Copy the page URI to the clipboard
Nguyễn Thị Thủy Ngân
(2022).
DOI: https://doi.org/10.21954/ou.ro.00014541
Abstract
Central nervous system infections are of an important focus for clinical research, especially in tropical settings such as Vietnam. Of particular concern is cryptococcal meningitis, a leading cause of death particularly in HIV patients. These issues suggest studies to improve our understanding of the epidemiology of central nervous system infections, and to advance the treatment of cryptococcal meningitis. With this thesis, I study the changing aetiology and outcomes of central nervous system infections at Cho Ray Hospital in Ho Chi Minh City, Vietnam and assess tamoxifen in combination with standard antifungal therapy for cryptococcal meningitis, and characterize the clinical Cryptococcus isolates as well as electrocardiograms in the tamoxifen trial.
The first results chapter, Chapter 2, I conducted a retrospective study of central nervous system infections presenting to Cho Ray Hospital, Ho Chi Minh City, Vietnam, from 2008 to 2017. Cryptococcal meningitis is an especially severe CNS infection, and the basis of my thesis is an open-label randomized controlled trial of tamoxifen combined with amphotericin B and fluconazole for cryptococcal meningitis, which aimed to improve treatment outcomes. This trial is presented in Chapter 3. In chapter 4, I describe the characteristics of clinical Cryptococcus isolates in the tamoxifen trial and investigate their association with the outcomes of the trial. Because QTc prolongation can be driven by the study drug, tamoxifen, I then characterized QTc and other electrocardiogram data of patients in the tamoxifen trial, in chapter 5.