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The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis.

Rolfes MA, Hullsiek KH, Rhein J, Nabeta HW, Taseera K, Schutz C, Musubire A, Rajasingham R, Williams DA, Thienemann F, Muzoora C, Meintjes G, Meya DB, Boulware DR - Clin. Infect. Dis. (2014)

Bottom Line: The adjusted relative risk of mortality was 0.31 (95% confidence interval: .12-.82).The association was observed regardless of opening pressure at baseline.Therapeutic LPs were associated with a 69% relative improvement in survival, regardless of initial intracranial pressure.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Medical School.

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Related in: MedlinePlus

Selection of cohort participants among HIV-infected individuals in South Africa and Uganda screened for cryptococcal meningitis. Abbreviations: ART, antiretroviral therapy; COAT, Cryptococcal Optimal ART Timing; HIV, human immunodeficiency virus; LP, lumbar puncture.
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CIU596F1: Selection of cohort participants among HIV-infected individuals in South Africa and Uganda screened for cryptococcal meningitis. Abbreviations: ART, antiretroviral therapy; COAT, Cryptococcal Optimal ART Timing; HIV, human immunodeficiency virus; LP, lumbar puncture.

Mentions: Four hundred seventy-four individuals were screened, and 257 were found to have cryptococcal meningitis and were considered for inclusion in this analysis. Nine individuals died or had a therapeutic LP on the same day as diagnosis and were excluded from further analysis, leaving 248 individuals for analysis (Figure 1). Included individuals were all HIV-infected and observed for a total of 1698 person-days (median follow-up 7 days [interquartile range [IQR]: 6–8 days]). The median age of the cohort was 36 years, median duration of headache was 2 weeks before diagnosis, 55% were male, and 29% had altered mental status (GCS <15).Figure 1.


The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis.

Rolfes MA, Hullsiek KH, Rhein J, Nabeta HW, Taseera K, Schutz C, Musubire A, Rajasingham R, Williams DA, Thienemann F, Muzoora C, Meintjes G, Meya DB, Boulware DR - Clin. Infect. Dis. (2014)

Selection of cohort participants among HIV-infected individuals in South Africa and Uganda screened for cryptococcal meningitis. Abbreviations: ART, antiretroviral therapy; COAT, Cryptococcal Optimal ART Timing; HIV, human immunodeficiency virus; LP, lumbar puncture.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4441057&req=5

CIU596F1: Selection of cohort participants among HIV-infected individuals in South Africa and Uganda screened for cryptococcal meningitis. Abbreviations: ART, antiretroviral therapy; COAT, Cryptococcal Optimal ART Timing; HIV, human immunodeficiency virus; LP, lumbar puncture.
Mentions: Four hundred seventy-four individuals were screened, and 257 were found to have cryptococcal meningitis and were considered for inclusion in this analysis. Nine individuals died or had a therapeutic LP on the same day as diagnosis and were excluded from further analysis, leaving 248 individuals for analysis (Figure 1). Included individuals were all HIV-infected and observed for a total of 1698 person-days (median follow-up 7 days [interquartile range [IQR]: 6–8 days]). The median age of the cohort was 36 years, median duration of headache was 2 weeks before diagnosis, 55% were male, and 29% had altered mental status (GCS <15).Figure 1.

Bottom Line: The adjusted relative risk of mortality was 0.31 (95% confidence interval: .12-.82).The association was observed regardless of opening pressure at baseline.Therapeutic LPs were associated with a 69% relative improvement in survival, regardless of initial intracranial pressure.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Medical School.

Show MeSH
Related in: MedlinePlus