<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022015000400172</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Efectos del riluzol en la evolución clínica y sobrevida de los pacientes con esclerosis lateral amiotrófica en Costa Rica]]></article-title>
<article-title xml:lang="en"><![CDATA[Effects of riluzole on clinical evolution and survival of patients with amyotrophic lateral sclerosis in Costa Rica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abadía-Cubillo]]></surname>
<given-names><![CDATA[Karla]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Cascante]]></surname>
<given-names><![CDATA[Cindy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Granados-Acuña]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro-Cordero]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Salas-Herrera]]></surname>
<given-names><![CDATA[Isaías]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,karlaabadia@gmail.com  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,aff2  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Nacional de Control del Dolor y Cuidados Paliativos  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Caja Costarricense de Seguro Social Dirección Farmacoepidemiología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af5">
<institution><![CDATA[,Centro Nacional de Control del Dolor y Cuidados Paliativos  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2015</year>
</pub-date>
<volume>57</volume>
<numero>4</numero>
<fpage>172</fpage>
<lpage>178</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022015000400172&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022015000400172&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022015000400172&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:Justificación y objetivo: en la actualidad no se ha publicado un estudio que permita conocer el uso del riluzol en pacientes con esclerosis lateral amiotrófica en Costa Rica. El objetivo de este estudio fue evaluar el impacto del riluzol en la evolución clínica y sobrevida de los pacientes con esclerosis lateral amiotrófica atendidos en el Centro Nacional de Control del Dolor y Cuidados Paliativos.Materiales y métodos: estudio analítico, observacional y retrospectivo basado en los registros de los pacientes con esclerosis lateral amiotrófi atendidos en el Centro Nacional de Control del Dolor y Cuidados Paliativos en un período comprendido entre enero del 2009 y mayo del 2014. El análisis estadístico fue realizado en Microsoft Excel y SPSS versión 18. Para el análisis de sobrevida se utilizó estimaciones de Kaplan - Meier y se efectuó un análisis de sobrevida multivariado empleando una regresión de Cox.Resultados: se analizó 235 expedientes clínicos con el diagnóstico de esclerosis lateral amiotrófi que se encontraban en control en el Centro Nacional de Control del Dolor y Cuidados Paliativos, de los cuales 142 (60%) estaban en tratamiento con riluzol y 93 (40%) sin tratamiento con este medicamento, para una relación de 1,5 pacientes con riluzol por uno sin riluzol. Un 66% correspondía a hombres y un 34% a mujeres. Los pacientes en tratamiento con riluzol presentaron una mediana de sobrevida de 25,0 meses (IC95% 19,8 - 30,5 meses) y los pacientes que no recibieron tratamiento de 18,0 meses (IC95% 7,8 - 28,2 meses), con un valor de p para la comparación de las distribuciones de sobrevida de 0,17. Adicionalmente se encontró una diferencia estadísticamente signifi en el tiempo entre el inicio del tratamiento con riluzol y la colocación del PEG (p &lt; =0,001). Los pacientes que recibieron el riluzol presentaron un promedio de tiempo mayor antes de requerir la colocación del PEG.Conclusiones: en los pacientes que utilizaban riluzol se demostró un incremento en la sobrevida de 7 meses comparado con los que no lo usaron (p=0,17); además se evidenció que los pacientes que tomaron el medicamento mostraron un retraso en la colocación de la gastrostomía endoscópica percutánea.Abreviaturas: CNCD y CP, Centro Nacional de Control del Dolor y Cuidados Paliativos; ELA, esclerosis lateral amiotrófica; CV, capacidad vital; PEG, gastrostomía endoscópica percutánea.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[AbstractBackground and aim: There is no study on the use of riluzol in patients with amyotrophic lateral sclerosis in Costa Rica. The objective of this study was to assess the impact of riluzole on clinical evolution and survival of patients with amyotrophic lateral sclerosis treated at the National Pain Control and Palliative Care Center.Materials and methods: An analytical, observational and retrospective study based on the records of patients with amyotrophic lateral sclerosis treated at the National Pain Control and Palliative Care Center between January 2009 and May 2014. The statistical analysis was performed using Microsoft Excel and SPSS version 18. Kaplan - Meier estimates were used for the analysis of survival estimates and a survival analysis was performed using a multivariate Cox regression.Results: We analyzed 235 medical records of patients diagnosed with ALS being controlled at the National Pain Control and Palliative Care Center, of which 142 (60%) were treated with riluzole and 93 (40%) did not take this drug, for a ratio of 1.5; 66% were men and 34% women. Patients treated with riluzole showed a median survival of 25.0 months (95% CI 19.8 to 30.5 months) and patients which didn´t receive treatment with riluzole showed a median survival of 18.0 months (95% CI 7.8 to 28.2 months), with a p-value of 0.17 for the comparison of survival distributions. In addition, a statistically significant difference in the time between the beginning of treatment with riluzole and placement of PEG (p-value 0.001) was found. Patients that received riluzole showed an increased average time before requiring the placement of PEG.Conclusions: Patients using riluzole showed an increase in survival of seven months compared with those who didn´t (p = 0.17). Also, we observed that patients taking the drug presented a delay in requiring the placement of the percutaneous endoscopic gastrostomy.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[esclerosis lateral amiotrófica]]></kwd>
<kwd lng="es"><![CDATA[sobrevida]]></kwd>
<kwd lng="es"><![CDATA[riluzol]]></kwd>
<kwd lng="es"><![CDATA[Costa Rica]]></kwd>
<kwd lng="en"><![CDATA[amyotrophic lateral sclerosis]]></kwd>
<kwd lng="en"><![CDATA[survival]]></kwd>
<kwd lng="en"><![CDATA[riluzole]]></kwd>
<kwd lng="en"><![CDATA[Costa Rica]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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