoxazole was generally safe and well tolerated. TRIAL REGISTRATION: Current Controlled Trials ISRCTN15281875.


Asunto(s)
Antiinfecciosos/administración & dosificación , Infecciones por VIH/mortalidad , Combinación Trimetoprim y Sulfametoxazol/administración & dosificación , Tuberculosis Pulmonar/prevención & control , Administración Oral , Adolescente , Adulto , Anciano , Método Doble Ciego , Métodos Epidemiológicos , Femenino , Infecciones por VIH/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/mortalidad
8.
BMJ ; 335(7613): 239, 2007 Aug 04.
Artículo en Inglés | MEDLINE | ID: mdl-17626056

RESUMEN

OBJECTIVE: To assess the long term risks and benefits of hormone replacement therapy (combined hormone therapy versus placebo, and oestrogen alone versus combined hormone therapy). DESIGN: Multicentre, randomised, placebo controlled, double blind trial. SETTING: General practices in UK (384), Australia (91), and New Zealand (24). PARTICIPANTS: Postmenopausal women aged 50-69 years at randomisation. At early closure of the trial, 56,583 had been screened, 8980 entered run-in, and 5692 (26% of target of 22,300) started treatment. INTERVENTIONS: Oestrogen only therapy (conjugated equine oestrogens 0.625 mg orally daily) or combined hormone therapy (conjugated equine oestrogens plus medroxyprogesterone acetate 2.5/5.0 mg orally daily). Ten years of treatment planned. PRIMARY OUTCOMES: major cardiovascular disease, osteoporotic fractures, and breast cancer. SECONDARY OUTCOMES: other cancers, death from all causes, venous thromboembolism, cerebrovascular disease, dementia, and quality of life. RESULTS: The trial was prematurely closed during recruitment, after a median follow-up of 11.9 months (interquartile range 7.1-19.6, total 6498 women years) in those enrolled, after the publication of early results from the women's health initiative study. The mean age of randomised women was 62.8 (SD 4.8) years. When combined hormone therapy (n=2196) was compared with placebo (n=2189), there was a significant increase in the number of major cardiovascular events (7 v 0, P=0.016) and venous thromboembolisms (22 v 3, hazard ratio 7.36 (95% CI 2.20 to 24.60)). There were no statistically significant differences in numbers of breast or other cancers (22 v 25, hazard ratio 0.88 (0.49 to 1.56)), cerebrovascular events (14 v 19, 0.73 (0.37 to 1.46)), fractures (40 v 58, 0.69 (0.46 to 1.03)), and overall deaths (8 v 5, 1.60 (0.52 to 4.89)). Comparison of combined hormone therapy (n=815) versus oestrogen therapy (n=826) outcomes revealed no significant differences. CONCLUSIONS: Hormone replacement therapy increases cardiovascular and thromboembolic risk when started many years after the menopause. The results are consistent with the findings of the women's health initiative study and secondary prevention studies. Research is needed to assess the long term risks and benefits of starting hormone replacement therapy near the menopause, when the effect may be different. TRIAL REGISTRATION: Current Controlled Trials ISRCTN 63718836.


Asunto(s)
Terapia de Reemplazo de Estrógeno/efectos adversos , Anciano , Neoplasias de la Mama/inducido químicamente , Enfermedades Cardiovasculares/inducido químicamente , Método Doble Ciego , Femenino , Fracturas Óseas/inducido químicamente , Humanos , Persona de Mediana Edad , Osteoporosis/inducido químicamente , Posmenopausia , Calidad de Vida , Factores de Riesgo , Resultado del Tratamiento
9.
Epidemiology ; 13(3): 347-55, 2002 May.
Artículo en Inglés | MEDLINE | ID: mdl-11964938

RESUMEN

BACKGROUND: Many cohort studies and clinical trials use repeated measurements of laboratory markers to track disease progression and to evaluate new therapies. A major problem in the analysis of such studies is that marker data are censored in some patients owing to withdrawal, loss to follow-up, or death. The objective of this paper is to evaluate the impact of selective dropouts attributable to death or disease progression on the estimates of marker change among different groups. METHODS: Data on CD4 cell count in human immunodeficiency virus 1-infected individuals from a clinical trial and a cohort study are used to illustrate this problem and a possible solution. Simulation studies are also presented. RESULTS: When the rate of dropout is greater in subjects whose marker status is declining rapidly, commonly used methods, like random effects models, that ignore informative dropouts lead to overoptimistic statements about the marker trends in all compared groups, because subjects with steeper marker drops tend to have shorter follow-up times and hence are weighted less in the estimation of the group rate of the average marker decline. CONCLUSIONS: The potential biases attributable to incomplete data require greater recognition in longitudinal studies. Sensitivity analyses to assess the effect of dropouts are important.


Asunto(s)
Sesgo , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Adolescente , Adulto , Recuento de Linfocito CD4 , Niño , Preescolar , Estudios de Cohortes , Interpretación Estadística de Datos , Didanosina/uso terapéutico , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/inmunología , Hemofilia A/sangre , Hemofilia A/complicaciones , Hemofilia A/inmunología , Humanos , Lactante , Análisis de los Mínimos Cuadrados , Estudios Longitudinales , Persona de Mediana Edad , Modelos Teóricos
10.
Control Clin Trials ; 23(2): 198-220, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11943448

RESUMEN

The Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT) is a large ongoing randomized trial of subcutaneous interleukin-2 (IL-2) plus antiretroviral therapy versus antiretroviral therapy alone in patients with HIV (human immunodeficiency virus) disease and CD4 cell counts of at least 300 cells/mm(3). The primary objective is to determine whether the addition of IL-2 to combination antiretroviral therapy improves morbidity and mortality. The aim is to recruit 4000 participants and follow them for an average of 5 years. Eligible subjects will be recruited at 275 investigational sites in 23 countries around the world. Coupled with broad eligibility criteria this will ensure widely applicable results. A range of secondary objectives will also be addressed in this setting that will include the conduct of observational studies and nested substudies with a public health focus. This article describes the rationale supporting the trial in addition to reviewing the study design, coordination, and governance.


Asunto(s)
Infecciones por VIH/tratamiento farmacológico , Interleucina-2/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Proyectos de Investigación , Adulto , Fármacos Anti-VIH/uso terapéutico , Ensayos Clínicos Fase III como Asunto/métodos , Recolección de Datos/métodos , Progresión de la Enfermedad , Quimioterapia Combinada , Femenino , Humanos , Inyecciones Subcutáneas , Masculino , Estudios Multicéntricos como Asunto/métodos , Selección de Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto/economía , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Tamaño de la Muestra , Análisis de Supervivencia , Estados Unidos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA