{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:21:37Z","timestamp":1788844897948,"version":"build-2803163510"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Institute of Neurologic Diseases and Stroke"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"name":"United Kingdom (UK) Medical Research Council"},{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004441","name":"Swedish International Development Cooperation Agency","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UK"},{"name":"Medical Research Council"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sodium abnormalities are frequent in central nervous system infections and may be caused by cerebral salt wasting, syndrome of inappropriate antidiuretic hormone secretion, or medication adverse events. In cryptococcal meningitis (CM), the prevalence of baseline hyponatremia and whether hyponatremia adversely impacts survival is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a secondary analysis of data from 2 randomized trials of human immunodeficiency virus\u2013infected adult Ugandans with CM. We grouped serum sodium into 3 categories: &amp;lt;125, 125\u2013129, and 130\u2013145\u2005mmol\/L. We assessed whether baseline sodium abnormalities were associated with clinical characteristics and survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 816 participants with CM, 741 (91%) had a baseline sodium measurement available: 121 (16%) had grade 3\u20134 hyponatremia (&amp;lt;125\u2005mmol\/L), 194 (26%) had grade 2 hyponatremia (125\u2013129\u2005mmol\/L), and 426 (57%) had a baseline sodium of 130\u2013145\u2005mmol\/L. Hyponatremia (&amp;lt;125\u2005mmol\/L) was associated with higher initial cerebrospinal fluid (CSF) quantitative culture burden (P\u2009&amp;lt;\u2009.001), higher initial CSF opening pressure (P\u2009&amp;lt;\u2009.01), lower baseline Glasgow Coma Scale score (P\u2009&amp;lt;\u2009.01), and a higher percentage of baseline seizures (P\u2009=\u2009.03). Serum sodium &amp;lt;125\u2005mmol\/L was associated with increased 2-week mortality in unadjusted and adjusted survival analyses (adjusted hazard ratio, 1.87 [95% confidence interval, 1.26\u20132.79]; P\u2009&amp;lt;\u2009.01) compared to those with sodium 130\u2013145\u2005mmol\/L.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Hyponatremia is common in CM and is associated with excess mortality. A standardized management approach to correctly diagnose and correct hyponatremia in CM needs to be developed and tested.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofac301","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T18:38:53Z","timestamp":1655491133000},"source":"Crossref","is-referenced-by-count":13,"title":["Association of Hyponatremia on Mortality in Cryptococcal Meningitis: A Prospective Cohort"],"prefix":"10.1093","volume":"9","author":[{"given":"Lillian","family":"Tugume","sequence":"first","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Fieberg","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Minnesota , Minneapolis, Minnesota , 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