New treatment guidelines are required to improve the tuberculosis control strategies that have been used for 30 years. Seven centers of the Barcelona Tuberculosis Research Unit (BTRU) (Unitat d’ Investigació en Tuberculosi de Barcelona) are collaborating with the Division of Tuberculosis Elimination of the United States Centers for Disease Control and Prevention in a series of clinical trials on latent tuberculosis infection and tuberculosis disease. BTRU participation began in 2004 with Study 26, an evaluation of the efficacy and tolerability of rifapentine plus isoniazid administered once weekly for 3 months compared with the standard treatment for latent tuberculos isinfection. The BTRU centers together enrolled 246 patients (3% of the total).General enrollment was completed in February, 2008. HIV-infected patient and child enrollment continues. Treatment with 12 doses instead of 270 doses is expected to be a clear success. However, the analysis will be completed in 2010. Study 28 (startedin2006), designed for the treatment of pulmonary tuberculosis, compared standard treatment with an experimental regimen substituting moxifloxacin for isoniazid. BTRU centers together enrolled 15 patients (3.5 % of the total).The provisional results (presented at the 47th Interscience Conferenceon Antimicrobial Agents and Chemotherapy in Chicago, 2007) showed no difference between the sputum conversion rate of each regimen at week 8 of treatment. Study 29 is currently underway,in which rifapentine was introduced in the experimental regimen for active tuberculosis treatment.

El control de la tuberculosis exige nuevas pautas terapéuticas que superen las actuales, disponibles desde hace más de 30 años. En virtud de una cuerdo, siete centros de la Unitat d’ Investigació en Tuberculosi de Barcelona (UITB) vienen colaborando con la División para la Eliminación de la Tuberculosis de los Centers for Disease Control de Estados Unidos en el desarrollo de diversos ensayos clínicos en el tratamiento de la infección y la enfermedad tuberculosa. La colaboración se inició en 2004 con el Estudio 26, que compara la eficacia y la tolerabilidad de rifapentina + isoniazida administradas una vez por semana durante tres meses frente a la pauta estándar, para la forma latente. Incluimos 246 sujetos (3 % del total). En febrero de 2008 se cerró la inclusión general. El estudio permanece abierto para sujetos VIH positivos y niños. Tratar con 12 dosis y no con 270 (terapia estándar) supondrán un éxito evidente. Habrá que esperar, sin embargo, hasta 2010 para conocer el análisis. El Estudio 28 (iniciado en 2006) comparó, para el tratamiento de la tuberculosis pulmonar, la pauta estándar con una experimental en la cual la isoniazida se sustituyo por moxifloxacino. La UITB incluyó 15 pacientes (3,5 % del total). Los resultados provisionales (presentados en la 47º Interscience Conference on Antimicrobial Agentsand Chemotherapy de Chicago de 2007) no mostraron diferencias entre las dos pautas en la conversión del esputo a las 8 semanas de tratamiento. Recientemente hemos comenzado el Estudio 29, en el cual la rifapentina sustituye a la rifampicina en la pauta estándar de tratamiento.

New treatment guidelines are required to improve the tuberculosis control strategies that have been used for 30 years. Seven centers of the Barcelona Tuberculosis Research Unit (BTRU) (Unitat d’ Investigació en Tuberculosi de Barcelona) are collaborating with the Division of Tuberculosis Elimination of the United States Centers for Disease Control and Prevention in a series of clinical trials on latent tuberculosis infection and tuberculosis disease. BTRU participation began in 2004 with Study 26, an evaluation of the efficacy and tolerability of rifapentine plus isoniazid administered once weekly for 3 months compared with the standard treatment for latent tuberculos isinfection. The BTRU centers together enrolled 246 patients (3% of the total).General enrollment was completed in February, 2008. HIV-infected patient and child enrollment continues. Treatment with 12 doses instead of 270 doses is expected to be a clear success. However, the analysis will be completed in 2010. Study 28 (startedin2006), designed for the treatment of pulmonary tuberculosis, compared standard treatment with an experimental regimen substituting moxifloxacin for isoniazid. BTRU centers together enrolled 15 patients (3.5 % of the total).The provisional results (presented at the 47th Interscience Conferenceon Antimicrobial Agents and Chemotherapy in Chicago, 2007) showed no difference between the sputum conversion rate of each regimen at week 8 of treatment. Study 29 is currently underway,in which rifapentine was introduced in the experimental regimen for active tuberculosis treatment.

El control de la tuberculosis exige nuevas pautas terapéuticas que superen las actuales, disponibles desde hace más de 30 años. En virtud de una cuerdo, siete centros de la Unitat d’ Investigació en Tuberculosi de Barcelona (UITB) vienen colaborando con la División para la Eliminación de la Tuberculosis de los Centers for Disease Control de Estados Unidos en el desarrollo de diversos ensayos clínicos en el tratamiento de la infección y la enfermedad tuberculosa. La colaboración se inició en 2004 con el Estudio 26, que compara la eficacia y la tolerabilidad de rifapentina + isoniazida administradas una vez por semana durante tres meses frente a la pauta estándar, para la forma latente. Incluimos 246 sujetos (3 % del total). En febrero de 2008 se cerró la inclusión general. El estudio permanece abierto para sujetos VIH positivos y niños. Tratar con 12 dosis y no con 270 (terapia estándar) supondrán un éxito evidente. Habrá que esperar, sin embargo, hasta 2010 para conocer el análisis. El Estudio 28 (iniciado en 2006) comparó, para el tratamiento de la tuberculosis pulmonar, la pauta estándar con una experimental en la cual la isoniazida se sustituyo por moxifloxacino. La UITB incluyó 15 pacientes (3,5 % del total). Los resultados provisionales (presentados en la 47º Interscience Conference on Antimicrobial Agentsand Chemotherapy de Chicago de 2007) no mostraron diferencias entre las dos pautas en la conversión del esputo a las 8 semanas de tratamiento. Recientemente hemos comenzado el Estudio 29, en el cual la rifapentina sustituye a la rifampicina en la pauta estándar de tratamiento.

OBJETIVOS: Identificar e caracterizar o principal cuidador dos pacientes candidatos a transplante do coração; comparar as diferenças entre as informações coletadas com os pacientes e cuidadores; e classificar os cuidadores segundo a sua dedicação e eficiência na assistência ao paciente, correlacionando-os aos dados sociodemográficos. MÉTODOS: Estudo descritivo realizado de outubro de 2004 a março de 2005, no ambulatório da UNIFESP, por meio de entrevista estruturada, com amostragem de 21 pacientes e seus cuidadores. RESULTADOS: O principal cuidador era membro da família (95%), na maioria das vezes, o cônjuge, sendo 13 (81%) mulheres e três (19%) homens, com idade variando de 24 a 65 anos (média de 44,3). Declararam-se 56% casados; 43,8% católicos; 29% cursaram o ensino fundamental, 24% completaram o ensino médio e 14% tinham nível superior. Atividade profissional era exercida por 68,8% e 81,4% possuíam renda própria. Todos os cuidadores residiam na mesma casa que o paciente. Estabelecido um escore, classificaram-se os cuidadores em oito (50%) "bons", sete (43,7%) "regulares" e apenas um (6,3%) foi considerado "ruim". Não encontramos correlação estatisticamente significante entre o escore e as variáveis escolaridade, atividade profissional e renda. CONCLUSÃO: É importante determinar os instrumentos para o reconhecimento e caracterização do cuidador. Neste estudo, identificou-se um familiar (cônjuge), do sexo feminino, com idade média de 44,3 anos, renda própria, classificados, na maioria, como "bons" ou "regulares", não havendo correlação com escolaridade, atividade profissional e renda. Novos estudos complementares, com casuística maior, deverão estabelecer a relação entre o papel do cuidador e os resultados do transplante cardíaco.

OBJECTIVES: To identify and describe the main caregiver of the patients on the heart transplant waiting list; to compare relevant information provided by patients and caregivers, and to classify the caregivers according to their dedication and efficiency in assisting the patient by correlating them to sociodemographic data. METHODS: Descriptive study performed from October 2004 to October 2005 at UNIFESP outpatient clinics. The study sample consisted of 21 patients and their caregivers. Data were collected through a structured interview. RESULTS: The main caregiver was a family member (95%), usually the spouse. There were 13 women (81%) and three men (19%). Patient age ranged from 24 to 65 years (mean 44.3). Patients were married (56%); catholic (43.8%); 29% have finished elementary school; 24% have finished high school; 14% have higher education; 68.8% have a regular job; and 81.4% had their own income. All caregivers lived in the same house as the patient. Once a score was established, the caregivers were classified as: "good" - 8 (50%); "regular" - 7 (43.7%); and "bad" 1 - (6.3%). The scores were correlated with education, professional activity, and income without any significant statistical correlation. CONCLUSION: It is important to determine the instruments to recognize and describe the caregivers. The caregiver is usually a family member (spouse), female, mean age of 44.3 years; has his/her own income and, most of the time, he/she is classified as "good" or "regular", and no correlation was found with education, professional activity and income. Further studies with a larger sample should establish the relationship between the caregiver's role and the heart transplant outcomes.