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Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis

There are still no unified guidelines of surgical treatment and timing for human immunodeficiency virus (HIV)-negative patients with cryptococcal meningitis (CM). The clinical data and follow-up data were collected from HIV-negative CM patients in Xiangya Hospital of Central South University from Ja...

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Autores principales: Zhao, Jie, Zhao, Xiang, Yang, Shaobo, Miao, Shuying, Liu, Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571884/
https://www.ncbi.nlm.nih.gov/pubmed/33080688
http://dx.doi.org/10.1097/MD.0000000000022546
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author Zhao, Jie
Zhao, Xiang
Yang, Shaobo
Miao, Shuying
Liu, Ying
author_facet Zhao, Jie
Zhao, Xiang
Yang, Shaobo
Miao, Shuying
Liu, Ying
author_sort Zhao, Jie
collection PubMed
description There are still no unified guidelines of surgical treatment and timing for human immunodeficiency virus (HIV)-negative patients with cryptococcal meningitis (CM). The clinical data and follow-up data were collected from HIV-negative CM patients in Xiangya Hospital of Central South University from January 2009 to November 2018, and 42 patients who were treated with surgical intervention were enrolled in the present study. These 42 patients were divided into ventriculoatrial (VA) group, ventriculoperitoneal group, external ventricle drainage (EVD) group, hydrocephalus (HYC) group, non-HYC group, EVD group, and non-EVD group (VA/ ventriculoperitoneal) according to different surgical procedures. Statistical analyses were conducted using SPSS (version 19.0, Chicago, IL). Signs of headache, fever, and loss of consciousness in the VA group were significantly improved compared with the EVD group at 1 week after operation (P < .05). The mortality rate of the VA group was significantly lower than that of the EVD group (P < .05). Moreover, male patients were more prone to have HYC (P < .05). Younger patients tended to develop HYC (P < .05). Cerebrospinal fluid sugar in the non-HYC group was significantly lower compared with the HYC group (P < .05). Time of CM-to-operation in the non-HYC group was markedly shorter compared with the HYC group (P < .01). VA procedure could be one of the first choices for the treatment of uncontrollable intracranial hypertension caused by CM. Severe uncontrollable headache, loss of consciousness, and cerebral hernia were indications of emergency surgery. Repeated headache, hearing impairment, and especially progressive loss of vision were indications of early surgery to avoid permanent damage to nerve functions of HIV-negative CM patients.
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spelling pubmed-75718842020-10-29 Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis Zhao, Jie Zhao, Xiang Yang, Shaobo Miao, Shuying Liu, Ying Medicine (Baltimore) 5300 There are still no unified guidelines of surgical treatment and timing for human immunodeficiency virus (HIV)-negative patients with cryptococcal meningitis (CM). The clinical data and follow-up data were collected from HIV-negative CM patients in Xiangya Hospital of Central South University from January 2009 to November 2018, and 42 patients who were treated with surgical intervention were enrolled in the present study. These 42 patients were divided into ventriculoatrial (VA) group, ventriculoperitoneal group, external ventricle drainage (EVD) group, hydrocephalus (HYC) group, non-HYC group, EVD group, and non-EVD group (VA/ ventriculoperitoneal) according to different surgical procedures. Statistical analyses were conducted using SPSS (version 19.0, Chicago, IL). Signs of headache, fever, and loss of consciousness in the VA group were significantly improved compared with the EVD group at 1 week after operation (P < .05). The mortality rate of the VA group was significantly lower than that of the EVD group (P < .05). Moreover, male patients were more prone to have HYC (P < .05). Younger patients tended to develop HYC (P < .05). Cerebrospinal fluid sugar in the non-HYC group was significantly lower compared with the HYC group (P < .05). Time of CM-to-operation in the non-HYC group was markedly shorter compared with the HYC group (P < .01). VA procedure could be one of the first choices for the treatment of uncontrollable intracranial hypertension caused by CM. Severe uncontrollable headache, loss of consciousness, and cerebral hernia were indications of emergency surgery. Repeated headache, hearing impairment, and especially progressive loss of vision were indications of early surgery to avoid permanent damage to nerve functions of HIV-negative CM patients. Lippincott Williams & Wilkins 2020-10-16 /pmc/articles/PMC7571884/ /pubmed/33080688 http://dx.doi.org/10.1097/MD.0000000000022546 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 5300
Zhao, Jie
Zhao, Xiang
Yang, Shaobo
Miao, Shuying
Liu, Ying
Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis
title Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis
title_full Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis
title_fullStr Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis
title_full_unstemmed Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis
title_short Surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis
title_sort surgical treatment and operation time in human immunodeficiency virus-negative cryptococcal meningitis
topic 5300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571884/
https://www.ncbi.nlm.nih.gov/pubmed/33080688
http://dx.doi.org/10.1097/MD.0000000000022546
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