American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2019
Yield and Efficiency of Novel Intensified Tuberculosis Case-Finding Algorithms for People Living with HIV.
The recommended tuberculosis (TB) intensified case finding (ICF) algorithm for people living with HIV (symptom-based screening followed by Xpert MTB/RIF [Xpert] testing) is insufficiently sensitive and results in unnecessary Xpert testing. ⋯ Point-of-care CRP-based screening can improve ICF efficiency among people living with HIV. Addition of TB-LAM and a single culture to Xpert confirmatory testing could enable HIV programs to increase the speed of TB diagnosis and ICF yield.
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Am. J. Respir. Crit. Care Med. · Mar 2019
Non-Communicable Respiratory Disease and Air Pollution Exposure in Malawi (CAPS): A Cross-Sectional Study.
Noncommunicable respiratory diseases and exposure to air pollution are thought to be important contributors to morbidity and mortality in sub-Saharan African adults. ⋯ The burden of chronic respiratory symptoms, abnormal spirometry, and air pollution exposures in adults in rural Malawi is of considerable potential public health importance. We found little evidence that air pollution exposures were associated with chronic respiratory symptoms or spirometric abnormalities and no evidence that the CAPS intervention had effects on the secondary trial outcomes. More effective prevention and control strategies for noncommunicable respiratory disease in sub-Saharan Africa are needed. Clinical trial registered with www.isrctn.com (ISRCTN 59448623).
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Am. J. Respir. Crit. Care Med. · Mar 2019
BAL Cell Gene Expression is Indicative of Outcome and Airway Basal Cell Involvement in IPF.
Idiopathic pulmonary fibrosis (IPF) is a fatal disease with a variable and unpredictable course. ⋯ Our results identify and validate a BAL signature that predicts mortality in IPF and improves the accuracy of outcome prediction based on clinical parameters. The BAL signature associated with mortality unmasks a potential role for airway basal cells in IPF.