Publications

Department of Medicine faculty members published more than 3,600 peer-reviewed articles in 2024.

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Volume 64 of Issue 12 | The Journal of antibiotics

In vitro and in vivo activity of frenolicin B against Plasmodium falciparum and P berghei.

2011

Authors: Fitzgerald JT, Henrich PP, O'Brien C, Krause M, Ekland EH, Mattheis C, Sá JM, Fidock D, Khosla C

Diabetes

Convergence of the insulin and serotonin programs in the pancreatic ß-cell.

2011

Authors: Ohta Y, Kosaka Y, Kishimoto N, Wang J, Smith SB, Honig G, Kim H, Gasa RM, Neubauer N, Liou A, Tecott LH, Deneris ES, German MS

Drug and alcohol dependence

Intensive intervention for alcohol-dependent smokers in early recovery: a randomized trial.

2011

Authors: Carmody TP, Delucchi K, Duncan CL, Banys P, Simon JA, Solkowitz SN, Huggins J, Lee SK, Hall SM

AIDS research and human retroviruses

Insulin resistance and cognition among HIV-infected and HIV-uninfected adult women: the Women's Interagency HIV Study.

2011

Authors: Valcour V, Maki P, Bacchetti P, Anastos K, Crystal H, Young M, Mack WJ, Cohen M, Golub ET, Tien PC

International journal of obesity (2005)

Shorter telomeres are associated with obesity and weight gain in the elderly.

2011

Authors: Njajou OT, Cawthon RM, Blackburn EH, Harris TB, Li R, Sanders JL, Newman AB, Nalls M, Cummings SR, Hsueh WC

Annals of internal medicine

Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study.

2011

Authors: Hubbard RA, Kerlikowske K, Flowers CI, Yankaskas BC, Zhu W, Miglioretti DL

Annals of internal medicine

Comparative effectiveness of digital versus film-screen mammography in community practice in the United States: a cohort study.

2011

Authors: Kerlikowske K, Hubbard RA, Miglioretti DL, Geller BM, Yankaskas BC, Lehman CD, Taplin SH, Sickles EA

Diagnostic accuracy of a low-cost, urine antigen, point-of-care screening assay for HIV-associated pulmonary tuberculosis before antiretroviral therapy: a descriptive study.

2011

Authors: Lawn SD, Kerkhoff AD, Vogt M, Wood R

View Abstract

BACKGROUND

The diagnostic accuracy of sputum smear microscopy and routine chest radiology for HIV-associated tuberculosis is poor, and culture-based diagnosis is slow, expensive, and is unavailable in most resource-limited settings. We assessed the diagnostic accuracy of a urine antigen test Determine TB-LAM Ag (Determine TB-LAM; Alere, Waltham, MA, USA) for screening for HIV-associated pulmonary tuberculosis before antiretroviral therapy (ART).

METHODS

In this descriptive study, consecutive adults referred to a community-based ART clinic in Gugulethu township, South Africa, were all screened for tuberculosis by obtaining sputum samples for fluorescence microscopy, automated liquid culture (gold-standard test), and Xpert MTB/RIF assays (Cepheid, Sunnyvale, CA, USA) and urine samples for the Clearview TB-ELISA (TB-ELISA; Alere, Waltham, MA, USA) and Determine TB-LAM test. Patients with Mycobacterium tuberculosis cultured from one or more sputum samples were defined as cases of tuberculosis. The diagnostic accuracy of Determine TB-LAM used alone or combined with sputum smear microscopy was compared with that of sputum culture and the Xpert MTB/RIF assay for all patients and subgroups of patients stratified by CD4 cell count.

FINDINGS

Patients were recruited between March 12, 2010, and April 20, 2011. Of 602 patients enrolled, 542 were able to provide one or more sputum samples, and 94 had culture-positive tuberculosis (prevalence 17·4%, 95% CI 14·2-20·8). Complete results from all tests were available for 516 patients (median CD4 count, 169·5 cells per μL; IQR 100-233), including 85 culture-positive tuberculosis, 24 of whom (28·2%, 95% CI 19·0-39·0) had sputum smear-positive disease. Determine TB-LAM test strips provided results within 30 min. Agreement was very high between two independent readers of the test strips (κ=0·97) and between the test strips and TB-ELISA (κ=0·84). Determine TB-LAM had highest sensitivity at low CD4 cell counts: 66·7% (95% CI 41·0-86·7) at <50 cells per μL, 51·7% (32·5-70·6) at <100 cells per μL, and 39·0% (26·5-52·6) at <200 cells per μL; specificity was greater than 98% for all strata. When combined with smear microscopy (either test positive), sensitivity was 72·2% (95% CI 46·5-90·3) at CD4 counts less than 50 cells per μL, 65·5% (45·7-82·1) at less than 100 cells per μL, and 52·5% (39·1-65·7) at less than 200 cells per μL, which did not differ statistically from the sensitivities obtained by testing a single sputum sample with the Xpert MTB/RIF assay.

INTERPRETATION

Determine TB-LAM is a simple, low-cost, alternative to existing diagnostic assays for tuberculosis screening in HIV-infected patients with very low CD4 cell counts and provides important incremental yield when combined with sputum smear microscopy.