Background: The incidence of nosocomial infections caused by multi-drug- and extended-drug resistant strains of Acinetobacter is constantly increasing all over the world, with a high mortality rate. We analyzed the in-hospital data on the sensitivity of Acinetobacter baumannii isolates and correlated them with antibiotic treatment and clinical outcomes of nosocomial infections over a 17-mo period. Methods: Retrospective analysis was performed at the Clinical Center “Bezanijska kosa,” Belgrade, Serbia. Microbiologic data (number and sensitivity of A. baumannii isolates) and clinical data (medical records of 41 randomly selected patients who developed nosocomial infection caused by A. baumannii) were matched. Results: Acinetobacter baumannii, detected in 279 isolates and obtained from 19 patients (12% of all samples), was resistant to almost all antibiotics tested, including carbapenems, with the exception of colistin and tigecycline. It was obtained most often from the respiratory tract samples. Empiric treatment of the nosocomial infections (pneumonia in 75% of cases) involved cephalosporins, metronidazole, and carbapenems (80%, 66%, and 61% of patients, respectively), whereas tigecyclin and colistin were used primarily in targeted therapy (20% and 12% of patients, respectively). The mortality rate of patients treated empirically was significantly higher (p < 0.01), reaching 100% in the elderly. Conclusions: Nosocomial A. baumannii infections represent a significant clinical problem because of their high incidence, lack of susceptibility to the most commonly used antibiotics, and the often inappropriate treatment, which favors the development of multi-drug-resistant strains.

We report good outcome after surgical treatment of two patients with meningoencephalocele associated with pharmacoresistant temporal lobe epilepsy. Surgical management of meningoencephaloceles may result in seizure freedom, although optimal surgical strategy is still controversial.

Objective: Cortical atrophy close to medial temporal structures has been described consistently in patients with temporal lobe epilepsy (TLE). Successful TLE surgery may have a neuroprotective effect preventing further atrophy of temporal and extratemporal cortex. However, the effects of epilepsy surgery on subcortical structures demand additional enlightenment. This work aimed to determine how epilepsy surgery affects volumes of subcortical structures in medically refractory temporal lobe epilepsy patients.Methods: We compared MRI volumes of subcortical structures in 62 patients with TLE (36 left, 26 right) before and after anterior temporal lobectomy with 38 TLE patients (20 left, 18 right) who were considered to be good surgical candidates and had at least two brain MRIs.Results: There were no volume differences in subcortical structures on preoperative and initial MRIs of non‐operated TLE patients. At baseline, the ipsilateral thalamus and putamen in TLE patients were marginally smaller than contralateral structures. Operated patients showed a significant postoperative volume reduction in ipsilateral thalamus, putamen, and globus pallidus. In contrast, there were no significant volumetric reductions in non‐operated patients longitudinally. There were no volumetric changes associated with different surgical outcomes or different postoperative cognitive outcomes.Significance: Our study demonstrated postoperative volume loss of thalamus, putamen and globus pallidus ipsilaterally to the side of resection. Our findings suggest surgery‐related changes, likely Wallerian degeneration within subcortical networks not related to seizure or cognitive outcome.Plain Language Summary: We studied 100 patients with epilepsy, comparing those who had surgery to those who did not. After surgery, the thalamus, putamen and globus pallidus on the same side as the surgery shrank significantly, but not in non‐surgery patients. This suggests surgery‐related changes in deeper brain structures, unrelated to seizure freedom or cognitive outcomes. This research sheds additional light on the response of the subcortical structure to epilepsy surgery, highlighting potential areas for further study.

The use of c3 and c4 in the treatment of G- infections in both hospitals should be re-evaluated in accordance with current guidelines and local resistance.

Background/Objectives: Functional seizures (FSs) are paroxysmal, time-limited events with motor, sensory, autonomic, or cognitive manifestations related to pathophysiological processes other than abnormal electric discharges in the brain. However, these seizures are often followed by different psychiatric comorbidities. Their impact on the overall quality of life and the cofounding factors, especially the ones that can be treated, were the main investigation aims of this study. Methods: This study comprised 76 patients who were diagnosed with FSs. This study included patients who were diagnosed with FSs via video-EEG telemetry. We used the “Likert scale” from the QOLIE 31 questionnaire to evaluate patients’ subjective perception of their quality of life. We researched the association of various clinical factors with the subjective QoL score. Results: A statistically significant marginal association was shown for seven variables, four of them with a positive association (subjective perception of disease severity, belief in treatments’ positive effects, functional seizure cessation, and not being afraid of next seizure) and three of them with a negative association (age at FS onset, depression symptoms, and current age of life). After Bonferroni correction for multiple testing only symptoms of depression stayed statistically significantly associated with outcome. Multivariable logistic regression following variable selection identified that six variables (age at FS onset, absence of psychiatric testing, perceiving oneself as mentally changed due to the disease, seizure severity, depressive symptoms, and fear of therapy side effects) were statistically significantly negatively associated with the outcome. Conclusions: It seems that patients who have FSs coexisting with depressive symptoms and also those with worse disease perception have less chances to be satisfied with their overall quality of life.