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Cough Frequency During Treatment Associated With Baseline Cavitary Volume and Proximity to the Airway in Pulmonary TB

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dc.contributor.author Proaño, Alvaro
dc.contributor.author Bui, David P.
dc.contributor.author López, José W.
dc.contributor.author Vu, Nancy M.
dc.contributor.author Bravard, Marjory A.
dc.contributor.author Lee, Gwenyth O.
dc.contributor.author Tracey, Brian H.
dc.contributor.author Xu, Ziyue
dc.contributor.author Comina, Germán
dc.contributor.author Ticona, Eduardo
dc.contributor.author Mollura, Daniel J.
dc.contributor.author Friedland, Jon S.
dc.contributor.author Moore, David A. J.
dc.contributor.author Evans, Carlton A.
dc.contributor.author Caligiuri, Philip
dc.contributor.author Gilman, Robert H.
dc.date.accessioned 2018-11-30T03:10:43Z
dc.date.available 2018-11-30T03:10:43Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4032
dc.description.abstract BACKGROUND: Cough frequency, and its duration, is a biomarker that can be used in low-resource settings without the need of laboratory culture and has been associated with transmission and treatment response. Radiologic characteristics associated with increased cough frequency may be important in understanding transmission. The relationship between cough frequency and cavitary lung disease has not been studied. METHODS: We analyzed data in 41 adults who were HIV negative and had culture-confirmed, drug-susceptible pulmonary TB throughout treatment. Cough recordings were based on the Cayetano Cough Monitor, and sputum samples were evaluated using microscopic observation drug susceptibility broth culture; among culture-positive samples, bacillary burden was assessed by means of time to positivity. CT scans were analyzed by a US-board-certified radiologist and a computer-automated algorithm. The algorithm evaluated cavity volume and cavitary proximity to the airway. CT scans were obtained within 1 month of treatment initiation. We compared small cavities (≤ 7 mL) and large cavities (> 7 mL) and cavities located closer to (≤ 10 mm) and farther from (> 10 mm) the airway to cough frequency and cough cessation until treatment day 60. RESULTS: Cough frequency during treatment was twofold higher in participants with large cavity volumes (rate ratio [RR], 1.98; P = .01) and cavities located closer to the airway (RR, 2.44; P = .001). Comparably, cough ceased three times faster in participants with smaller cavities (adjusted hazard ratio [HR], 2.89; P = .06) and those farther from the airway (adjusted HR, 3.61;, P = .02). Similar results were found for bacillary burden and culture conversion during treatment. CONCLUSIONS: Cough frequency during treatment is greater and lasts longer in patients with larger cavities, especially those closer to the airway. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof urn:issn:1931-3543
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject tuberculosis en_US
dc.subject cough en_US
dc.subject CT en_US
dc.subject mycobacteria en_US
dc.title Cough Frequency During Treatment Associated With Baseline Cavitary Volume and Proximity to the Airway in Pulmonary TB en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.chest.2018.03.006
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.077


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