Introduction. Deja vu (franc. Déjà vu) is a phenomenon experienced by two thirds of all people. However, this phenomenon can follow aura during the temporal lobe epilepsy. It is believed that it originates from hippocampus, which plays a major role in generating epileptic discharges. Some authors emphasize that in these patients déjà vu phenomenon is not an aura but rather it sometimes refers to the attack itself. Method. In this case report, an eightyear-old girl suffering from repeated crisis of consciousness is described. Case report. The aim of the study was to present the case of an eightyearold girl who underwent three crisis of consciousness, headache behind the forehead as well as the repeated déjà vu phenomenon. The girl was hospitalized, after which medical history was taken and physical examination, as well as other diagnostic tests, were performed. EEG recording revealed an increased electrocortical epileptic activity above the right frontotemporal region. An antiepileptic therapy (Karbapin) leading to attack control was introduced. Conclusion. It is necessary to give temporal lobe epilepsy in children with déjà vu phenomenon serious consideration.

Backgroun/Aim. Although majority of guidelines recommend triazoles (voriconazole, posaconazole, itraconazole and isavuconazole) as first-line therapeutic option for treatment of invasive aspergillosis, echinocandins (caspofungin, micafungin and anidulafungin) are also used for this purpose. However, head-to-head comparison of triazoles and echinocandins for invasive aspergillosis was rarely target of clinical trials. The aim of this meta-analysis was to compare efficacy and safety of triazoles and echinocandins when used for treatment of patients with invasive aspergillosis. Methods. This meta-analysis was based on systematic search of literature and selection of high-quality evidence according to pre-set inclusion and exclusion criteria. The literature search was made for comparison of treatment with any of triazoles (isavuconazole, itraconazole, posaconazole or voriconazole) versus any of echinocandins (caspofungin, anidulafungin or micafungin). The effects of triazoles (itraconazole, posaconazole or voriconazole) and echinocandins (caspofungin, anidulafungin or micafungin) were summarized using RevMan 5.3.5 software, and heterogeneity assessed by the Cochrane Q test and I? values. Several types of bias were assessed, and publication bias was shown by the funnel plot and Egger?s regression. Results. Two clinical trials and three cohort studies were included in this meta-analysis. Mortality in patients with invasive aspergillosis who were treated with triazoles was significantly lower than in patients treated with echinocandins [odds ratio 0.29 (0.13, 0.67)], and rate of favorable response (overall treatment success) 12 weeks after the therapy onset was higher in patients treated with triazoles [3.05 (1.52, 6.13)]. On the other hand, incidence of adverse events was higher with triazoles than with echinocandins in patients treated for invasive aspergillosis [3.75 (0.89, 15.76)], although this difference was not statistically significant. Conclusion.Triazoles (voriconazole in the first place) could be considered as more effective and somewhat less safe therapeutic option than echinocandins for invasive aspergillosis: However, due to poor quality of studies included in this meta-analysis, definite conclusion should await results of additional, well designed clinical trials.

Objective. To determine reasons and their actual role in occurrence of complications in users of soft contact lenses. Methods. This was a qualitative study in which a constructivist grounded theory approach was used to analyze obtained data. The study population consisted of two groups of subjects: 10 students who were identified as users of soft contact lenses and 4 ophthalmologists. Each of the respondents participated ina single interview. Based on audio recordings of these interviews appropriate transcripts of conversations were made and analyzed. After elimination of waste words 11 key categories were crystallized. Results. Recommendations of the ophthalmologists perhaps have the decisive role in the formation of attitude that users will have regarding the adequate hygiene of soft contact lenses: hand hygiene, proper cleanliness of storage for soft contact lenses and using the solution in the allotted time are imperative for users of soft contact lenses. Sleeping with soft contact lenses for a long period and more frequently than it was specified in the recommendation of an ophthalmologist is one of the greatest reasons for development of dry eye symptoms, while swimming with soft contact lenses increases the risk for occurrence of eye

Risk Factors for Healthcare-Associated Infections Caused by Cefepime-Resistant Pseudomonas Aeruginosa A Marko M. Folić1,2, Zorana M. Djordjević3, Dragan R. Milovanović1,2, Dejana T. Ružić Zečević1,2, Nikola V. Rosić1, Slobodan M. Janković1,2 A 1 Clinical Centre Kragujevac, Clinical Pharmacology Department, Kragujevac, Serbia 2 University of Kragujevac, Faculty of Medical Science, Kragujevac, Serbia 3 Clinical Centre Kragujevac, Department of Hospital Infections Control, Kragujevac, Serbia

Background/Aim. Measuring health-related quality of life is of great help to clinicians when they have to choose optimal therapy for their patients or estimate its effects. The aim of this study was to translate the oral health-related quality of life [OHQoL-UK(W)] questionnaire from English to Serbian, to make necessary cultural adaptations of the translation, and to test its reliability in a sample of adult Serbian patients. Methods. After obtaining permission from the authors, translation and cultural adaptation of the OHQoL- UK(W) was made according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. Reliability of the Serbian translation was tested on a sample of 250 patients through calculation of Cronbach?s alpha, as a measure of internal consistency. Results. Serbian translation of the OHQoL-UK(W) had very similar degree of internal consistency (Cronbach?s alpha 0.947), and correlated satisfactorily with the visual analogue scale (VAS) score and inversely with the Decay-missingfilled teeth (DMFT) index. Factorial analysis revealed only one factor, as in the original scale. Conclusions. Serbian translation of the OHQoL-UK(W) is reliable instrument for measuring oral health-related quality of life in adult dentistry patients.

Background/Aim. Liver damage, with potentially serious consequences, is not uncommon in hospitalized cardiac patients. The aim of our study was to determine the risk factor profile for liver damage in patients hospitalized from a deterioration of their acute or chronic cardiac illness. Methods. The study had observational case-control design with retrospective data collections from medical files of adult patients hospitalized in a tertiary health care center. The cases (n = 140) were subjects with novel liver injury (which emerged during hospital stay) and three control subjects were matched (age, date) for each case subject (n = 420). The primary outcome was hepatotoxicity (present or absent) and independent variables were proposed risk factors. Statistical analysis included descriptive methods, hypothesis testing and univariate and multivariate binary logistic regression, with p ? 0.05. Results. In the whole study population, there were 432 (77.1%) females and the mean age of patients was 64.1 years [standard deviation (SD) = 10.7, range 24?85 years]. The most common illnesses were coronary heart disease (n = 385), hypertension (n = 334) and arrhythmia (n = 115). Mean value of Charlson Comorbidity Index (CCI) score was 3.8 (SD=1.7; range 1-10) corresponding to estimated CCI 10-years survival rate of 54.4% (SD = 33.5%). In the group of cases, 114 (81.4%) of the patients had hepatocellular, 9 (6.4%) cholestatic and 17 (12.2%) mixed type of hepatic injury. Factors independently associated with hepatotoxic event were previous occasional alcohol intake odds ratio (OR) 96.47; 95% confidence interval (CI) 28.95?321.43; p < 0.001), amiodarone (OR 3.70; 95% CI 1.82?7.53; p < 0.001), enoxaparin (OR 3.29; 95% CI 1.79?6.05; p < 0.001), obesity (OR 2.78; 95% CI 1.15? 6.71; p < 0.023), atorvastatin (OR 2.67; 95% CI 1.33?5.38; p < 0.006) and CCI total score (OR 1.89; 95% CI 1.53?2.34; p < 0.001). Conclusion. Major factors associated with acute liver damage in patients hospitalized in cardiology ward of a tertiary health care institution were patient?s constitutional and habitual characteristics (occasional alcohol intake, obesity, CCI total score) and drugs with known hepatotoxic properties (amiodarone, enoxaparin, atorvastatin).

Previous research suggested that several genetic polymorphisms are associated with increased risk of ischaemic stroke (IS) in young adults. However, the predictive biomarkers of IS in young adults are still unclear. Our aim was to assess the contribution of modifiable and genetic factors in IS in young adults. In total, 40 stroke patients and 40 healthy controls aged 20 to 50 years were recruited. Data on modifiable factors were collected, then participants were genotyped for seven SNPs linked to thrombophilia: ACE rs1799752, PAI-1 rs1799889, APOE rs1412 and rs429358, FV rs6025 and rs1800595, and FII rs62623459. Significantly increased risk factors: hypertension and dyslipidaemia in stroke patients compared with the controls: 50.0 % vs 27.5 % and 75.0 % vs 40.0% (P = 0.039 and P = 0.002, respectively) were observed. Stroke patients compared with controls did not differ in distribution of ACE, APOE, FV, and FII variants. The 4G4G homozygotes of the PAI-1 gene were significantly more prevalent in stroke patients compared to the controls: 42.5 % vs 17.5 %, (P = 0.033). In the group with the small vessel occlusion subtype of stroke, statistically significant overrepresentation of 4G4G homozygotes and frequency of the 4G allele compared with controls: 57.1 % vs 17.5 % and 0.7 vs 0.45 (P = 0.026 and P = 0.03, respectively) were observed. Independent predictors of stroke incident were: dyslipidaemia (OR (95% CI) = 4.2 (1.4-12.4)) and 4G4G genotype (OR (95% CI) = 3.9 (1.1-13.7)). These results confirm the contribution of dyslipidaemia and 4G4G genotype in the increased risk of IS in young Bosnian adults.

OBJECTIVE The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients. PATIENTS AND METHODS A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method. RESULTS There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±12.86 vs. Vitamin D LTG 17.97±9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±10.87 vs. OCLN LTG 27.87±28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08± 1.38 vs. T-score LTG: 0.37± 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±1.17 vs. Z. score CBZ: 0.38±0.96; F=4.069, P=0.046) (Table 3). CONCLUSION The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD.