American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jul 2015
Randomized Controlled TrialRacial Differences in Outcomes within the National Lung Screening Trial: Implications for Widespread Implementation.
Black individuals with lung cancer (LC) experience higher mortality because they present with more advanced disease and are less likely to undergo curative resection for early-stage disease. The National Lung Screening Trial (NLST) demonstrated improved LC mortality by screening high-risk patients with low-dose computed tomography (LDCT). The benefit of LDCT screening in black individuals is unknown. ⋯ Black individuals screened with LDCT had decreased mortality from lung cancer. However, the demographics associated with improved LC survival were less commonly found in black individuals. The overall mortality in the NLST was higher for black individuals than white individuals, but improved in black individuals screened, suggesting that this subgroup may have had improved access to care. To realize the reductions in mortality from LC screening, dissemination efforts need to be tailored to meet the needs of this community.
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Am. J. Respir. Crit. Care Med. · Jul 2015
Characteristics and Prognosis of Never Smokers and Smokers with Asthma in the Copenhagen General Population Study: a Prospective Cohort Study.
Asthma is associated with complications, cardiovascular comorbidities, and higher mortality in some individuals. ⋯ Never-smokers with asthma had an increased risk of asthma and COPD exacerbations, and possibly pneumonias. Importantly, the risks for lung cancer, cardiovascular comorbidities, and death were restricted to smokers with asthma. Thus, tobacco smoking was the main explanation for poor prognosis in asthma.
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Am. J. Respir. Crit. Care Med. · Jul 2015
Fluoroquinolone Therapy for the Prevention of Multi-drug Resistant Tuberculosis in Contacts: a Cost-effectiveness Analysis.
Fluoroquinolone (FQN) therapy of latent tuberculosis infection among contacts of individuals with multidrug-resistant tuberculosis (MDR-TB) is controversial. ⋯ In our model, FQN preventive therapy resulted in substantial health system savings and in reduced mortality, incidence of MDR-TB, and incidence of acquired FQN-resistant disease as well as improved quality of life. FQN therapy remained cost saving with improved outcomes even if the effectiveness of therapy in preventing MDR-TB was as low as 10%.