American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2016
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialImproving Appropriate Neurological Prognostication After Cardiac Arrest: A Stepped Wedge Cluster RCT.
Predictions about neurologic prognosis that are based on early clinical findings after out-of-hospital cardiac arrest (OHCA) are often inaccurate and may lead to premature decisions to withdraw life-sustaining treatments (LST) in patients who might otherwise survive with good neurologic outcomes. ⋯ A multicenter quality intervention improved rates of appropriate neurologic prognostication after OHCA but did not increase survival with good neurologic outcome. Clinical trial registered with www.clinicaltrials.gov (NCT 01472458).
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Am. J. Respir. Crit. Care Med. · Nov 2016
Infectiousness of HIV Seropositive Tuberculosis Patients in a High-burden African Setting.
Policy recommendations on contact investigation of HIV-seropositive patients with tuberculosis have changed several times. Current epidemiologic evidence informing these recommendations is considered low quality, and few large studies investigating the infectiousness of HIV-seropositive and -seronegative index cases have been performed in sub-Saharan Africa. ⋯ This study suggests that HIV-seropositive tuberculosis cases may be less infectious than HIV-seronegative patients only when they are smear-negative or lack cavitary lung disease. These results may explain heterogeneity between prior studies and provide evidence suggesting that tuberculosis contact investigation should include HIV-seropositive index cases in high disease burden settings.