Comparison of same day diagnostic tools including Gene Xpert and unstimulated IFN-γ for the evaluation of pleural tuberculosis: a prospective cohort study.

Abstract:

BACKGROUND:The accuracy of currently available same-day diagnostic tools (smear microscopy and conventional nucleic acid amplification tests) for pleural tuberculosis (TB) is sub-optimal. Newer technologies may offer improved detection. METHODS:Smear-microscopy, adenosine deaminase (ADA), interferon gamma (IFN-γ), and Xpert MTB/RIF [using an unprocessed (1 ml) and centrifuged (~20 ml) sample] test accuracy was evaluated in pleural fluid from 103 consecutive patients with suspected pleural TB. Culture for M.tuberculosis and/or histopathology (pleural biopsy) served as the reference standard. Patients were followed prospectively to determine their diagnostic categorisation. RESULTS:Of 93 evaluable participants, 40 had definite-TB (reference positive), 5 probable-TB (not definite but treated for TB) and 48 non-TB (culture and histology negative, and not treated for TB). Xpert MTB/RIF sensitivity and specificity (95% CI) was 22.5% (12.4 - 37.6) and 98% (89.2 - 99.7), respectively, and centrifugation did not improve sensitivity (23.7%). The Xpert MTB/RIF internal positive control showed no evidence of inhibition. Biomarker specific sensitivity, specificity, PPV, and NPVs were: ADA (48.85 IU/L; rule-in cut-point) 55.3% (39.8 - 69.9), 95.2% (83.9 - 98.7), 91.4 (73.4 - 95.4), 69.7% (56.7 - 80.1); ADA (30 IU/L; clinically used cut-point) 79% (63.7 - 89), 92.7% (80.6 - 97.5), 91.0 (73.4 - 95.4), 82.7% (69.3 - 90.1); and IFN-γ (107.7 pg/ml; rule-in cut-point) 92.5% (80.2 - 97.5), 95.9% (86.1 - 98.9), 94.9% (83.2 - 98.6), 93.9% (83.5 - 97.9), respectively (IFN-γ sensitivity and NPV better than Xpert [p < 0.05] and rule-in ADA [p < 0.05]). CONCLUSION:The usefulness of Xpert MTB/RIF to diagnose pleural TB is limited by its poor sensitivity. IFN-γ is an excellent rule-in test and, compared to ADA, has significantly better sensitivity and rule-out value in a TB-endemic setting.

journal_name

BMC Pulm Med

journal_title

BMC pulmonary medicine

authors

Meldau R,Peter J,Theron G,Calligaro G,Allwood B,Symons G,Khalfey H,Ntombenhle G,Govender U,Binder A,van Zyl-Smit R,Dheda K

doi

10.1186/1471-2466-14-58

subject

Has Abstract

pub_date

2014-04-08 00:00:00

pages

58

issn

1471-2466

pii

1471-2466-14-58

journal_volume

14

pub_type

杂志文章
  • The yield of immediate post lung biopsy CT in predicting iatrogenic pneumothorax.

    abstract:BACKGROUND:The most prevalent complication of percutaneous lung biopsy is pneumothorax (PNX). A routine immediate post-procedure CT scan (ICT) to spot PNX is done in many centers. However, the diagnostic yield of this practice has not been studied broadly. We sought to evaluate whether an ICT could replace the routine ...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-020-1128-8

    authors: Brzezinski RY,Vigiser I,Fomin I,Israeli L,Shenhar-Tsarfaty S,Bar-Shai A

    更新日期:2020-04-15 00:00:00

  • Digital versus analogue chest drainage system in patients with primary spontaneous pneumothorax: a randomized controlled trial.

    abstract:BACKGROUND:Patients with a primary spontaneous pneumothorax (PSP) who are treated with chest tube drainage are traditionally connected to an analogue chest drainage system, containing a water seal and using a visual method of monitoring air leakage. Electronic systems with continuous digital monitoring of air leakage p...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-020-1173-3

    authors: Ruigrok D,Kunst PWA,Blacha MMJ,Tomlow B,Herbrink JW,Japenga EJ,Boersma W,Bresser P,van der Lee I,Mooren K

    更新日期:2020-05-11 00:00:00

  • Impairment of pulmonary vascular reserve and right ventricular systolic reserve in pulmonary arterial hypertension.

    abstract:BACKGROUND:Exercise capacity is impaired in pulmonary arterial hypertension (PAH). We hypothesized that cardiovascular reserve abnormalities would be associated with impaired hemodynamic response to pharmacological stress and worse outcome in PAH. METHODS:Eighteen PAH patients (p) group 1 NYHA class II/III and ten con...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/1471-2466-14-69

    authors: Domingo E,Grignola JC,Aguilar R,Arredondo C,Bouteldja N,Messeguer ML,Roman A

    更新日期:2014-04-24 00:00:00

  • Systematic review of the epidemiological evidence comparing lung cancer risk in smokers of mentholated and unmentholated cigarettes.

    abstract:BACKGROUND:US mentholated cigarette sales have increased considerably over 50 years. Preference for mentholated cigarettes is markedly higher in Black people. While menthol itself is not genotoxic or carcinogenic, its acute respiratory effects might affect inhalation of cigarette smoke. This possibility seems consisten...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1186/1471-2466-11-18

    authors: Lee PN

    更新日期:2011-04-18 00:00:00

  • Antibiotics for treatment of acute exacerbation of chronic obstructive pulmonary disease: a network meta-analysis.

    abstract:BACKGROUND:Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the most common reason for the hospitalization and death of pulmonary patients. The use of antibiotics as adjuvant therapy for AECOPD, however, is still a matter of debate. METHODS:In this study, we searched the PubMed, EmBase, and Coch...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,meta分析

    doi:10.1186/s12890-017-0541-0

    authors: Zhang HL,Tan M,Qiu AM,Tao Z,Wang CH

    更新日期:2017-12-12 00:00:00

  • Electromagnetic navigation bronchoscopy to access lung lesions in 1,000 subjects: first results of the prospective, multicenter NAVIGATE study.

    abstract:BACKGROUND:Electromagnetic navigation bronchoscopy (ENB) is an image-guided, minimally invasive approach that uses a flexible catheter to access pulmonary lesions. METHODS:NAVIGATE is a prospective, multicenter study of the superDimension™ navigation system. A prespecified 1-month interim analysis of the first 1,000 p...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s12890-017-0403-9

    authors: Khandhar SJ,Bowling MR,Flandes J,Gildea TR,Hood KL,Krimsky WS,Minnich DJ,Murgu SD,Pritchett M,Toloza EM,Wahidi MM,Wolvers JJ,Folch EE,NAVIGATE Study Investigators.

    更新日期:2017-04-11 00:00:00

  • Protocol for a mixed-methods study of supplemental oxygen in pulmonary fibrosis.

    abstract:BACKGROUND:Little is known about whether or how supplemental oxygen affects patients with pulmonary fibrosis. METHODS/DESIGN:A mixed-methods study is described. Patients with pulmonary fibrosis, informal caregivers of pulmonary fibrosis patients and practitioners who prescribe supplemental oxygen will be interviewed t...

    journal_title:BMC pulmonary medicine

    pub_type: 临床试验,杂志文章

    doi:10.1186/1471-2466-14-169

    authors: Belkin A,Fier K,Albright K,Baird S,Crowe B,Eres L,Korn M,Maginn L,McCormick M,Root ED,Vierzba T,Wamboldt FS,Swigris JJ

    更新日期:2014-11-01 00:00:00

  • Survival of bronchiectatic patients with respiratory failure in ICU.

    abstract:BACKGROUND:The outcome of patients with bronchiectasis during and after their stay in the intensive care unit (ICU) has seldom been reported in the literature. Managing these patients in the ICU can be challenging because of the complex nature of their disease. This study aims to identify the in-hospital and long-term ...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/1471-2466-7-17

    authors: Alzeer AH,Masood M,Basha SJ,Shaik SA

    更新日期:2007-12-10 00:00:00

  • Assessing airway inflammation in clinical practice - experience with spontaneous sputum analysis.

    abstract:BACKGROUND:The assessment of airway inflammation for the diagnosis of asthma or COPD is still uncommon in pneumology-specialized general practices. In this respect, the measurement of exhaled nitric oxide (NO), as a fast and simple methodology, is increasingly used. The indirect assessment of airway inflammation, howev...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/1471-2466-8-5

    authors: Holz O,Seiler T,Karmeier A,Fraedrich J,Leiner H,Magnussen H,Jörres RA,Welker L

    更新日期:2008-02-28 00:00:00

  • Malignant pleural mesothelioma: diagnostic value of medical thoracoscopy and long-term prognostic analysis.

    abstract:BACKGROUND:Malignant pleural mesothelioma (MPM) is marked by its difficult diagnosis and poor prognosis. Medical thoracoscopy (MT) is an effective and safe procedure for the diagnosis of exudative pleural effusions and many factors associated with poor prognosis of MPM. We conducted this study to investigate the value ...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-018-0619-3

    authors: Xu LL,Yang Y,Wang Z,Wang XJ,Tong ZH,Shi HZ

    更新日期:2018-04-03 00:00:00

  • MDA-5 associated rapidly progressive interstitial lung disease with recurrent Pneumothoraces: a case report.

    abstract:BACKGROUND:Clinically hypomyopathic dermatomyositis is a rare disease that is important to recognize, investigate and treat early as it is associated with poor prognosis. In a proportion of patients, myositis specific antibodies could be negative, but with high clinical suspicion, myositis associated antibodies should ...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-018-0622-8

    authors: Alqatari S,Riddell P,Harney S,Henry M,Murphy G

    更新日期:2018-04-17 00:00:00

  • miR-34a in serum is involved in mild-to-moderate COPD in women exposed to biomass smoke.

    abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities. The main causes of COPD are Gene-environment interactions associated with tobacco smoking (COPD-TS) and biomass smoke (COPD-BS). It is w...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-019-0977-5

    authors: Velasco-Torres Y,Ruiz-López V,Pérez-Bautista O,Buendía-Roldan I,Ramírez-Venegas A,Pérez-Ramos J,Falfán-Valencia R,Ramos C,Montaño M

    更新日期:2019-11-27 00:00:00

  • Determination of respiratory gas flow by electrical impedance tomography in an animal model of mechanical ventilation.

    abstract:BACKGROUND:A recent method determines regional gas flow of the lung by electrical impedance tomography (EIT). The aim of this study is to show the applicability of this method in a porcine model of mechanical ventilation in healthy and diseased lungs. Our primary hypothesis is that global gas flow measured by EIT can b...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/1471-2466-14-73

    authors: Bodenstein M,Boehme S,Bierschock S,Vogt A,David M,Markstaller K

    更新日期:2014-04-29 00:00:00

  • The features of AECOPD with carbon dioxide retention.

    abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) with carbon dioxide retention is associated with a worsening clinical condition and the beginning of pulmonary ventilation decompensation. This study aimed to identify the factors associated with carbon dioxide retention. METHODS:This was a retrospective study of...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-018-0691-8

    authors: Wei X,Yu N,Ding Q,Ren J,Mi J,Bai L,Li J,Qi M,Guo Y

    更新日期:2018-07-31 00:00:00

  • Evaluation of sensitivity and specificity of CanPatrol™ technology for detection of circulating tumor cells in patients with non-small cell lung cancer.

    abstract:BACKGROUND:The early diagnosis of non-small cell lung cancer is of great significance to the prognosis of patients. However, traditional histopathology and imaging screening have certain limitations. Therefore, new diagnostical methods are urgently needed for the current clinical diagnosis. In this study we evaluated t...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-020-01314-4

    authors: Li J,Liao Y,Ran Y,Wang G,Wu W,Qiu Y,Liu J,Wen N,Jing T,Wang H,Zhang S

    更新日期:2020-10-20 00:00:00

  • Early exposure to hyperoxia and mortality in critically ill patients with severe traumatic injuries.

    abstract:BACKGROUND:Hyperoxia is common early in the course of resuscitation of critically ill patients. It has been associated with mortality in some, but not all, studies of cardiac arrest patients and other critically ill cohorts. Reasons for the inconsistency are unclear and may depend on unmeasured patient confounders, the...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-017-0370-1

    authors: Russell DW,Janz DR,Emerson WL,May AK,Bernard GR,Zhao Z,Koyama T,Ware LB

    更新日期:2017-02-03 00:00:00

  • Is daily physical activity affected by dynamic hyperinflation in adults with cystic fibrosis?

    abstract:BACKGROUND:The aim of this study was to investigate the relationship between dynamic hyperinflation and daily physical activity (DPA) in adults with cystic fibrosis (CF). METHODS:Thirty-four clinically stable CF were studied. All patients undertook incremental cardiopulmonary exercise testing (CPET). CPET-related meas...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-018-0623-7

    authors: Savi D,Di Paolo M,Simmonds NJ,Pascucci C,Quattrucci S,Palange P

    更新日期:2018-04-19 00:00:00

  • Inhaled β-agonist does not modify sympathetic activity in patients with COPD.

    abstract:BACKGROUND:Neurohumoral activation is present in COPD and might provide a link between pulmonary and systemic effects, especially cardiovascular disease. Because long acting inhaled β-agonists reduce hyperinflation, they could reduce sympathoexcitation by improving the inflation reflex. We aimed to evaluate if inhaled ...

    journal_title:BMC pulmonary medicine

    pub_type: 临床试验,杂志文章

    doi:10.1186/s12890-015-0054-7

    authors: Haarmann H,Mohrlang C,Tschiesner U,Rubin DB,Bornemann T,Rüter K,Bonev S,Raupach T,Hasenfuß G,Andreas S

    更新日期:2015-04-30 00:00:00

  • Development, effectiveness and cost-effectiveness of a new out-patient Breathlessness Support Service: study protocol of a phase III fast-track randomised controlled trial.

    abstract:BACKGROUND:Breathlessness is a common and distressing symptom affecting many patients with advanced disease both from malignant and non-malignant origin. A combination of pharmacological and non-pharmacological measures is necessary to treat this symptom successfully. Breathlessness services in various compositions aim...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2466-12-58

    authors: Bausewein C,Jolley C,Reilly C,Lobo P,Kelly J,Bellas H,Madan P,Panell C,Brink E,De Biase C,Gao W,Murphy C,McCrone P,Moxham J,Higginson IJ

    更新日期:2012-09-19 00:00:00

  • Evaluation of the global lung function initiative 2012 reference values for spirometry in a Swedish population sample.

    abstract:BACKGROUND:The Global Lung Function Initiative 2012 (GLI) reference values are currently endorsed by several respiratory societies but evaluations of applicability for adults resident in European countries are lacking. The aim of this study was to evaluate if the GLI reference values are appropriate for an adult Caucas...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-015-0022-2

    authors: Backman H,Lindberg A,Sovijärvi A,Larsson K,Lundbäck B,Rönmark E

    更新日期:2015-03-25 00:00:00

  • Severe but not moderate hyperoxia of newborn mice causes an emphysematous lung phenotype in adulthood without persisting oxidative stress and inflammation.

    abstract:BACKGROUND:Preterm newborns typically require supplemental oxygen but hyperoxic conditions also damage the premature lung. Oxygen-induced lung damages are mainly studied in newborn mouse models using oxygen concentrations above 75% and looking at short-term effects. Therefore, we aimed at the investigation of long-term...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-019-0993-5

    authors: Kindermann A,Binder L,Baier J,Gündel B,Simm A,Haase R,Bartling B

    更新日期:2019-12-16 00:00:00

  • A phase I study evaluating the pharmacokinetics, safety and tolerability of an antibody-based tissue factor antagonist in subjects with acute lung injury or acute respiratory distress syndrome.

    abstract:BACKGROUND:The tissue factor (TF)-dependent extrinsic pathway has been suggested to be a central mechanism by which the coagulation cascade is locally activated in the lungs of patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS) and thus represents an attractive target for therapeutic int...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2466-12-5

    authors: Morris PE,Steingrub JS,Huang BY,Tang S,Liu PM,Rhode PR,Wong HC

    更新日期:2012-02-16 00:00:00

  • How people with chronic obstructive pulmonary disease perceive their illness: a qualitative study between mind and body.

    abstract:BACKGROUND:Although many studies on people with Chronic Obstructive Pulmonary Disease (COPD) have examined the mutual impact of physical status and emotional experience, there is limited knowledge about the way COPD people first-hand perceive their condition. This study was designed to investigate the illness perceptio...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-020-1157-3

    authors: Pozzar M,Volpato E,Valota C,Pagnini F,Banfi PI

    更新日期:2020-05-04 00:00:00

  • Serological assessment of neutrophil elastase activity on elastin during lung ECM remodeling.

    abstract:BACKGROUND:During the pathological destruction of lung tissue, neutrophil elastase (NE) degrades elastin, one of the major constituents of lung parenchyma. However there are no non-invasive methods to quantify NE degradation of elastin. We selected specific elastin fragments generated by NE for antibody generation and ...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-015-0048-5

    authors: Kristensen JH,Karsdal MA,Sand JM,Willumsen N,Diefenbach C,Svensson B,Hägglund P,Oersnes-Leeming DJ

    更新日期:2015-05-03 00:00:00

  • Case report of endoprosthesis -Y implantation in severe respiratory failure in the MPSII patient; comparison with literature data.

    abstract:BACKGROUND:The tracheobronchomalacia is a life-threatening complication of mucopolysaccharidosis (MPS) without known effective, optimal treatment. The severe expiratory collapse of the trachea and bronchi is one of causes of the high rate of deaths in the course of airway impairment in MPSII patients. CASE PRESENTATIO...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-020-1143-9

    authors: Gocyk W,Warmus J,Olechnowicz H,Bik-Multanowski M,Pawlinski L,Kiec-Wilk B

    更新日期:2020-04-20 00:00:00

  • Effects of ghrelin treatment on exercise capacity in underweight COPD patients: a substudy of a multicenter, randomized, double-blind, placebo-controlled trial of ghrelin treatment.

    abstract:BACKGROUND:The aim of this substudy of the ghrelin treatment, multicenter, randomized, double-blind, placebo-controlled trial was to investigate the effects of ghrelin administration on exercise capacity and the underlying mechanisms in underweight patients with chronic obstructive pulmonary disease (COPD) using cardio...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/1471-2466-13-37

    authors: Miki K,Maekura R,Nagaya N,Kitada S,Miki M,Yoshimura K,Tateishi Y,Motone M,Hiraga T,Mori M,Kangawa K

    更新日期:2013-06-10 00:00:00

  • Effectiveness of pulmonary rehabilitation for patients with asthma: study protocol of a randomized controlled trial (EPRA).

    abstract:BACKGROUND:Asthma patients are enrolled in multimodal pulmonary rehabilitation (PR) programs. However, available data for the effectiveness of PR in asthma are sparse. Therefore, the primary aim of this randomized control trial (RCT) is to evaluate short-term (end of rehabilitation) and intermediate-term effectiveness ...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/s12890-017-0389-3

    authors: Schultz K,Seidl H,Jelusic D,Wagner R,Wittmann M,Faller H,Nowak D,Schuler M

    更新日期:2017-03-09 00:00:00

  • Birt-Hogg-Dubé syndrome: a literature review and case study of a Chinese woman presenting a novel FLCN mutation.

    abstract:BACKGROUND:The Birt-Hogg-Dubé (BHD) syndrome is a very rare autosomal dominant form of genodermatosis caused by germline mutations in the folliculin (FLCN) gene, which is mapped to the p11.2 region in chromosome 17. BHD commonly presents cutaneous fibrofolliculomas, pulmonary cysts, renal cell carcinoma, and recurrent ...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1186/s12890-017-0383-9

    authors: Hao S,Long F,Sun F,Liu T,Li D,Jiang S

    更新日期:2017-02-21 00:00:00

  • Relationship of flow-volume curve pattern on pulmonary function test with clinical and radiological features in idiopathic pulmonary fibrosis.

    abstract:BACKGROUND:The flow-volume (FV) curve pattern in the pulmonary function test (PFT) for obstructive lung diseases is widely recognized. However, there are few reports on FV curve pattern in idiopathic pulmonary fibrosis (IPF). In this study, we investigated the relationship between FV curve pattern and clinical or radio...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章

    doi:10.1186/s12890-020-01254-z

    authors: Nakagawa H,Otoshi R,Isomoto K,Katano T,Baba T,Komatsu S,Hagiwara E,Nakano Y,Kuwahira I,Ogura T

    更新日期:2020-08-12 00:00:00

  • Safety profile and clinical activity of multiple subcutaneous doses of MEDI-528, a humanized anti-interleukin-9 monoclonal antibody, in two randomized phase 2a studies in subjects with asthma.

    abstract:BACKGROUND:Interleukin-9 (IL-9)-targeted therapies may offer a novel approach for treating asthmatics. Two randomized placebo-controlled studies were conducted to assess the safety profile and potential efficacy of multiple subcutaneous doses of MEDI-528, a humanized anti-IL-9 monoclonal antibody, in asthmatics. METHO...

    journal_title:BMC pulmonary medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2466-11-14

    authors: Parker JM,Oh CK,LaForce C,Miller SD,Pearlman DS,Le C,Robbie GJ,White WI,White B,Molfino NA,MEDI-528 Clinical Trials Group.

    更新日期:2011-02-28 00:00:00